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Exercise and reproductive dysfunction

  • Eileen C Chen
    Affiliations
    Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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  • Robert G Brzyski
    Correspondence
    Reprint requests: Robert G. Brzyski, M.D., Ph.D., University of Texas Health Science Center at San Antonio, Department of Obstetrics and Gynecology, 7703 Floyd Curl Drive, San Antonio, Texas 78284 (FAX: 210-567-4958)
    Affiliations
    Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
    Search for articles by this author

      Abstract

      Objective: To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management.
      Design: A MEDLINE search was performed to review all articles with title words related to menstrual dysfunction, amenorrhea, oligomenorrhea, exercise, and athletic activities from 1966 to 1998. The pathophysiology, proposed mechanisms, clinical manifestations, evaluation, and management of exercise-associated reproductive dysfunction were compiled.
      Conclusion(s): Exercise-induced menstrual irregularity appears to be multifactorial in origin and remains a diagnosis of exclusion. The underlying mechanisms are mainly speculative. Clinical manifestations range from luteal phase deficiency to anovulation, amenorrhea, and even delayed menarche. Evaluation should include a thorough history and a complete physical plus pelvic examination. Most cases are reversible with dietary and exercise modifications. Hormonal replacement in cases of a prolonged hypoestrogenic state with evidence of increased bone loss is recommended, although the long-term consequences of prolonged hormonal deficiency are ill-defined.

      Keywords

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