运动性闭经机理的探讨

测定运动后闭经及月经正常的运动员和非运动员的血清考的松、雌二醇、孕酮和催乳素,作者认为血清考的松升高可能是运动后闭经原因之一。同时还发现,运动后闭经运动员血清考的松升高的同时,骨密度减少。

THE MECHANISMS OF EXERCISE ASSOCIATED WITH AMENORRHEA

Women engaged in vigorous athletics commonly experience amenorrhea and may develop decreased bone density by mechanisms which are poorly understood. Since glucocorticoids suppress reproductive function and cause osteopor0sis in various settings, we measured serum cortisol, mineral density of lumbar bone and reproductive hormones in 4 groups: amenorrheic (>1 year)athletes (n=19); eumenorrheic athletes (n=35); normal cyclic nonathletes (n=10); and a transition group of amenorrheic athletes who resumed menses within 6 months of study entry (n=7). Mean (±SEM) weekly serum cortisol levels were significantly higher (p<0.01) in amenorrheic athletes (21.2±5.3μg/dl) than in eumenorrheic athletes (14.9±2.9μg/dl), nonathletic women (14.4±3.5 μg/dl) and the transition group (13.7±3.2μg/dl). Of 9 women whose cortisol levels were abnormally high (>21μg/dl), 8 were amenorrheic and 1 was a eumenorrheic athlete. Bone mineral density was significantly lower(p<0.01) in amenorrheic athletes than in the other three groups. These data suggest that increased glucocorticoid levels may be an etiologic factor in women associated with exercise amenorrhea and could also contribute to their decreased bone density. It is difficult to regain menses within 6 months in amenorrheic athletes with hypercortisolemia.