Sex steroid metabolism and menstrual irregularities in the exercising female

Sports Medicine

Volumn 25, Issue 6, 1998, Pages 369-406

  De Crée, Carl ^a,b  

^a UNIVERSITY OF BEDFORDSHIRE   (United Kingdom)

^b Inst Gyneco Endocrinological Res   (Belgium)

Author keywords

[No Author keywords available]

Indexed keywords

4 AMINOBUTYRIC ACID; CATECHOLAMINE; CORTICOTROPIN RELEASING FACTOR; ESTROGEN; GONADORELIN; NORADRENALIN; OPIATE PEPTIDE; PROGESTERONE; PROLACTIN; SEX HORMONE; SOMATOMEDIN C;

AMENORRHEA; ATHLETE; BODY FAT; BODY MASS; CALORIC INTAKE; EATING DISORDER; EXERCISE; FEMALE; FITNESS; GONADOTROPIN RELEASE; HUMAN; HYPERPROLACTINEMIA; MENSTRUAL CYCLE; MENSTRUAL IRREGULARITY; METHODOLOGY; NORADRENALIN BRAIN LEVEL; OSTEOPOROSIS; PROSPECTIVE STUDY; REVIEW; STEROID METABOLISM; STRESS FRACTURE; SUBFERTILITY; TRAINING;

ADIPOSE TISSUE; ADOLESCENT; AMENORRHEA; ANOVULATION; BODY COMPOSITION; ENERGY INTAKE; EXERCISE; FEMALE; GONADAL STEROID HORMONES; HUMANS; LACTIC ACID; LUTEAL PHASE; MENSTRUATION DISTURBANCES; PROGNOSIS; PUBERTY, DELAYED; SPORTS;

EID: 0031874546     PISSN: 01121642     EISSN: None     Source Type: Journal    
DOI: 10.2165/00007256-199825060-00003     Document Type: Review

References (300)

1. Keizer HA, Poortman J, Bunnik GSJ. Influence of physical exercise on sex-hormone metabolism. J Appl Physiol 1980; 48 (5): 765-9
2. Keizer HA, Van Schaik FW, De Beer EL. Exercise-induced changes in estradiol metabolism and their possible physiological meaning. Med Sport 1981; 14: 141-7
3. Keizer HA, Kuipers H. Verstappen FT. Limitations of concentration measurements for evaluation nf endocrine status of exercising women. Can J Appl Sport Sci 1982; 7 (2): 79-84
4. Bonen A. Exercise-related disturbances in the menstrual cycle. In: Borer KT, Edington DW, White TR, editors. Frontiers of exercise biology. Champaign (IL): Human Kinetics Publishers, 1983: 214-37
5. Keizer HA. Exercise- and training-induced menstrual cycle irregularities (AMI). Int J Sports Med 1986; 7: 38-44
6. Baker ER. Menstrual dysfunction and hormonal status in athletic women: a review. Fertil Steril 1981; 36 (6): 691-6
7. Carlberg KA, Buckman MT, Peake GT. Body composition of oligo/amenorrheic athletes. Med Sci Sports Exerc 1983; 15 (3): 215-7
8. Frisch RE, Wyshak G, Vincent L. Delayed menarche and amenorrhea in ballet dancers. N Engl J Med 1980; 303: 17-9
9. Jurkowski JE, Jones NL, Walker WC. Ovarian hormonal responses to exercise. J Appl Physiol 1978; 44 (1): 109-14
10. Prior JC. Endocrine 'conditioning' with endurance training, a preliminary review. Can J Appl Sport Sci 1982; 7: 148-57
11. Prior JC, Cameron K, Yuen BH. Menstrual cycle changes with marathon training: anovulation and short-luteal phase. Can J Appl Sport Sci 1982; 7: 173-7
12. Shangold MM. Sports and menstrual function. Physician Sports Med 1980; 8 (8): 66-70
13. Harber VJ, Webber CE, Sutton JR. The effect of amenorrhea on bone calcaneal bone density and total bone turnover in runners. Int J Sports Med 1991; 12 (5): 505-8
14. Heinrich CH, Going SB, Pamentier RW. Bone mineral content of cyclically menstruating female resistance and endurance trained athletes. Med Sci Sports Exerc 1990; 22 (5); 558-63
15. Arena B, Maffuli N, Maffuli F. Reproductive hormone and menstrual changes with exercise in female athletes. Sports Med 1995; 19 (4): 278-87
16. Bonen A, Keizer HA. Athletic menstrual irregularity, endocrine responses to exercise and training. Physician Sports Med 1984; 12 (8): 78-90
17. Highet R. Athletic amenorrhea: an update on aetiology, complications and management. Sports Med 1989; 7 (2): 82-108
18. Keizer HA, Rogol AD. Physical exercise and menstrual cycle alterations: what are the mechanisms? Sports Med 1990; 10 (4): 218-35
19. Kolka MA, Stephenson LA. The menstrual cycle and the female athlete. Phys Educ 1982; 39 (2): 136-41
20. Loucks AB, Horvath SM. Athletic amenorrhea: a review. Med Sci Sports Exerc 1985; 17 (1): 56-72
21. Loucks AB, Cameron JB, De Souza MJ. Durability of the reproductive axis in eumenorrheic women during 1 yr of endurance training [letter]. J Appl Physiol 1993; 74 (4): 2045-6
22. Tremblay MS, Chu SY, Mureika R. Methodological and statistical considerations for exercise-related hormone evaluations. Sports Med 1995; 20 (2): 90-108
23. Vollmann RF. The menstrual cycle. Philadelphia (PA): W.B. Saunders, 1977
24. Brisson GR, Dulac S, Peronnet F. The onset of menarche: a late event in pubertal progression to be affected by physical training. Can J Appl Sport Sci 1982; 7 (2): 61-7
25. Frisch RE, Gotz-Welbergen AV, Mac-Arthur JW. Delayed menarche and amenorrhea of college athletes in relation to age of onset of training. JAMA 1981; 246: 1559-63
26. Mesaki N, Sasaki J, Shoji M. Delayed menarche followed by early onset of athletic training [English abstract], Acta Obstet Gynaec Jpn 1984; 36 (1): 49-56
27. Warren MP, Brooks-Gunn J, Hamilton LH. Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. N Engl J Med 1986; 314 (21): 1348-53
28. Warren MP. The effects of exercise on pubertal progression and reproductive function in girls. J Clin Endocrinol Metab 1980; 51: 1150-7
29. Stager JM, Robertshaw D, Miescher E. Delayed menarche in swimming in relation to age and onset of training and athletic performance. Med Sci Sports Exerc 1984; 16: 550-5
30. Malina RM. Menarche in athletes: a synthesis and hypothesis. Ann Hum Biol 1983; 10 (1): 1-24
31. Bonen A, Belcastro AN, Ling WY. Profiles of selected hormones during menstrual cycles of teenage athletes. J Appl Physiol 1981; 50: 545-51
32. Prior JC, Ho Yuen B, Clement P. Reversible luteal phase changes and infertility associated with marathon training. Lancet 1982; 11 (8292): 269-70
33. Prior JC, Vigna YM, Schulzer M. Determination of luteal phase length by quantitative basal temperature methods: validation against the midcycle LH peak. Clin Invest Med 1990; 13: 123-31
