Hyperandrogenism in female athletes with functional hypothalamic amenorrhea: A distinct phenotype

International Conference on Sports Medicine and Fitness

March 23-25, 2015 Chicago, USA

Asma Javed, Rahul Kashyap and Aida N Lteif

Posters-Accepted Abstracts: J Sports Med Doping Stud

Abstract :

This study was conducted to compare the reproductive, metabolic and skeletal profiles of young athletic women (15-30 years of age) with functional hypothalamic amenorrhea (FHA) as well as clinical or biochemical hyperandrogenism (FHAEX+ HA) with BMI matched women with FHA due to exercise (FHA-EX) or anorexia nervosa (FHA-AN) alone. The main outcomes assessed included reproductive hormone profile such as LH, FSH, total testosterone, pelvic ultrasound features, metabolic function and skeletal health markers such as number of stress fractures and bone mineral density (BMD) as assessed by spine DXA z-scores. FHA-EX+HA were older at diagnosis compared to the other groups with a median (IQR) age of 22 (18.75-25.25) years vs. 17.5 (15.75-19) for FHA-EX; (P<0.01) and 18 (16-22.25) for FHA-AN (P=0.01). There were no differences among the groups based on the number of hours of exercise per week, type of physical activity or duration of amenorrhea. Median (IQR) LH/FSH ratio was higher in FHA-EX+HA than both other groups, 1.44 (1.03-1.77) vs. 0.50 (0.20- 0.94) for FHA-EX and 0.67 (0.51-0.87) for FHA-AN (P<0.01 for both). Total testosterone concentrations were not different among the groups. Median (IQR) fasting serum glucose concentration was higher in FHA-EX+HA vs. FHA-EX, 88.5 (82.8-90) vs. 83.5 (78.8-86.3) (P=0.01) but not different from FHA-AN (P=0.31). Percentage of women with stress fractures was lower in FHA-EX+HA (4.5%) as compared to both FHA-EX (27.3%) and FHA-AN (50%); P=0.04 and 0.002 respectively. The LH/FSH ratio was positively associated with serum glucose (r=0.29; P=0.02) as well as with DXA spine score (r=0.39; P=0.049) in the entire cohort. In a small cohort of female athletes with hyperandrogenism, a distinct reproductive hormone profile consisting of higher LH to FHS ratio may be associated with adverse metabolic health markers but improved skeletal health.