US EPA

7436425 

Journal Article 

Exercise and the Hypothalamus: Ovulatory Adaptations 

Liu, AY; Petit, MA; Prior, JC; , 

2020 

123-151 

10.1007/978-3-030-33376-8_8 

http://link.springer.com/10.1007/978-3-030-33376-8_8
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Physically active women with regular menstrual cycles (21–35 days long) who increase exercise training may experience adaptive changes of their reproductive system. Ovulatory disturbances, oligomenorrhea, and amenorrhea are no longer evidence of “disease,” but of protection from pregnancy while adapting to energetic and other training-related demands; this is known as relative energy deficiency in sport. The most common hypothalamic reproductive adaptation for women is the development of subclinical ovulatory disturbances (regular cycles without ovulation or with short luteal phases). If the woman in athletic training is an adolescent, <12 years from menarche, or took combined hormonal contraception before developing robustly ovulatory cycles, and is also experiencing psychosocial stressors, then she may further develop oligomenorrhea (cycles >35 but <90 days apart) or amenorrhea (cycles ≥90 days apart). The common path to hypothalamic adaptation in exercising men and women involves exercise-related relative energy insufficiency and other stressful experiences. Accounting for the life experience and current context of an exercising woman with hypothalamic adaptation, gradually increasing exercise intensity and duration, creating a positive and supportive social/emotional environment, and sharing knowledge that these changes are protective and reversible will decrease any negative effects of intense physical exercise.