34. Shangold MM. Menstrual irregularity in athletes: basic principles, evaluation, and treatment. Can J Appl Sport Sci 1982; 7 (2): 68-70
35. Bauman JE. Basal body temperature: unreliable method of ovulation detection. Fertil Steril 1981; 36 (6): 729-33
36. Wetzels LCG, Hoogland HJ, De Haan J. Hasal body temperature as a method of ovulation detection: comparison with ultrasonographical findings. Gynaecol Obstet Invest 1982; 13: 239-40
37. De Crée C, Lewin R, Ostyn M. Failure to induce ovulation with clomiphene citrate and bromocriptine in luteal deficient women athletes. Int J Sports Med 1991; 12 (3): 269-75
38. Loucks A, Mortola JF, Girton L. Alterations in the hypothalamic-piluitary-ovarian and the hypothalamic-pituitary-adrenal axes in athletic women. J Clin Endocrinol Metab 1989; 68 (2): 402-11
39. Harlow SD, Matanoski GM. The association between weight, physical activity, stress and variation in the length of the menstrual cycle. Am J Epidemiol 1991; 133 (1): 38-49
40. Prior JC. Exercise-related adaptive changes of the menstrual cycle. In: D. MacLeod, Maughan O, Nimmo M, et al., editors. Exercise: benefits, limits and adaptations. London: E. & F.N. Spon. 1987: 239-54
41. Bonen A. Exercise-induced menstrual cycle changes: a functional temporary adaptation to metabolic stress. Sports Med 1994; 17 (6): 373-92
42. Feicht CB, Sanborn C, Martin BJ. Is athletic amenorrhea specific to runners? Am J Obstet Gynecol 1982; 143: 859-61
43. Glass AR, Deuster PA, Kyle SB. Amenorrhea in Olympic marathon runners. Fertil Steril 1987; 48 (5): 740-5
44. Lutter JM, Cushman S. Menstrual patterns in female runners. Physician Sports Med 1982; 10 (9): 60-72
45. Mann GV. Menstrual effects of athletic training. Med Sport 1981; 14: 198-9
46. Schwartz B, Cumming DC, Riordan E. Exercise-induced amenorrhea: a distinct identity. Am J Obstet Gynecol 1981; 141 (6): 662-70
47. Speroff L, Redwine DB. Exercise and menstrual dysfunction Physician Sports Med 1980; 8: 41-52
48. Wakat DK, Sweeney KA, Rogol AD. Reproductive system function in women cross-country runners. Med Sci Sports Exerc 1982; 14: 263-9
49. Yen SSC. Female hypogonadotropic hypogonadism: hypothalamic amenorrhea syndrome. Endocrin Metabol Clin North Am (Neuroendocrinology II) 1943; 22 (1): 29-58
50. Baker ER, Mathur RS, Kirk RF. Female runners and secondary amenorrhea: correlation with age, parity, mileage, and plasma hormonal and sex hormone binding globulin concentrations. Fertil Steril 1981; 36 (2): 183-7
51. Abraham SF, Beumont PJV, Fraser IS. Moly weight, exercise and menstrual status among ballet dancers in training. Br J Obstet Gynaecol 1982; 89 (7): 507-10
52. Calabrese LH, Kirkendall DT, Floyd M. Menstrual abnormalities, nutritional patterns and body composition in female classical ballet dancers. Physician Sports Med 1983; 11 (2): 86-98
53. Graves JE, Pollock ML, Sparling PB. Body composition of elite female distance runners. Int J Sports Med 1987; 8 Suppl. 2: 96-102
54. Plowman SA, Liu NY, Wells CL. Body composition and sexual maturation in premenarcheal athletes and nonathletes. Med Sci Sports Exerc 1991; 23 (1): 23-9
55. Henley K. Exercise induced menstrual dysfunction. Ann Rev Med 1988; 39: 443-51
56. Myburgh KH, Watkin VA, Noakes TD. Are risk factors for menstrual dysfunction cumulative. Physician Sports Med 1992; 20 (4): 114-25
57. Loucks AB, Horvath SM, Freedom PS. Menstrual status and validation of body fat prediction in athletes. Hum Biol 1984; 56: 383-92
58. Frisch RE, Revelle R, Cook S. Components of weight at menarche and the initiation of the adolescent growth spurt in girls: estimated total water lean body weight and fat. Hum Biol 1973; 45: 449-83
59. Gray P, Dale E. Variables associated with secondary amenorrhea. J Sport Sci 1983; 1: 55-67
60. Cohen JL, Kim CS, May PB. Exercise, body weight and amenorrhea in professional ballet dancers. Physician Sports Med 1982; 10 (4): 92-101
61. Frisch RE, MacArthur JW. Menstrual cycles: fatness as a determinant of minimum weight for height necessary for the maintenance or onset of menstruation. Science 1974; 185: 949-51
62. Brooks SM, Sanburn CF, Albrecht BH. Diet in athletic amenorrhea. Lancet 1984; 11: 559-60
63. Mansfield MJ, Emans SJ. Anorexia nervosa, athletics and amenorrhea. Pediatr Clin North Am 1989; 36: 533-49
64. Sanborn CF, Martin BJ, Wagner WW. Is athletic amenorrhoea specific to runners? Am J Obstet Gynecol 1982; 143: 859-61
65. Beumont PJV, Abraham SF, Argall WJ. Plasma gonadotrophins and LHRH infusions in anorexia nervosu. Obstet Gynecol Surv 1980; 130: 609-10
66. Brooks-Gunn J, Warren MP, Hamilton LH. The relation of eating problems and amenorrhea in ballet dancers. Med Sci Sports Exerc 1987; 19 (1): 41-4
67. Sirinathsinghj DJ, Mills IH. Concentration of plasma dehydroepiandrosterone, 5-androstenediol and their sulphates, testosterone, and cortisol in normal healthy women and in women with anorexia nervosa. Acta Endocrinol 1985; 108 (2): 255-60
68. Loucks AB, Horvath SM. Exercise-induced stress responses of amenorrheic and eumenorrheic runners. J Clin Endocrinol Metab 1984; 59(6): 1109-20
69. 3 syndrome in exercising women. Am J Physiol 1993; 264 (33): R924-30
70. Loucks AB, Vaitukaitis J, Cameron JL. The reproductive system and exercise in women. Med Sci Sports Exerc 1992; 24 (6 Suppl.): S288-93
71. Loucks AB, Verdun M, Heath EM. Low energy availability, not the stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol 1998; 84 (1): 37-46
72. Wilmore JH, Wambsgans KC, Brenner M. Is there energy conservation in amenorrheic compared with eumenorrheic distance runners? J Appl Physiol 1982; 72 (1): 15-22
73. Dominguez C. Altered binding of serum thyroid hormone to thyroxine-binding globulin in women with functional hypothalamic amenorrhea. Fertil Steril 1997; 68 (6): 992-6
74. Carlberg KA, Buckman MT, Peake GT. Body composition of oligo-amenorrheic athletes. Med Sci Sports Exerc 1983; 15 (3): 215-7
