Exercise-associated secondary amenorrhea in physically active women linked to cardiovascular disease: JAHA

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2024-04-02 20:00 GMT | Update On 2024-04-03 07:08 GMT

Canada: A recent systematic review and meta-analysis has shed light on the impact of secondary amenorrhea on cardiovascular disease (CVD) risk in physically active women. The findings were published online in the Journal of the American Heart Association.

Observational studies linked secondary amenorrhea to several cardiovascular (CV) risk factors in physically active women.

"Estrogen deficiency resulting from exercise-associated secondary amenorrhea in physically active women may affect CV physiology and certain CVD risk factors," the researchers wrote. However, they noted that research in the area is observational, and findings should be interpreted cautiously.

They add, "As exercise-associated amenorrhea is reversible and primary prevention of cardiovascular disease is important for public health, it may be important to treat secondary amenorrhea and restore estrogen levels.

Exercise-associated secondary amenorrhea leads to estrogen deficiency, which may result in dysfunction in estrogen's normal cardioprotective pathways. Estrogen may be essential in a woman's endothelial adaptations to exercise. Nicole L. Tegg, Faculty of Nursing University of Alberta Edmonton Alberta Canada, and colleagues aimed to assess the association between secondary amenorrhea in physically active women and CVD risk.

For this purpose, the researchers performed a literature search in January 2023 and updated in August 2023 of the online databases from inception to present with no date or language limitations. Citation chaining was done to screen for additional studies. Eight sources were searched for gray literature.

The review included studies that compared physically active women with amenorrhea to physically active women with eumenorrhea aged 18 to 35 years with evidence of cardiovascular disease, alterations to cardiovascular physiology, or CVD risks. Eighteen observational studies from three countries were included. The quality of evidence was good overall.

"Physically active women with secondary amenorrhea had significantly lower estradiol, resting heart rate, flow-mediated dilation, systolic blood pressure, and diastolic blood pressure and higher total cholesterol, high-density lipoprotein, triglycerides, and low-density lipoprotein cholesterol," the researchers reported.

In conclusion, the systematic review and meta-analysis found that functional hypothalamic amenorrhea may obviate CV benefits of exercise and may adversely impact CV physiology and certain CVD risk factors, including, endothelial function and lipid profiles.

The findings highlight a need to further investigate the long-term CV consequences of hypoestrogenemia. Given the hormonal profiles of athletes with amenorrhea (AAs) and the evidence suggesting AAs may demonstrate increased CVD risk factors, determining the causative factor of amenorrhea is important so that appropriate interventions may be explored to restore menses and thereby, estrogen levels.

.Finally, increasing awareness of the CV health consequences linked with energy deficiency is of paramount importance.

"There is a need for high-quality, large‐scale longitudinal studies to investigate the underlying relationships between secondary amenorrhea and the development of cardiovascular diseases and to increase the understanding of the clinical relevance of findings in this area," the researchers wrote.

Reference:

Tegg NL, Myburgh C, O'Donnell E, Kennedy M, Norris CM. Impact of Secondary Amenorrhea on Cardiovascular Disease Risk in Physically Active Women: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2024 Mar 18:e033154. doi: 10.1161/JAHA.123.033154. Epub ahead of print. PMID: 38497482.

Article Source : Journal of the American Heart Association

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Medha Baranwal

Comments Policy

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

Exercise-associated secondary amenorrhea in physically active women linked to cardiovascular disease: JAHA

Similar News

Dapagliflozin reduced mortality risk in aortic stenosis patients undergoing TAVI: Study

Tirzepatide Matches dulaglutide in Heart Protection, Offers Added Benefits in SURPASS-CVOT trial

Subclinical Primary Aldosteronism Raises Risk of MACE Even With Normal BP, Suggests Study

Brisk Walking Just 15 Minutes a Day May Cut Death Risk by 20 Percent: Study Finds

Kidney Injury Significantly Increases Hypertension Risk, Study Finds

Medical Bulletin 31/July/2025

Study compares common type 2 diabetes drugs, finding higher cardiovascular risk for one medication: JAMA

Ventricular Arrhythmias in Sarcoidosis Linked to Triple Mortality Risk and Higher Device Implantation Rates: Study