Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Patras University Medical School, Patras, Greece.
Hormones (Athens). 2011 Apr-Jun;10(2):104-16. doi: 10.14310/horm.2002.1300.
To highlight the recent developments in the field of menstrual function in sports and to provide an overview of our current understanding in regard to the pathophysiology, evaluation and management strategies of exercise-related reproductive dysfunction.
A PUBMED search was carried out and all articles published from 1980 to 2010 with title words related to exercise, athletes, menstrual function and primary and secondary amenorrhea were reviewed. The review structure includes a pathophysiology overview, menstrual dysfunction among different athletic disciplines, clinical manifestations, evaluation and management strategies, with particular emphasis on recent data regarding the use of oral contraceptives and hormone replacement therapy.
Exercise-related reproductive dysfunction appears to be multifactorial in origin and remains a diagnosis of exclusion. Recent findings underscore the endocrine role of adipose tissue in the regulation of metabolism and reproduction, providing further data on our understanding of the pathophysiology of exercise-related reproductive dysfunction. Clinical manifestations range from primary amenorrhea or delayed menarche to luteal phase deficiency, oligomenorrhea, anovulation and secondary amenorrhea. Amenorrhea constitutes the most serious clinical consequence and is associated with bone pathology. Early diagnosis, thorough evaluation and individualized management (ranging from diet and exercise, or behavior adjustments to pharmacologic treatment) should be achieved in order to preserve bone mass.
强调运动领域中月经功能的最新发展，并概述我们目前对与运动相关的生殖功能障碍的病理生理学、评估和管理策略的理解。
对从 1980 年到 2010 年的 PUBMED 进行了检索，对所有与运动、运动员、月经功能和原发性和继发性闭经相关的标题词进行了综述。综述结构包括病理生理学概述、不同运动学科的月经功能障碍、临床表现、评估和管理策略，特别强调了最近关于口服避孕药和激素替代疗法使用的数据。
运动相关的生殖功能障碍似乎是多因素起源的，仍然是一个排除性诊断。最近的发现强调了脂肪组织在代谢和生殖调节中的内分泌作用，为我们对运动相关生殖功能障碍的病理生理学的理解提供了进一步的数据。临床表现从原发性闭经或初潮延迟到黄体期不足、月经稀发、无排卵和继发性闭经。闭经是最严重的临床后果，与骨病理学有关。为了保持骨量，应早期诊断、彻底评估和个体化管理（从饮食和运动或行为调整到药物治疗）。