75. Katch FI, Katch VL, Behnke AR. The underweight female. Physician Sports Med 1980; 8: 55-60
76. McArthur JW, Bullen BA, Beitins IZ. Hypothalamic amenorrhea in runners of normal body composition. Endocr Res Comm 1980; 7: 13-25
77. Bullen BA, Skrinar GS, Beitins IZ. Induction of menstrual cycle disorders by strenuous exercise in untrained women. N Engl J Med 1985; 312: 1349-53
78. Trussel J. Statistical flaws in evidence for the Frisch hypothesis that fatness triggers menarche. Hum Biol 1980; 52 (2): 711-20
79. De Souza MJ, Maresh CM, Abraham A. Body compositions of eumenorrheic, oligomenorrheic and amenorrheic runners. J Appl Sport Sci Res 1987; 2: 13-5
80. Sanborn CF, Albrecht BH, Wagner Jr WW. Athletic amenorrhea: lack of association with body fat. Med Sci Sports Exerc 1987; 19 (3): 207-12
81. Wells RF. Body composition and the menstrual cycle. Excel 1988; 4 (3): 18-9
82. Bronson FH, Manning JM. The energetic regulation of ovulation: A realistic role for body fat. Biol Reprod 1991; 44 (6): 945-50
83. Sinning WE, Little KD. Body composition and menstrual function in athletes. Sports Med 1987; 4: 35-45
84. Vigersky RA, Andersen AE, Thompson RH. Hypothalamic dysfunction in secondary amenorrhea, associated with simple weight loss. N Engl J Med 1977; 297: 1141
85. Warren MP, Vande Wiele RL. Clinical and metabolic features of anorexia nervosa. Am J Obstet Gynecol 1973; 117: 435
86. Deuster PA, Kyle SB, Moser PB. Nutritional survey of highly trained women runners. Fertil Steril 1986; 46: 636-43
87. Keys A, Brozek J. The biology of human starvation. Minneapolis (MN): University of Minnesota Press, 1950
88. Dale E, Goldberg DL. Implications of nutrition in athletes' menstrual cycle irregularities. Can J Appl Sport Sci 1982; 7 (2): 74-8
89. Smith NJ. Excessive weight loss and food aversion in athletes simulating anorexia nervosa. Pediatrics 1980; 66 (1): 139-42
90. Yates A, Leekey K, Shisslak CM. Running An analogue of anorexia? N Engl J Med 1983; 308: 251-5
91. Loosli AR, Gillien DM, Benson J. Inadequate nutrition and chronic caloric restriction among ballet dancers. Med Sci Sports Exerc 1985; 77 (2): 201
92. Kaiserauer SA, Snyder AC, Sleeper M. Nutritional, physiological, and menstrual status of the distance runner. Med Sci Sports Exerc 1989; 21: 120-5
93. Myerson M, Gutin B, Warren MP. Resting metabolic rate and energy balance in amenorrheic and eumenorrheic runners. Med Sci Sports Exerc 1991; 23: 15-22
94. Nelson ME, Fisher EC, Catsos PO. Diet and bone status in amenorrheic runners. J Clin Nutr 1986; 43: 910-6
95. Mulligan K, Butterfield GE. Discrepancies between energy intake and expenditure in physically active women. Br J Nutr 1990; 64: 23-36
96. Dueck CA, Manore MM, Matt KS. Role of energy balance in athletic menstrual dysfunction. Int J Sport Nutr 1996; 6: 165-90
97. Edwards JE, Lindeman A, Stanger J. Energy balance in highly trained female endurance runners. Med Sci Sports Exerc 1993; 25: 1398-404
98. De Crée C, Lewin A, Barros A. Hypoestrogenemia rhabdomyelysis in the female judoist: a new worrying phenomenon? J Clin Endocrinol Metab 1995; 80 (12): 3639-46
99. Borgen JS, Corbin Ch B. Eating disorders among female athletes. Physician Sports Med 1987; 15 (2): 88-95
100. Walberg JL, Johnston CS. Menstrual function and eating behavior in female recreational weight lifters and competitive body builders. Med Sci Sports Exerc 1991; 23 (1): 30-6
101. Johnson MD. Disordered eating in active and athletic women. Clin Sports Med 1994; 13: 355-69
102. Weight LM, Noakes TD. Is running an analog of anorexia? A survey of the incidence of eating disorders in female distance runners. Med Sci Sports Exerc 1987; 19 (3): 213-7
103. Schoeller DA, Bandini LG, Dietz WH. Inaccuracies in self-reported intake identified by comparison with the doubly labelled water method. Can J Physiol Pharmacol 1990; 68: 941-9
104. Pirke KM, Schweiger U, Strowitzki T. Dieting causes menstrual irregularities in normal weight young women through impairment of episodic luteinizing hormone secretion. Fertil Steril 1989; 51: 2263-8
105. De Souza MJ, Metzger DA. Reproductive dysfunction in amenorrheic athletes and anorexic patients: a review. Med Sci Sports Exerc 1991; 23 (9): 995-1007
106. Frisch RE. Amenorrhea, vegetarianism, and/or low fat. Lancet 1986; 1: 1024
107. Hill PL, Garbaczewski L, Haley N. Diet and follicular development. Am J Clin Nutr 1984; 39: 771-7
108. Morimoto Y, Dishi T, Hanasaki N. Interrelations among amenorrhea, serum gonadotropins and body weight in anorexia nervosa. Endocr Jpn 1980; 27: 191-4
109. Steiner RA. Nutritional and metabolic factors in the regulation of reproductive hormone secretion in the primate. Proc Nutr Soc 1987; 46: 159-75
110. Schweiger U, Laessle R, Pfister H. Diet-induced menstrual irregularities: effects of age and weight loss. Fertil Steril 1987; 48 (5): 746-51
111. Mesaki N, Sasaki J, Shoji M. Menstrual characteristics in college athletes [English abstract]. Acta Obst Gynaec Jpn 1984; 36 (2): 247-54
112. Morin LP. Environment and hamster reproduction: responses to phase-specific starvation during estrous cycle. Am J Physiol 1986; 251: R663-669
113. Gray JM, Greenwood MRC. Time course of effects of ovarian hormones on food intake and metabolism. Am J Physiol 1982; 243: E407-12
114. 2A promoter polymorphism - 1438G/A, anorexia nervosa, and obsessive-compulsive disorder. Lancet 1998; 351 (9118): 1785
115. Moisan J, Meyer F, Gingra S. Leisure physical activity and age at menarche. Med Sci Sports Exerc 1991; 23 (10): 1170-5
116. Yaginuma T. Progress and therapy of stress amenorrhea. Fertil Steril 1979; 32: 36-9
117. Shangold MM, Levine HS. The effect of marathon training upon menstrual function. Am J Obstet Gynecol 1982; 143 (8): 862-9
