Energetic and Hormonal Predictors of Advanced Menstrual Recovery in Exercising Women with Oligo/Amenorrhea
Research Poster Health & Life Sciences 2025 Graduate ExhibitionPresentation by Ana Carla Chierighini Salamunes
Exhibition Number 112
Abstract
PURPOSE: To determine the predictors of advanced menstrual recovery (AMR), defined as experiencing two consecutive menstrual cycles of <36 days, in exercising women with functional hypothalamic oligo/amenorrhea (FHOA). METHODS: FHOA exercising women (21.8±0.7 years; n=25) from a 12-month randomized clinical trial that increased energy intake (+330±65 kcal/day) who experienced AMR were categorized as REC and otherwise non-REC. AMR predictors were measured at baseline (BL) and pre-recovery (PRE), i.e., the intervention time point that preceded AMR (REC) or the two last measured menstrual cycles (non-REC). Predictors were: body composition, energy intake, resting metabolic rate, daily urinary estrone-1-glucuronide (E1G) and pregnanediol glucuronide (PdG), and serum total triiodothyronine, insulin-like growth factor 1 (IGF-1), leptin, ghrelin, and peptide YY. T-tests, Mann-Whitney tests, and logistic regressions determined group differences and AMR predictors. RESULTS: BL fat mass (FM: 14.7±0.7 vs 11.6±0.7 kg, p<0.01) and %fat (25.7±1.0 vs 21.8±1.0 %, p<0.01), and FM at PRE (15.3±0.6 vs 13.4±0.5 kg, p=0.02) were higher in REC than non-REC. Leptin and IGF-1 at PRE were higher in REC than non-REC (7.5±1.3 vs 4.6±0.7 ng/mL, p=0.03; 273.1±13.5 vs 229.6±19.3 ng/mL, p=0.04). E1G and PdG increased only in REC (from 27.6±4.5 to 35.3±5.0 ng/mL, p<0.01; from 1.2±0.2 to 1.3±0.2 ng/mL, p<0.01). No other differences were observed. Predictors of AMR were BL %fat and FM, and FM and IGF-1 at PRE (p<0.05). CONCLUSION: AMR was associated with an increase in E1G and PdG. Fat may play an important role in AMR. IGF-1 and leptin are potential markers to monitor recovery from FHOA.
Importance
Recently, our laboratory demonstrated that experiencing at least two consecutive menstrual cycles of <36 days was necessary to improve reproductive hormone levels in energy deficient exercising women with menstrual disturbances (absent or irregular menstrual cycles). Based on those findings, my research is the first to investigate the metabolic and energetic predictors of an advanced level of menstrual recovery. My research demonstrates the importance of increasing fat mass in order to achieve high-quality menstrual recovery. Additionally, I am the first to demonstrate that insulin-like growth factor 1 (IGF-1) and leptin are likely the best blood markers to be monitored clinically and in research when the goal is to improve reproductive function in energy deficient exercising women.