Is there an association between athletic amenorrhea and endothelial cell dysfunction?

HOCH, A. Z., R. L. DEMPSEY, G. F. CARRERA, C. R. WILSON, E. H. CHEN, V. M. BARNABEI, P. R. SANDFORD, T. A. RYAN, and D. D. GUTTERMAN. Is There an Association between Athletic Amenorrhea and Endothelial Cell Dysfunction?Med. Sci. Sports Exerc., Vol. 35, No. 3, pp. 377–383, 2003. Purpose: To test the hypothesis that young females with athletic amenorrhea and oligomenorrhea show signs of early cardiovascular disease manifested by decreased endothelium-dependent dilation of the brachial artery. Methods: Ten women with athletic amenorrhea (mean SE, age 21.9 1.2 yr), 11 with oligomenorrhea (age 20.8 1.1 yr), and 11 age-matched controls (age 20.2 1.1 yr) were studied. Study subjects were amenorrheic an average of 2.3 (range 0.6 –5) yr and oligomenorrheic an average of 6.2 yr. All ran a minimum of 25 miles·wk 1 . They were nonpregnant and free of metabolic disease. Brachial artery flow-mediated dilation (endothelium-dependent) was measured with a noninvasive ultrasound technique in each group. Results: Endothelium-dependent brachial artery dilation was reduced in the amenorrheic group (1.08 0.91%) compared with oligomenorrheic (6.44 1.3%; P 0.05) and eumenorrheic (6.38 1.4%; P 0.05) groups. Conclusion: Athletic amenorrhea is associated with reduced endothelium-dependent dilation of the brachial artery. This may predispose to accelerated development of cardiovascular disease. Key Words: FEMALE ATHLETE TRIAD, WOMEN’S HEALTH, CARDIOVASCULAR DISEASE, FEMALE ATHLETES