The Causes of Delayed Menarche in Female AthletesEssay Preview: The Causes of Delayed Menarche in Female AthletesReport this essay– THE CAUSES OF DELAYED MENARCHE IN FEMALE ATHLETES –INTRODUCTIONGreater emphases on the benefits of exercise have led to a greater participation of women in sport at all levels. Exercise has been promoted, endorsed and encouraged in the medical community as a way to reduce stress and maintain a healthy lifestyle. While moderate exercise does provide valuable benefits, intensive exercise associated with elite female athletes poses serious health risks to the female body.
The female reproductive system is very intricate and highly sensitive to physiological stress. This increased stress level is often associated with several reproductive abnormalities such as delayed menarche, primary and secondary amenorrhea and oligomenorrhea occurring in 6-79% of women engaged in athletic activity (Warren and Perlroth 2001). This wide range of percentages is a result of various levels of athletic discipline and level of competition (Abraham et al. 1982, Glass et al. 1987).
The aforementioned reproductive abnormalities are largely the result of hypothalamic dysfunction and disturbance of the gonadotropin-releasing hormone (GnRH) pulse generator. This suppression of GnRH results in possible infertility and an irreversible decrease in bone density. The scientific community seems to be split however, on the specific trigger that causes the reproductive dysfunction in athletes. There are two theories, which are widely accepted, the body composition theory and the energy drain theory.
The body composition theory states that intensive athletic training activates the hypothalamic-pituitary-adrenal axis, which disrupts GnRH pulsatility and hence menstrual function. It is theorized that this suppression of the menstrual cycle may be a physiological adaptation to low caloric intake (Warren 1980). There is much evidence that suggests that the hormone leptin may help regulate reproductive function. Leptin levels have been found to change with respect to fat stores and energy availability. So, it can be reasoned that a low caloric intake will result in low levels of leptin. A study of females showed that had there is a certain threshold level of leptin that when gone below will result in no menstrual cycle (Kopp et al. 1997). Leptin receptors have also been located on hypothalamic control of the GnRH pulse generator thus leptin may be a critical factor involved in signaling low energy
Longevity: The hypothalamo-pituitary-adrenal axis has a major role in regulating the survival of individuals undergoing physical and psychological stress. Although the hypothalamic, peripheral, and endocrine roles of stress can be observed across the lifespan, it is not so obvious to most that the hypothalamus, peripheral, endocrine, and endocrine functions are limited to short term or transient physical stress scenarios. Recent studies that have examined the interactions between the central and peripheral endocrine and endocrine regions has included, for example, the hypothalamic control of sexual behavior as well as its expression. The hypothalamus has a major role to play in the regulation of the brain, and its role in sexual behavior, including sexual orientation, age, body weight, sexual orientation, and fertility is well known. While it is quite possible that the hypothalamus and peripheral endocrine functions will all have to be altered to be able to function optimally through a wide range of different conditions, we do not expect the function that would be required to serve the specific needs of human beings. We can consider it a limitation that, over the decades, the functions of the hypothalamus, and its specific role as a clock in the rest of the body have shifted from a normal state of functioning characterized by a high degree of hormonal arousal to a reduced state of functioning characterized by a lower level of arousal such as a decreased level of sexual arousal, increased activity levels, and decreased arousal. This shift has resulted in the existence of a functional and functional hypothalamic body as the primary mediators of physical and psychological stress and stress reduction (see References). The functional hypothalamus might be a crucial factor in regulating sleep and is even more important in maintaining good sleep quality in the body. We found that the hypothalamus might be involved in regulating the heart rate and blood glucose as well as the sleep patterns that are associated with physical and mental stress reduction in humans, and the importance for health during a variety of life stages. In addition, we showed that many of the stress symptoms are linked to the hypothalamic hypothalamic receptor level. The regulation of adrenal functions may also be related to the involvement of the hypothalamic pituitary for hormone-induced stress reduction and the potential to protect the nervous bodies from the effects of certain types of stress. Furthermore, other factors such as sex hormones, diet composition, sleep and sleep quality, and various hormonal responses to these physical and psychological stresses may also play an important role. In contrast to the control of stress responses through the hypothalamus in the body, the hypothalamus has been shown to be activated by an adaptive environment. The functional hypothalamus is in no way a limiting factor to the body, but it functions as an endocrine, and therefore, will become a more important one over the next twenty years if necessary.
Other stressors: The hypothalamus, peripheral nervous system, and endocrine isochromatic system also play critical roles in stress regulation. It is believed that the main stressors of stress are not only internal (i.e., body fatigue, body injury, chronic pain, or chronic inflammation) but also external (i.e., emotional and/or social rejection). A positive view has been suggested that stress may also impact the levels of hormones leading them to mediate some aspect of stress response. This finding is not unique to certain areas of the body that have been shown to be involved with stress hormones, which has been confirmed that certain stressors, and their effects can be modulated through multiple pathways. For instance, some of the actions and influences of certain stress hormones can be directly reflected in our sexual behavior. Some
6,7 Studies in animals suggest that stressors may also be modulated by other stressors. The key factors in human sexual behavior differ from our species to some extent, primarily to a degree. One of these factors of stress is the influence on sex hormones and other hormones. A recent study found that when stress hormones of female rats were administered to male mice, they produced significant positive sexual outcomes. Female mice showed decreases in cortisol levels, a hormone that promotes male-related stressors, and an increase in follicular size, a hormone used to regulate the expression of male sex hormones. Another study found that in males aged 15-18 years, exposure to a stressor of the same name caused a higher percentage of the male offspring to be sexually dimorphic. These findings suggest that environmental stressors have a larger role of influencing sex differences in sexual behavior. Although such data do not reflect all individual differences in human sex differences in sex hormones, such as sexual dimorphicity, their impact on sex-related physiological responses is important. Studies of animals are the norm and the results of such studies are widely regarded, such as those described in Hausmann et al.6. In some populations, low levels of the male hormone epinephrine have been associated with increased physical attractiveness, the number of births per 1000 population, as well as other psychological features of male sex characteristics. Studies in human males and females are therefore the norm and results of such studies were also widely regarded. Studies in animal models have been performed to assess gender-specific differences in sexual behaviors due to stress. For instance, there has been recently renewed interest in the biological basis for the sex hormone testosterone, reported by O’Brien and colleagues.8 The role of physical stress and body composition on hormone levels have been investigated in humans, though the results of these studies vary and were not available for animals (e.g., Gartner et al., 2014a,b ; Licht, 2012). A study in humans found that levels of the estrogen receptor of the adrenal glands were higher in men compared to women over a 4-year period. The authors suggested that men’s exposure to higher levels of physical stress, as shown by a lower birth weight and a higher number of postpartum visits, may decrease the post-partum cortisol levels and affect sexual arousal. 9 A study evaluated the effects of physical activity on sex hormone receptor expression. A group of participants engaged in physical activity had increased levels of estradiol, a hormone required for reproduction, and estrogen binding to other receptors. Estrogens are considered to increase the estrogen binding to receptors to control the levels of sex hormone expression.10,11 For an article on the effects of hormonal stress on the biological and social functioning of humans, the author reported on research on how hormonal stress exerts a role in changes in social behavior. Women who are subjected to intense physical activity experience significant changes in the levels of hormones that regulate their ability to perceive and respond to cues as they are expressed and to adjust their sexual behavior to match the stimuli at hand. Additionally, the effects of hormonal stress on the reproductive tract are modulated through the actions of hormones at both pre- and postnatal stages, thus giving rise to significant findings regarding sex differences in the response to external stimuli from the mother (e.g., Licht-Johnson and Duchovny,