High frequency of luteal phase deficiency and anovulation in recreational women runners: blunted elevation in follicle-stimulating hormone observed during luteal-follicular transition.
High frequency of luteal phase deficiency and anovulation in recreational women runners: blunted elevation in follicle-stimulating hormone observed during luteal-follicular transition.
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DOI：
10.1210/jcem.83.12.5334
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发表时间：
1998-12
期刊：
影响因子：
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通讯作者：
M. J. Souza;B. E. Miller;A. Loucks;A. Luciano;L. Pescatello;C. Campbell;B. Lasley
中科院分区：
文献类型：
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作者：
M. J. Souza;B. E. Miller;A. Loucks;A. Luciano;L. Pescatello;C. Campbell;B. Lasley
本调查的目的是评估三个连续月经周期的特征，并确定久坐和适度运动、定期月经的女性样本中黄体期不足 (LPD) 和不排卵的频率。在连续三个月经周期中，受试者每天收集尿液样本以分析 FSH、雌酮结合物 (E1C)、孕二醇-3-葡萄糖醛酸苷 (PdG) 和肌酐 (Cr)。久坐组（n=11）和运动组（n=24）在年龄（27.0+/-1.3岁）、体重（60.3+/-3.1公斤）、妇科年龄（13.8+/-1.2岁）和月经周期长度（28.3+/-0.8天）方面相似。月经周期根据内分泌数据分为排卵期、LPD 期或无排卵期。没有久坐的女性 (0%) 的月经周期分类不一致，但 46% 的运动女性的月经周期分类不一致。运动女性中 LPD 的样本患病率为 48%，3 个月样本患病率为 79%。在久坐的女性中，90% 的月经周期是排卵的（SedOvul；n=28），而在运动的女性中，只有 45% 的月经周期是排卵的（ExOvul；n=30）； 43% 为 LPD（ExLPD；n=28），12% 为无排卵（ExAnov；n=8）。在ExLPD周期中，与ExOvul（14.8+/-0.9和12.9+/-0.3天）和SedOvul（15.9+/-0.6和12.9+/-0.4天）周期相比，卵泡期显着更长（17.9+/-0.7天），黄体期显着更短（8.2+/-0.5天）。与 SedOvul 周期 (5.0+/-0.4 microg/mg Cr) 相比，ExLPD (2.9+/-0.3 microg/mg Cr) 和 ExAnov (0.8+/-0.1 microg/mg Cr) 周期中的黄体期 PdG 排泄较低 (P < 0.001)。 ExOvul 周期在黄体期的 PdG 排泄量 (3.7+/-0.3 microg/mg Cr) 也比 SedOvul 周期少 (P < 0.01)。与 SedOvul 周期相比，ExOvul、ExLPD 和 ExAnov 周期中卵泡期第 2-5 天的 E1C 排泄量较低 (P=0.05)，并且在第 6-12 天期间 ExLPD 和 ExAnov 周期中的 E1C 排泄量仍然较低 (P < 0.02)。与 SedOvul 和 ExOvul 周期（分别为 1.0+/-0.1 和 1.1+/-0.1 ng/mg Cr）相比，ExLPD（0.7+/-0.1 ng/mg Cr）周期中黄体-卵泡转变期间 FSH 的升高较低（P < 0.007）。 ExAnov 周期中的能量平衡和能量可用性低于其他月经周期类别（P < 0.05）。患有 LPD 的运动女性在黄体-卵泡过渡期间 FSH 升高迟缓，这可能解释了她们卵泡雌二醇水平较低的原因。 FSH 的这些变化可能与 LH 搏动紊乱共同作用，作为定期月经、锻炼的女性黄体期和排卵障碍频率较高的主要和直接因素。
The purposes of this investigation were to evaluate the characteristics of three consecutive menstrual cycles and to determine the frequency ofluteal phase deficiency (LPD) and anovulation in a sample of sedentary and moderately exercising, regularly menstruating women. For three consecutive menstrual cycles, subjects collected daily urine samples for analysis of FSH, estrone conjugates (E1C), pregnanediol-3-glucuronide (PdG), and creatinine (Cr). Sedentary (n=11) and exercising (n=24) groups were similar in age (27.0+/-1.3 yr), weight (60.3+/-3.1 kg), gynecological age (13.8+/-1.2 yr), and menstrual cycle length (28.3+/-0.8 days). Menstrual cycles were classified by endocrine data as ovulatory, LPD, or anovulatory. No sedentary women (0%) had inconsistent menstrual cycle classifications from cycle to cycle, but 46% of the exercising women were inconsistent. The sample prevalence of LPD in the exercising women was 48%, and the 3-month sample incidence was 79%. In the sedentary women, 90% of all menstrual cycles were ovulatory (SedOvul; n=28), whereas in the exercising women only 45% were ovulatory (ExOvul; n=30); 43% were LPD (ExLPD; n=28), and 12% were anovulatory (ExAnov; n=8). In ExLPD cycles, the follicular phase was significantly longer (17.9+/-0.7 days), and the luteal phase was significantly shorter (8.2+/-0.5 days) compared to ExOvul (14.8+/-0.9 and 12.9+/-0.3 days) and SedOvul (15.9+/-0.6 and 12.9+/-0.4 days) cycles. Luteal phase PdG excretion was lower (P < 0.001) in ExLPD (2.9+/-0.3 microg/mg Cr) and ExAnov (0.8+/-0.1 microg/mg Cr) cycles compared to SedOvul cycles (5.0+/-0.4 microg/mg Cr). ExOvul cycles also had less (P < 0.01) PdG excretion during the luteal phase (3.7+/-0.3 microg/mg Cr) than the SedOvul cycles. E1C excretion during follicular phase days 2-5 was lower (P=0.05) in ExOvul, ExLPD, and ExAnov cycles compared to SedOvul cycles and remained lower (P < 0.02) in the ExLPD and ExAnov cycles during days 6-12. The elevation in FSH during the luteal-follicular transition was lower (P < 0.007) in ExLPD (0.7+/-0.1 ng/mg Cr) cycles compared to SedOvul and ExOvul cycles (1.0+/-0.1 and 1.1+/-0.1 ng/mg Cr, respectively). Energy balance and energy availability were lower (P < 0.05) in ExAnov cycles than in other menstrual cycle categories. The blunted elevation in FSH during the luteal-follicular transition in exercising women with LPD may explain their lower follicular estradiol levels. These alterations in FSH may act in concert with disrupted LH pulsatility as a primary and proximate factor in the high frequency of luteal phase and ovulatory disturbances in regularly menstruating, exercising women.