118. Webb JL, Millan DL, Stolz CJ. Gynecological survey of American female athletes competing at the Montreal Olympic Games. J Sport Med Phys Fitness 1979; 12: 405-12
119. Tomten SE, Høstmark AT, Strømme SB. Exercise intensity: an important factor in the etiology of menstrual dysfunction? Scan J Med Sci Sports 1996; 6: 329-36
120. Keizer HA, Platen P, Menheere PP. The hypothalamic/pituitary axis under exercise stress: the effects of aerobic and anaerobic training. In: Rogol A, Laron Z, editors. Hormones and sport. Serono Symposium Publications (vol. 55). New York: Raven Press, 1989: 101-15
121. Zaharieva E. Survey of sports women at the Tokyo Olympics. J Sports Med Phys Fitness 1965; 5: 215-9
122. Warren MP, Jeweewicz R, Dyren Furth I. The significance of weightloss in the evaluation of pituitary response to LH-RH in women with secondary amenorrhea. J Clin Endocrinol Metab 1975; 40: 601
123. Dixon G, Eurman P, Stern B. Hypothalamic function in amenorrheic runners. Fertil Steril 1984; 42: 377-83
124. Mougin C, Baulay A, Henriet MT. Assessment of plasma opioid peptides, β-endorphin and met-enkephalin, at the end of an international nordic ski race. Eur J Appl Physiol 1987; 56 (3): 281-6
125. Qian P. Menstrual dysfunction in Norwegian top athletes. Acta Obstet Gynecol Scand 1984; 63: 693-7
126. Güler F, Hasçelik Z. Menstrual dysfunction rate and delayed menarche in top athletes of team games. Sports Med Training Rehab 1993; 4(2): 99-106
127. Mesaki N, Sasaki J, Nabeshima Y. Decrease of pulsatile gonadotropin secretion in female athletes. Jpn J Phys Fitness Sports Med 1941; 40 (4): 365-71
128. Ronkainen H, Pakarinen A, Kauppila A. Pubertal and menstrual disorders of female runners, skiers and volleyball players. Gynecol Obstet Invest 1984; 18: 183-9
129. Kuipers H, Keizer HA. Overtraining in elite athletes: a review and directions for the future. Sports Med 1988; 6: 79-92
130. Keller N, Richardson UI, Yales FE. Protein binding and the biological activity of corticosteroids: the in vivo induction of hepatic and pancreatic alanine amnio-transferases by corticosteroids in normal and estrogen-treated rats. Endocrinology 1969; 84: 49
131. Pardridge W. Transport of protein-bound hormones into tissues in vivo. Endocr Rev 1981; 2 (1): 103-23
132. Berg A, Keul J. Physiological and metabolic responses of female athletes during laboratory and field exercise. In: Women and sport: series on medicine and sport 14. Basel: Karger, 1981: 125-40
133. Speroff L, Glass RH, Kase NG. Clinical gynaecological endocrinology and infertility. 3rd ed. Baltimore: Williams & Wilkins, 1983
134. Vervoorn C, Quist AM, Erich WR. Trainingsbegeleiding met hulp van hormoongegevens (Coaching and use of hormonal data) [English abstract]. Geneeskd Sport 1990; 23 (2): 65-73
135. Vervoorn C, Vermulst L, Boelens-Quist AM. Toepassing van hormoononderzoek bij trainingsbegeleiding van Nederlandse toproeisters (Application of hormonal investigation in the coaching of Dutch top-oarswomen) [English abstract]. Geneeskd Sport 1990; 23 (3): 87-96
136. Scott G, Tuttle WW. The periodic fluctuation in physical efficiency during the menstrual cycle. Res Q 1932; 3: 137-44
137. Bemben DA, Salm PC, Salm AJ. Ventilatory and blood lactate responses to maximal treadmill exercise during the menstrual cycle. J Sports Med Phys Fitness 1995; 35 (4): 257-62
138. De Bruyn-Prévost P, Masset C, Sturbois X. Physiological respouse from 18-25 years women to aerobic and anaerobic physical fitness tests at different periods during the menstrual cycle. J Sports Med Phys Fitness 1984; 24: 144-8
139. De Souza MJ, Maguire MS, Rubin KR. Effects of menstrual phase and amenorrhea on exercise performance in runners. Med Sci Sports Exerc 1990; 22 (5): 575-80
140. Higgs SZ, Robertson LA. Cyclic variations in perceived exertion and physical work capacity in females. Can J Appl Sport Sci 1981; 6(4): 191-6
141. 2 delivery, and performance during exercise. J Appl Physiol 1981; 51 (6): 1493-9
142. Stephenson LA, Kolka MA, Wilkerson JE. Perceived exertion and anaerobic threshold during the menstrual cycle. Med Sci Sports Exerc 1982; 14: 218-22
143. Frye AJ, Kamon E. Responses to dry heat of men and women with similar aerobic capacities. J Appl Physiol 1981; 50: 65-70
144. Kawahata A. Sex differences in sweating. In: Yoshimura EH, Ogata K, Itoh S. editors. Essential problems in climactic physiology. Kyoto: Nakado, 1960: 169-84
145. Schoene RB, Robertson HT, Pierson DJ. Respiratory drives and exercises in menstrual cycles of athletic and non-athletic women. J Appl Physiol 1981; 50 (6): 1300-5
146. Lebrun CM, McKenzie DC, Prior JC. Effects of menstrual cycle phase on athletic performance. Med Sci Sports Exerc 1995; 27 (3): 437-44
147. Lebrun CM. The effect of the phase of the menstrual cycle and the birth control pill in athlelic performance. Clin Sports Med 1994; 13: 419-41
148. Schoene RB, Pierson DJ, Lakshminaragavan S. Effect of medroxyprogesteroneacetate on respiratory drives and occlusion pressure. Bull Eur Physiopath Resp 1980; 16: 645-53
149. Keizer HA, Kuipers H, de Haan J. Multiple hormonal responses to physical exercise in eumenorrheic trained and untrained women. Int J Sports Med 1987; 8 Suppl. 3: 139-50
150. Lavoie J.-M, Dionne N, Helie R. Menstrual cycle phase dissociation of blood glucose homeostasis during exercise. J Appl Physiol 1987; 62 (3): 1084-9
151. Nicklas BJ, Hackney AC, Sharp RL. The menstrual cycle and exercise: performance, muscle glycogen and substrate responses. Int J Sports Med 1989; 10: 264-9
152. Achmed-Soraur H, Bailey CJ. Role of ovarian hormones in the long-term control of glucose homeostasis, glycogen formation and gluconeogenesis. Ann Nutr Metab 1981; 25: 208-12
153. Kendrick ZV, Ellis GS. Effect of estradiol on tissue glycogen metabolism and lipid availability in exercising male rats. J Appl Physiol 1991; 71 (5): 1694-9
