What is the role of body fat in the pathogenesis of amenorrhea?

Updated: Oct 14, 2019
  • Author: Kristi A Tough DeSapri, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Evidence suggests a negative correlation between body fat levels and menstrual abnormalities. A critical body fat level must be present for the reproductive system to function normally.

In some female athletes, the synergistic effects of excessive exercise and disordered eating cause severe suppression of GnRH, leading to low estradiol levels. The female athletic triad, as defined by the American College of Sports Medicine, is characterized by low energy availability with or without disordered eating, amenorrhea, and osteoporosis. [3] A 2009 study by DeSouza et al found that about half of exercising women could be amenorrheic. [8] Amenorrhea can be the initial presentation of female athlete triad. [9]

Anorexia nervosa is a serious psychiatric disease with severe medical complications including primary amenorrhea (15%), osteopenia (52%), and osteoporosis (35%). [10]

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