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Javed A, Kashyap R, Lteif AN. Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype. Int J Womens Health. 2015;7:103-11doi: 10.2147/IJWH.S73011.
Javed, A., Kashyap, R., & Lteif, A. N. (2015). Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype. International journal of women's health, 7103-11. https://doi.org/10.2147/IJWH.S73011
Javed, Asma, et al. "Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype." International journal of women's health vol. 7 (2015): 103-11. doi: https://doi.org/10.2147/IJWH.S73011
Javed A, Kashyap R, Lteif AN. Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype. Int J Womens Health. 2015 Jan 13;7:103-11. doi: 10.2147/IJWH.S73011. eCollection 2015. PMID: 25610004; PMCID: PMC4298294.
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Int J Womens Health. 2015 Jan 13;7:103-11. doi: 10.2147/IJWH.S73011. eCollection 2015.

Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: a distinct phenotype.

International journal of women's health

Asma Javed, Rahul Kashyap, Aida N Lteif

Affiliations

  1. Pediatric and Adolescent Medicine, Division of Pediatric Endocrinology Mayo Clinic, Rochester, MN, USA.
  2. Department of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

PMID: 25610004 PMCID: PMC4298294 DOI: 10.2147/IJWH.S73011

Abstract

OBJECTIVE: To compare the reproductive, metabolic, and skeletal profiles of young athletic women with functional hypothalamic amenorrhea (FHA) as well as clinical or biochemical hyperandrogenism (FHA-EX+HA) with body mass index matched women with FHA due to exercise (FHA-EX) or anorexia nervosa (FHA-AN) alone.

DESIGN: Retrospective cohort study.

SETTING: Tertiary care teaching hospital.

POPULATION: Adolescents and young women, 15-30 years of age, diagnosed with FHA along with concurrent signs of hyperandrogenism (n=22) and body mass index matched control groups consisting of 22 women in each group of FHA-EX and FHA-AN.

MAIN OUTCOMES: 1) Reproductive hormone profile: luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, pelvic ultrasound features. 2) Metabolic function and skeletal health markers: fasting glucose, cholesterol, number of stress fractures and bone mineral density as assessed by spine dual-energy X-ray absorptiometry z scores.

RESULTS: FHA-EX+HA group was older at diagnosis compared to the other groups with a median (interquartile range [IQR]) age of 22 (18.75-25.25) years versus (vs) 17.5 (15.75-19) for FHA-EX; (P<0.01) and 18 (16-22.25) years for FHA-AN (P=0.01). There were no differences among the groups based on number of hours of exercise per week, type of physical activity or duration of amenorrhea. Median (IQR) LH/FSH ratio was higher in FHA-EX+HA than both other groups, 1.44 (1.03-1.77) vs 0.50 (0.20-0.94) for FHA-EX and 0.67 (0.51-0.87) for FHA-AN (P<0.01 for both). Total testosterone concentrations were not different among the groups. Median (IQR) fasting serum glucose concentration was higher in FHA-EX+HA vs FHA-EX, 88.5 mg/dL (82.8-90 mg/dL) vs 83.5 mg/dL (78.8-86.3 mg/dL) (P=0.01) but not different from FHA-AN (P=0.31). Percentage of women with stress fractures was lower in FHA-EX+HA (4.5%) as compared to both FHA-EX (27.3%) and FHA-AN (50%); P=0.04 and 0.01 respectively. The LH/FSH ratio was weakly positively associated with serum glucose (adjusted r (2)=0.102; P=0.01) as well as with dual-energy X-ray absorptiometry spine score (adjusted r (2)=0.191; P=0.04) in the entire cohort.

CONCLUSION: In a small cohort of female athletes with hyperandrogenism, a distinct reproductive hormone profile consisting of higher LH to FHS ratio may be associated with adverse metabolic health markers but improved skeletal health.

Keywords: functional hypothalamic amenorrhea; hyperandrogenism; polycystic ovary syndrome; young athletes

References

  1. J Clin Endocrinol Metab. 1995 Sep;80(9):2740-4 - PubMed
  2. Mayo Clin Proc. 2013 Sep;88(9):996-1009 - PubMed
  3. Fertil Steril. 2003 Apr;79(4):947-55 - PubMed
  4. Fertil Steril. 2009 Feb;91(2):456-88 - PubMed
  5. J Clin Endocrinol Metab. 2002 Mar;87(3):1017-23 - PubMed
  6. J Clin Endocrinol Metab. 2006 Feb;91(2):492-7 - PubMed
  7. Trends Endocrinol Metab. 2003 Oct;14(8):365-70 - PubMed
  8. Fertil Steril. 2005 May;83(5):1454-60 - PubMed
  9. J Endocrinol. 2001 Jul;170(1):3-11 - PubMed
  10. J Clin Endocrinol Metab. 2000 Mar;85(3):1021-5 - PubMed
  11. Maturitas. 2012 Jan;71(1):55-61 - PubMed
  12. Am J Obstet Gynecol. 2008 Dec;199(6):596-609 - PubMed
  13. J Clin Endocrinol Metab. 1998 Sep;83(9):3078-82 - PubMed
  14. Ann N Y Acad Sci. 2008;1135:179-84 - PubMed
  15. J Clin Endocrinol Metab. 2004 Jun;89(6):2745-9 - PubMed
  16. N Engl J Med. 2010 Jul 22;363(4):365-71 - PubMed
  17. Med Sci Sports Exerc. 2009 Jun;41(6):1241-8 - PubMed
  18. Mayo Clin Proc. 2011 May;86(5):382-8 - PubMed
  19. Fertil Steril. 2004 Jan;81(1):19-25 - PubMed
  20. Ann N Y Acad Sci. 2008;1135:163-78 - PubMed
  21. J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45 - PubMed
  22. Rocz Akad Med Bialymst. 2003;48:131-4 - PubMed
  23. Reprod Biol Endocrinol. 2012 Nov 22;10:96 - PubMed
  24. J Clin Endocrinol Metab. 2000 Oct;85(10):3496-506 - PubMed
  25. Fertil Steril. 2006 Jun;85(6):1849-51 - PubMed
  26. Annu Rev Med. 2001;52:401-19 - PubMed

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