Acta Scientiarum Polonorum Technologia Alimentaria

Background. Some factors which have been considered to be responsible for female athlete triad include the specific type and amount of high intensity training in young female athletes (especially when begun before puberty), reduced body weight, a lower percentage of fat tissue, and psychological stress. The aim of this study is to estimate the risk of amenorrhoea in female athletes with menstrual irregularity, on the basis of body composition results, nutritional factors, and endocrine factors.

Material and methods. Fifty-five female professional athletes with menstrual irregularities, of mean ages 17.9 ±2.1 years, with mean training histories of 5.8 ±2.6 years, and BMIs of 20.6 ±1.4 kg/m² participated in the study. The first group (ED) included athletes from endurance disciplines (n = 30), while the second group (WD) consisted of females from weight category disciplines (n = 25). A second classification was also employed, distinguishing between the group of athletes (IH) with luteinizing hormone to follicle-stimulating hormone ratio LH/FSH < 0.6 (n = 24) – diagnosed as hypofunction of the hypothalamus-pituitary axis – and a second group (GR) containing athletes with LH/FSH > 0.6, diagnosed as a good result (n = 31). Nutritional status was evaluated on the basis of body composition analysis using the BIA method employing a Harpenden skinfold callipers, which yielded measurements of the percentage of adipose tissue (FM), fat-free mass (FFM), and skinfold thickness (ST). Nutritional values were estimated by examining dietary records for 7 consecutive days, and using threefold recall for the last 24 h. Moreover, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E), progesterone (P), and serum leptin levels were measured.

Results. Significant differences were found between the hormone levels of for each discipline group: for LH, the ED group had 3.6 ±2.5 mlU/ml, and the WC group had 5.4 ±2.4 mlU/ml (p < 0.05), while for FSH, the values were ED: 5.0 ±1.8 mlU/ml, WC: 6.3 ±1.5 mlU/ml
(p < 0.05). Furthermore, IH athletes had significantly lower LH levels compared with GR athletes (IH: 2.8 ±0.9 mlU/ml, GR: 6.2 ±2.7 mlU/ml, p < 0.05). FSH, LH, LH/FSH, and leptin levels were positively correlated with energy and intake of most nutrients. These results again confirm the strong influence of anthropometric parameters (BMI: r = 0.85, ST: r = 0.43, p < 0.05), body composition (FM%: r = 0.79, FFM%: r = –0.79, p < 0.05), and age at menarche (r = –0.39, p < 0.05) on serum leptin levels in IH athletes.

Conclusion. Improperly balanced diets, low fat mass, and low leptin levels are factors which predispose to amenorrhoea. Furthermore, a gonadotropin level suggestive of hypothalamic-pituitary axis hypofunction, and positively correlated with energy intake and with leptin level, is a further factor conducive to amenorrhoea.