Maïmoun L, Paris F, Coste O, Sultan C
Service de médecine nucléaire, hôpital Lapeyronie, université de Montpellier 1 (UM1), CHRU de Montpellier, 34295 Montpellier, France; PhyMedExp, University of Montpellier, Inserm U1046, CNRS UMR 9214, 34295 Montpellier cedex 5, France.
Unité d'endocrinologie et gynécologie pédiatrique, département de pédiatrie, hôpital A.-de-Villeneuve, UMI, CHRU de Montpellier, 34295 Montpellier, France.
Gynecol Obstet Fertil. 2016 Nov;44(11):659-663. doi: 10.1016/j.gyobfe.2016.09.001. Epub 2016 Oct 15.
Participation in recreational physical activity is widely acknowledged to provide significant health benefits. Conversely, intense training imposes several constraints, such as intermittent or chronic metabolic and psychogenic training stressors and maintenance of very low body fat to maximize performance. Adolescent and adult athletic women are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function particularly on hypothalamic-pituitary-gonadal axis. Female athletes, particularly those participating in sports needing leanness or low body weight, present a high prevalence of menstrual disorders with clinical manifestations ranging from delayed menarche, oligomenorrhea to primary and secondary amenorrhea. A high degree of variability according to the type of sport and the intensity of the practice is however observed. Exercise-related reproductive dysfunction may have some consequences for growth velocity and peak bone mass acquisition during adolescence and bone pathologies in adults. Recent findings highlight the endocrine role of adipose tissue and energy balance in the regulation of homeostasis and reproductive function. A better understanding of the mechanisms whereby intense training affects the endocrine systems may orient research to develop innovative strategies probably based on individualized nutritional approach to improve the medical care of these female athletes and protect their reproductive function.
参与休闲体育活动被广泛认为能带来显著的健康益处。相反,高强度训练会带来一些限制,比如间歇性或慢性的代谢和心理性训练压力源,以及维持极低的体脂以最大化运动表现。因此,青春期和成年女运动员存在过度训练和/或饮食摄入不良的风险,这可能对内分泌功能产生多种影响,尤其是对下丘脑 - 垂体 - 性腺轴。女性运动员,特别是那些参加需要苗条身材或低体重的运动项目的运动员,月经紊乱的发生率很高,临床表现从初潮延迟、月经过少到原发性和继发性闭经不等。然而,根据运动类型和训练强度观察到高度的变异性。与运动相关的生殖功能障碍可能会对青春期的生长速度和峰值骨量获取以及成年人的骨骼病变产生一些影响。最近的研究结果突出了脂肪组织和能量平衡在调节体内平衡和生殖功能中的内分泌作用。更好地理解高强度训练影响内分泌系统的机制,可能会引导研究方向,开发出可能基于个性化营养方法的创新策略,以改善这些女运动员的医疗护理并保护她们的生殖功能。