154. Bonen A, Haynes FJ, Watson-Wright W. Effects of the menstrual cycle on metabolic responses to exercise. J Appl Physiol 1983; 55: 1506-13
155. Eston RG, Burke EJ. Effects of the menstrual cycle on selected responses to short constant-load exercise. J Sport Sciences 1984; 2 (2): 145-53
156. Lamont LS. Lack of influence of the menstrual cycle on blood lactate. Physician Sports Med 1986; 14: 159-63
157. Quadagno DL, Faquin L, Lim G-N. The menstrual cycle: does it affect athletic performance? Physician Sports Med 1991; 19: 121-4
158. Casper RF, Wilkinson D, Cotteral MA. The effect of increased cardiac output on luteal phase gonadal steroids: a hypothesis for runners' amenorrhea. Fertil Steril 1984; 41: 264-368
159. Khodiguian N, Farrar PA, Nguyen M. Effect of menstrual cycle on ligamentous knee joint laxity [abstract 965]. Med Sci Sports Exerc 1994; 26 (5 Suppl.): S172
160. Chen H, Tang Y. Effects of menstrual cycle on respiratory muscle function. Am Rev Resp Dis 1989; 140: 1359-62
161. Sarwar R, Beltran Niclos B, Rutherford OM. Changes in muscle strength, relaxation rate and fatiguahility during human menstrual cycle. J Physiol 1996; 493 (1): 267-72
162. Davies BN, Elford JC, Jamieson KF. Variations in performance of simple muscle tests at different phases of the menstrual cycle. J Sports Med Phys Fitness 1991; 31 (4): 532-7
163. Greeves JP, Cable NT, Luckas MJ. Effects of acute changes in oestrogen on muscle function of the first dorsal interosseus muscle in humans. J Physiol 1997; 500 (1): 265-70
164. Rice PL. Relationship of estrogen to strength, percent body fat and oxygen uptake in women. J Sports Med Phys Fitness 1988; 281: 45-50
165. Phillips SK, Rutherford OM, Birch K. Hormonal influences on muscle force: evidence for an inotropic effect of oestrogen. Sports Exerc Injury 1995; 1: 58-63
166. Dibrezzo RO, Fort IL, Brown B. Dynamic strength and work variations during three stages of the menstrual cycle. J Orthopaedic Sports Phys Ther 1988; 10: 113-6
167. Dibrezzo R, Fort IL, Brown B. Relationships among strength, endurance, weight and body fat during three phases of the menstrual cycle. J Sports Med Phys Fitness 1991; 31: 89-94
168. Gaebelein CJ, Senay Jr LC. Vascular volume dynamics during ergometer exercise at different menstrual phases. Eur J Appl Physiol 1982; 50 (1): 1-11
169. Nielsen B, Sjogaard G, Bonde-Petersen F. Cardiovascular, hormonal and body fluid changes during prolonged exercise. Eur J Appl Physiol 1984; 53: 63-70
170. Dombovy ML, Bonekat HW, Williams TJ. Exercise performance and ventilatory response in the menstrual cycle. Med Sci Sports Exerc 1987; 19: 111-7
171. Haymes EM. Physiological responses of female athletes to heat stress: a review. Med Sci Sports Exerc 1984; 12 (3): 45-59
172. Doskin VA, Kozeeva TV, Lisitskaya TS. Changes in working capacity of female athletes in different phases of the menstrual cycle. Hum Physiol 1980; 5: 144-9
173. Puretz SL. Menses and exercise: attitudes and actions. J Sports Med Phys Fitness 1986; 26: 140-5
174. Robertson LA, Higgs SL. Menstrual cycle variations in physical work capacity, post exercise blood lactate and perceived exertion [abstract]. Can J Appl Sport Sci 1983; 8: 220
175. Friedmann B, Kindermann W. Energy metabolism and regulatory hormones in women and men during endurance exercise. Eur J Appl Physiol 1989; 59 (1-2): 1-9
176. Eston RG. The regular menstrual cycle and athletic performance. Sports Med 1984; 1 (6): 431-45
177. Bolch OH, Warren JC. Induction of premature menstruation with anabolic steroids. Am J Obstet Gynecol 1973; 117 (1): 121-5
178. Donike M, Ueki M, Kuroda Y. Detection of dihydrotestosterone (DHT) doping: alterations in steroid profile and reference ranges for DHT and its 5α-metabolites. J Sports Med Phys Fitness 1995; 35 (4): 235-50
179. Sutton JR, Coleman MJ, Casey JH. Androgen responses during physical exercise. BMJ 1973; 1 (352): 520-2
180. Keizer HA, Beckers E, de Haan J. Exercise-induced changes in the percentage of free testosterone und estradiol in trained and untrained women. Int J Sports Med 1987; 8 Suppl. 3: 151-3
181. Brown WJ. Oestradiol response to exercise 'through the ages'. Aust J Sci Med Sport 1992; 24 (1): 18-24
182. Bunt JC. Metabolic actions of estradiol: significance for acute and chronic response. Med Sci Sports Exerc 1990; 22: 286-90
183. Bunt JC, Bahr JM, Bemben DA. Comparison of estradiol and testosterone levels during and immediately following prolonged exercise in moderately active and trained males and females. Endocr Res 1987; 13 (2): 157-72
184. Mesaki N, Sasaki J, Shoji M. Hormonal changes during incremental exercise in athletic women [English abstract]. Acta Obst Gynaec Jpn 1986; 38 (1): 45-52
185. Mesaki N, Sasaki J, Shoji M. Hormonal changes during continuous exercise in athletic women [English abstract]. Acta Obst Gynaec Jpn 1987; 39 (1): 63-9
186. Bullen BA, Skrinar GS Beitins IZ. Endurance training effects on plasma hormonal responsiveness and sex hormone excretion. J Appl Physiol 1984; 56 (6): 1453-63
187. Cumming DC, Rebar RW, Stern B. The effects of acute exercise on endocrine homeostasis. In: Rogol A, Laron Z, editors. Hormones and sport. Serono Symposium Publications (vol. 55). New York: Raven Press, 1989: 73-87
188. Galbo H. Hormonal and metabolic adaptation to exercise. Stuttgart: Georg Thieme Verlag, 1983
189. Baker ER, Mathur RS, Kirk RF. Plasma gonadotropins, prolactin and steroid hormone concentration in female runners immediately after a long distance run. Fertil Steril 1982; 38: 38-41
190. Brisson GR, Volle MA, De Caruifel D. Exercise dissociation of the blood prolactin response in young women according to sports habits. Horm Metab Res 1980; 12: 201-5
191. Chang FE, Dodds WG, Sullivan M. The acute effects of exercise on prolactin and growth hormone secretion: comparison between sedentary women and women runners with normal and abnormal menstrual cycles. J Clin Endocrinol Metab 1986; 62 (3): 551-6
