Abstract

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 osteoporosis 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 +/- 5.3) my-g/dl) than in eumenorrheic athletes (14.9 +/- 2.9 my-g/dl), nonathletic women (14.4 +/- 3.5 my-g/dl) and the transition group (13.7 +/- 3.2 my-g/dl). Of 9 women whose cortisol levels were abnormally high (> 21 my-g/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. Verf.-Referat