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Neuroendocrine Abnormalities in Female Athletes

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The Female Athlete Triad

Abstract

This chapter will review hormonal changes noted acutely and chronically with exercise, specifically focusing on abnormalities noted in female athletes with menstrual dysfunction and/or energy deficiency. Where information regarding amenorrheic (presumably energy deficient) athletes is lacking, hormonal patterns in women with anorexia nervosa have been included. The last two decades have shed much light on the intricate relationships between exercise, nutrition, appetite regulation, stress, and the reproductive system. In athletes with functional hypothalamic amenorrhea (FHA), a combination of nutritional deficits, stress, and hormonal aberrations lead to a disruption of gonadotropin-releasing hormone (GnRH) pulsatility, subsequently causing menstrual irregularity or amenorrhea. Particularly, low fat mass and alterations in hormones such as ghrelin, leptin, peptide YY, and cortisol have been associated with altered luteinizing hormone (LH) levels and LH pulsatile patterns. Importantly, one of the most severe consequences of FHA is poor bone health. In fact, many hormonal alterations that contribute to FHA also have deleterious effects on bone. This chapter will discuss relationships among the various hormonal changes in FHA and bone metabolism. Thus, it will describe some of the known and suspected mechanisms leading to the Female Athlete Triad (Triad), and will discuss the current data on hormonal interventions thus far attempted to treat Triad.

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Authors and Affiliations

  1. Division of Sports Medicine, Boston Children’s Hospital, 319 Longwood Avenue, Boston, MA, 02115, USA

    Kathryn E. Ackerman MD, MPH

  2. Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Neuroendocrine Unit, BUL 457, 55 Fruit Street, Boston, MA, 02114, USA

    Madhusmita Misra MD, MPH

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  1. Kathryn E. Ackerman MD, MPH
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  2. Madhusmita Misra MD, MPH
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Correspondence to Kathryn E. Ackerman MD, MPH .

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  1. Hasbro Children's Hospital, Providence, Rhode Island, USA

    Catherine M. Gordon

  2. Brigham and Women's Hospital, Boston, Massachusetts, USA

    Meryl S. LeBoff

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Ackerman, K.E., Misra, M. (2015). Neuroendocrine Abnormalities in Female Athletes. In: Gordon, C., LeBoff, M. (eds) The Female Athlete Triad. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7525-6_6

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