192. Keizer HA, van Soest OP, Beckers E. Exercise-induced changes in estradiol metabolism and their possible physiological meaning. Med Sport 1981; 14: 141-7
193. Mesaki N, Motobu M, Sasaki J. Hypothalamic-pituitary function in female athletes [English abstract]. Jpn J Fertil Steril 1988; 33 (2): 291-6
194. Mesaki N, Sasaki J, Nabeshima Y. Exercise decreases the pulsatile secretion of luteinizing hormone. Jpn J Fertil Steril 1992; 37 (1): 16-21
195. Zichella L, Agatone S, Carilli I. Sport and reproduction in women. Med Sports 1981; 14: 209-15
196. Carr DB, Bullen BA, Skrinar GS. Physical conditioning facilitates the exercise-induced secretions of beta-endorphin and beta-lipotropin in women. N Engl J Med 1981; 305 (10): 560-3
197. Heitkamp H.-C, Huber W, Scheib K. β-Endorphin and adrenocorticotrophin after incremental exercise and marathon running: female responses. Eur J Appl Physiol 1996; 72 (5-6): 417-24
198. McMurray RG, Forsythe WA, Mar MH. Exercise intensity-related responses of β-endorphin and catecholamines. Med Sci Sports Exerc 1987; 19 (6): 570-4
199. Rakhila P, Hakala E, Salminen K. Responses of plasma endorphins to running exercises in male and female endurance athletes. Med Sci Sports Exerc 1987; 19 (5): 451-5
200. Rauramo I, Salminen K, Laatikainen T. Release of β-endorphin in response to physical exercise in non-pregnant and pregnant women. Acta Obstet Gynecol Scand 1986; 65 (6): 609-12
201. Troullos ES, Hargreaves KM, Goldstein DS. Epinephrine suppresses stress-induced increases in plasma immunoreactive β-endorphin in humans. J Clin Endocrinol Metab 1989; 69 (3): 546-51
202. Viswanathan M, Van Dijk JP, Graham TE. Exercise- and cold-induced changes in plasma β-endorphin and β-lipotropin in men and women. J Appl Physiol 1987; 62 (2): 622-7
203. Goldfarb AH, Jamurtas AZ. β-Endorphin response to exercise: an update. Sports Med 1997; 24 (1): 8-16
204. Mesaki N, Sasaki J, Motobu M. Effect of naloxone on hormonal changes during exercise. Acta Obst Gynaec Jpn 1989; 41 (12): 1991-8
205. Métivier G. Pituitary and gonadal secretory variations and control mechanisms during physical exercise. J Sports Med 1985; 25: 18-26
206. Yahiro J, Glass AR, Ferns WB. Exaggerated gonadotropin response to luteinizing hormone-releasing hormone in amenorrheic runners. Am J Obstet Gynecol 1987; 156 (3): 586-91
207. Sforzo GA. Opioids and exercise: an update. Sports Med 1989; 7 (2): 82-108
208. Platen P, Schenkmann A, Velde C. Effects of high voluminous training and hypocaloric diets on the hypothalamo-pituitary-thyroidal axis in female athleles (abstract). Med Sci Sports Exerc 1996; 28 (5 Suppl.): S25
209. Weltman JY, Veldhuis JD, Weltman AL. Reliability of estimates of pulsatile characteristics of luteinizing hormone (LH) and growth hormone (GH) release in women. J Clin Endocrinol Metab 1990; 71: 1646-52
210. Hornum M, Cooper DM. Brasel JA. Exercise-induced changes in circulating growth factors with cyclic variation in plasma estradiol in women. J Appl Physiol 1997; 82 (6): 1946-51
211. Shangold MM, Gatz ML, Thysen B. Acute effects of exercise on plasma concentrations of prolactin and testosterone in recreational women runners. Fertil Steril 1981; 35 (6): 699-702
212. De Crée C. The possible role of endogenous opioid peptides and catecholestrogens in provoking menstrual irregularities in women athletes. Int J Sports Med 1990; 11 (5): 329-48
213. De Crée C, Ball P, Seidlitz B, et al. Plasma 2-hydroxycatecholestrogen responses to acute submaximal and maximal exercise in untrained women. J Appl Physiol 1997; 82 (1): 364-70
214. De Crée C, Ball P, Seidlitz B, et al. Responses of catecholestrogen metabolism to acute graded exercise in normal menstruating women before and after training training. J Clin Endocrinol Melab 1997; 82 (10): 3342-8
215. De Crée C, Van Kranenburg G, Geurten P, et al. 4-Hydroxycatecholestrogen metabolism responses to exercise and training: possible implications for menstrual cycle irregularities and breast cancer. Fertil Steril 1997; 67 (3): 505-16
216. Bonen A, Keizer HA. Pituitary, ovary and adrenal hormone responses to marathon running. Int J Sports Med 1987; 8 Suppl. 3: 161-7
217. Bortz WW.-II, Angwin P, Meford IN. Catecholamines, dopamine, and endorphin levels during extreme exercise. N Engl J Med 1981; 305: 466-7
218. Cumming DC, Vickovic MM, Wall SR. The effect of acute exercise on pulsatile release of luteinizing hormone in women runners. Am J Obstet Gynec 1985; 153 (5): 482-5
219. Demers LM, Harrison TS, Halbert DR. Effect of prolonged exercise on plasma prostaglandin levels. Prostaglandins Med 1981; 6: 413-8
220. Hale RW, Kosasa T, Krieger J. A marathon: the immediate effect on female runners' luteinizing hormone, follicle stimulating hormone, prolactin, testosterone, and cortisone levels. Am J Obstet Gynccol 1984; 146 (5): 550-6
221. McArthur JW. Endorphins and exercise in females: possible connection with reproductive dysfunction. Med Sci Sports Exerc 1985; 17 (1): 82-8
222. Strassman RJ, Appenzeller O, Lewy AJ. Increase in plasma melatonin, β-endorphin, and cortisol after a 28.5 mile mountain race: relationship to performance and lack of effect of Naltrexone. J Clin Endocrinol Metab 1989; 69 (3): 540-5
223. Montagnani CF, Arena B, Maffuli N. Estradiol and progesterone during exercise in healthy untrained women. Med Sci Sports Exerc 1992; 24 (7): 764-8
224. Häkkinen K, Pakarinen A, Kyröläinen H. Neuromuscular adaptations and serum hormones in females during prolonged power training. Int J Sports Med 1990; 11 (2): 91-8
225. Kraemer WJ, Fleck SJ, Dziados JE. Changes in hormonal concentrations after different heavy-resistance exercise protocols in women. J Appl Physiol 1993; 75 (2): 594-604
226. Kraemer WJ, Gordon SE, Fleck SJ. Endogenous anabolic hormonal and growth factor responses to heavy resistance exercise in male and females. Int J Sports Med 1991; 12 (2): 228-35
227. Walberg-Rankin J, Franke WD, Gwazdaukas FC. Response of beta-endorphin and estradiol to resistance exercise in females during energy balance and energy restriction. Int J Sports Med 1992; 13 (7): 542-7
228. Weiss LW, Cureton KJ, Thompson FN. Comparison of serum testosterone and androstenedione responses to weight lifting in men and women. Eur J Appl Physiol 1983; 50 (3): 413-20
229. Cumming DC, Wall SR, Galbraith MA. Reproductive hormone responses to resistance exercise. Med Sci Sports Exerc 1987; 19 (3): 234-8
230. Kraemer R, Heleniak R, Tryniecki J. Follicular and luteal phase hormonal responses to low-volume resistive exercise. Med Sci Sports Exerc 1995; 27 (6): 809-17
231. Peltenburg AL, Erich WB, Thijssen JH. Sex hormone profiles of premenarcheal athletes. Eur J Appl Physiol 1984; 52 (4): 385-92
232. Carli G, Martinelli A, Balid L. The effect of swimming training on hormone levels in girls. J Sports Med 1983; 23: 45-50
233. Keizer HA. Hormonal responses in women as a function of physical exercise and training. Int J Sports Med 1987; 8 Suppl. 3: 137-74
234. Keizer HA, Kuipers H, de Haan J. Effect of a 3-month endurance training program on metabolic and multiple hormonal responses to exercise. Int J Sports Med 1987; 8 Suppl. 3: 154-60
235. Keizer HA, van Soest OP. Exercise-induced androgen responses in trained and untrained women. Exerc Physiol 1986; 2: 35-48
236. Tegelman R, Johansson C, Hemmingson P. Endogenous anabolic and catabolic steroid hormones in male and female athletes during off season. Int J Sports Med 1989; 10(2): 103-6
237. Broocks A, Pirke KM, Sschweiger U. Cyclic ovarian function in recreational athletes. J Appl Physiol 1990; 68 (5): 2083-6
238. Boyden TW, Pamenter RW, Stanforth P. Sex steroids and endurance running in women. Fertil Steril 1983; 39: 629-32
239. Russel JB, Mitchell D, Musey PI. The relationship of exercise to anovulatory cycles in female athletes: hormonal and physical characteristics. Obstet Gynecol 1984; 63 (4): 452-6
240. De Crée C, Ball P, Seidlitz B, et al. Effects of a training program on resting plasma 2-hydroxycatecholestrogen levels in eumenorrheic women. J Appl Physiol 1997; 83 (5): 1551-6
241. Snow R, Barbieri RL, Frisch R. Estrogen 2-hydroxylase oxidation and menstrual function among elite oarswomen. J Clin Endocrinol Metab 1989; 69 (2): 369-76
242. De Crée C, Van Kranenburg G, Geurten P, et al. Exercise-induced changes in enzymatic O-methylation of catcholestrogens by erythrocytes of normal menstruating females. Med Sci Sports Exerc 1997; 29 (12): 1580-7
243. Sanfilippo JS, Nealon NA. Relationship between beta endorphin and prolactin in female runners. Infertility 1985; 8 (1): 59-67
244. Westerlind KC, Byrnes WC, Freedson PS. Exercise and serum androgens in women. Physician Sports Med 1987; 15 (5): 87-94
245. Jenkins PJ, Ibanez-Santos X, Holly J. IGFBP-1: A metabolic signal associated with exercise-induced amenorrhea. Neuroendocrinology 1993; 57 (4): 600-4
246. Chandra AM, Patra PB, Chatterjee P. Adrenocortical activity in female rats following long-term exposure to treadmill running. Endokrinologie 1978; 72: 239-42
247. Chandra AM, Patra PB, Chatterjee P. Effect of longterm treadmill running on gonadal activity in female rats. Endokrinologie 1978; 72: 299-303
248. Casanueva FF, Borras CG, Burguera B. Steroids and neuroendocrine function in anorexia nervosa. J Steroid Biochem 1987; 27: 1-3
249. De Souza MJ, Maguire MS, Maresh CM. Adrenal activation and the prolactin response to exercise in eumenorrheic and amenorrheic runners. J Appl Physiol 1991; 70 (6): 2378-87
250. Ding JH, Sheckter CB, Drinkwater BL. High serum cortisol levels in exercise-associated amenorrhea. Ann Int Med 1988; 108: 530-4
251. Harber VJ, Sutton JR, Duncan MacDougal J. Plasma concentrations of β-endorphin in trained eumenorrheic and amenorrheic women. Fertil Steril 1997; 67 (4); 648-53
252. Hohtari H, Salminen-Lappalainen K, Laatikainen T. Response of plasma endorphins, corticotropin, cortisol, and luteinizing hormone in the corticotropin-releasing stimulation test in eumenorrheic and amoenorrheic athletes. Fertil Steril 1991; 55: 276-80
253. Hohtari H, Elovaino R, Salminen K. Plasma corticotropin-releasing hormone, corticotropin, and endorphin at rest and during exercise in eumenorrheic and amenorrheic athletes. Fertil Steril 1988; 50 (2): 233-8
254. Boyden TW, Pamenter RW, Grosso D. Prolactin responses, menstrual cycles and body composition of women runners. J Clin Endocrinol Metab 1982; 54 (4): 711-4
255. Rogol AD, Weltman A, Weltman JY. Durability of the reproductive axis in eumenorrheic women during 1 yr of endurance training. J Appl Physiol 1992; 72 (4): 1571-80
256. Boyden TW, Pamenter RW, Stanforth PR. Impaired gonadotropin responses to gonadotropin-releasing hormone stimulation in endurance-trained women. Fertil Steril 1984; 41: 359-63
257. Rogol AD, Weltman JY, Evans WS. Long-term endurance training alters the hypothalamic pituitary axes for gonadotropins and growth-hormone. Endocrinol Metab Clin North Am (Neuroendocrinology I) 1992; 21 (4): 817-32
258. Bonen A. Recreational exercise does not impair menstrual cycles: a prospective study. Int J Sports Med 1992; 13 (2): 110-20
259. Beitins IZ, McArthur JW, Turnbull BA. Exercise induces two types of human luteal dysfunction: confirmation by urinary free progesterone. J Clin Endocrinol Metab 1991; 72: 1350-8
260. Mesaki N, Sasaki J, Sohda S. Suppression by L-dopa of prolactin secretion during exercise in female athletes. Jpn J Fertil Steril 1991; 36 (4): 739-44
261. O'Herlihy C. Jogging and suppression of ovulation [letter]. N Engl J Med 1982; 306 (1): 50-1
262. Parr RB, Bachman LA, Moss RA. Iron deficiency in female athletes. Physician Sports Med 1984; 12 (4): 81-6
263. Burrow GN, Wortzman G, Rewcastle NB. Micro adenomas of the pituitary and abnormal sellar tomograms in an unselected autopsy series. N Engl J Med 1981; 304 (3): 156-8
264. Strauzenberg SE, Kassner R, Bohm R. Iron deficiency in female athletes. Med Sport 1981; 14: 200-8
265. Veldhuis JD, Evans WS, Demers LM. Altered neuroendocrine regulation of gonadotropin secretion in women distance runners. J Clin Endocrinol Metab 1985; 61 (3): 557-63
266. Soules MR, Clifton DK, Cohen NL. Luteal phase deficiency: abnormal gonadotropin and progesterone secretion patterns. J Clin Endocrinol Metab 1989; 69: 813-9
267. Soules MR, McLachlan RI, Ek ML. Luteal phase deficiency: characterization of reproductive hormones over the menstrual cycle. J Clin Endocrinol Metab 1989; 69: 804-12
268. Cumming DC, Vickovic MM, Wall SR. Defects in pulsatile LH release in normally menstruating runners. J Clin Endocrinol Metab 1985; 60 (4): 810-2
269. Loucks AB. Effects of exercise training on the menstrual cycle: existence and mechanisms. Med Sci Sports Exerc 1990; 22: 275-80
270. Warren MP. Amenorrhea in endurance runners. J Clin Endocrinol Metab 1992; 75 (6): 1393-7
271. Loucks AB, Heath EM, Law Sr T. Dietary restriction reduces luteinizing hormone (LH) pulse frequency during waking hours and increases LH pulse amplitude during sleep in young menstruating women. J Clin Endocrinol Metab 1994; 78 (4): 910-5
272. Loucks AB, Laughlin GA, Mortola JF. Hypothalamic-pituitary-thyroidal function in eumenorrheic and amenorrheic athletes. J Clin Endocrinol Metab 1992; 75 (2): 514-8
273. Frisch RE, Canick JA, Tulchinsky D. Human fatty marrow aromatizes androgen to estrogen. J Clin Endocrinol Metab 1980; 51: 394-6
274. De Crée C. Endogenous opioid peptides in the control of the normal menstrual cycle and their possible role in athletic menstrual irregularities. Obstet Gynecol Surv 1989; 44 (10): 720-32
275. Ellingboe J, Veldhuis JD, Mendelson JH. Effect of endogenous opioid blockade on the amplitude and frequency of pulsatile luteinizing hormone secretion in man. J Clin Endocrinol Metab 1982; 54: 854-7
276. Ruffin MT, Hunter RE, Arendt EA. Exercise and secondary amenorrhoea linked through endogenous opioids. Sports Med 1990; 10: 65-71
277. Russel JB, DeCherney AH, Collins DC. The effect of naloxone and metoclopramide on the hypothalamic pituitary axis in oligomenorrheic and eumenorrheic swimmers. Fertil Steril 1989; 52 (4): 583-8
278. Sheps DS, Koch G, Bradgon EE. The reproducibility of resting and post-exercise plasma β-endorphins. Life Sci 1981; 43 (9): 787-91
279. Grossman A, Moult PJ, McIntyre H. Opiate mediation of amenorrhea in hyperpolactinaemia and in weight-loss related amenorrhea. Clin Endocrinol 1982; 17: 379-88
280. 2α modulate acute responses of luteal cells to luteinizing hormone. Endocrinol 1982; 110 (1): 38-46
281. Gambacciani M, Yen SSC, Rasmussen DD. GnRH release from the mediobasal hypothalamus: in vitro inhibition by corticotropin-releasing factor. Neuroendocrinology 1986; 43 (4): 533-6
282. Genazzani AD, Petraglia F, Gastaldi M. Growth hormone (GH)-releasing hormone-induced GH response in hypothalamic amenorrhea: evidence of altered central neuromodulation. Fertil Steril 1996; 65 (5): 935-8
283. Laughlin GA, Yen SSC. Nutritional and endocrine-metabolic aberrations in amenorrheic athletes. J Clin Eindocrinol Metab 1996; 81 (12): 4301-9
284. Laughlin GA, Dominguez CE, Yen SS. Nutritional and endocrine-metabolic aberrations in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab 1998; 83 (1): 23-32
285. Hiney JK, Ojeda SR, Dees WL. Insulin-like growth factor I: a possible metabolic signal involved in the regulation of female puberty. Neuroendocrinology 1991; 54: 420-3
286. Laughlin GA, Yen SS. Hypoleptinemia in women athletes: absence of a diurnal rhythm with amenorrhea. J Clin Endocrinol Metab 1997; 82 (1): 318-21
287. Monahan T. Treating athletic amenorrhea: a matter of instinct. Physician Sports Med 1987; 15 (7): 184-9
288. De Crée C, Vermeulen A, Ostyn M. Are high-performance young women athletes doomed to become low-performance old wives? Reconsidering the increased risk for osteoporosis in female athletes. J Sports Med Phys Fitness 1991; 31 (1): 108-14
289. Loucks AB. Skeletal demineralization in the amenorrheic athlete. In: MacLeod D, Maughan R, Nimmo M. et al., editors. Exercise: benefits, limits and adaptations. London: E. & F. N. Spon. 1987: 255-69
290. Prior JC. Ovulation disturbances and exercise training. Clin Obstet Gynecol 1991; 34: 180-90
291. Genazzani AD, Petraglia F, Gastaldi M. Naltrexone treatment restores menstrual cycles in patients with weight loss-related amenorrhea. Fertil Steril 1995; 64 (5): 951-6
292. Barrow GW, Saha S. Menstrual irregularity and stress fractures in collegiate female distance runners. Am J Sports Med 1988; 16 (3): 209-16
293. Dugowson CE. Nontraumatic femur fracture in an oligomenorrheic athlete. Med Sci Sports Exerc 1991; 23 (12): 1323-5
294. Lloyd T, Triantafyllou SJ, Baker ER. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Med Sci Sports Exerc 1986; 18 (4): 374-9
295. Snead DB, Stubbs C, Weltman JY. Dietary patterns, eating behavior, and bone mineral density in women runners. Am J Clin Nutr 1992; 56: 705-11
296. Simon JR, Nilson KL. Repeated stress fractures in an amenorrheic marathoner. Physician Sports Med 1989; 17 (4): 65-71
297. American College of Sports Medicine. Position stand: the female athletic triad. Med Sci Sports Exerc 1997; 29 (5): i-ix
298. Chilibeck PD, Sale DG, Webber CE. Exercise and bone mineral density. Sports Med 1995; 19 (2): 103-22
299. Prior JC, Vigna YM, McKay DW. Reproduction for the athletic woman: new understandings of physiology and management. Sports Med 1992; 14 (3): 190-9
300. De Crée C, Lewin R, Ostyn M. The suitability of cyproterone acetate in the treatment of osteoporosis associated with athletic amenorrhea. Int J Sports Med 1988; 9 (3): 187-92