Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training.

IF 11.6 1区 医学 Q1 SPORT SCIENCES
Kristin L Popp, Brittany N Bozzini, Marinaliz Reynoso, Jennifer Coulombe, Katelyn I Guerriere, Susan P Proctor, Colleen M Castellani, Leila A Walker, Nicholas Zurinaga, Katherine Kuhn, Stephen A Foulis, Mary L Bouxsein, Julie M Hughes, Nanette Santoro
{"title":"Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training.","authors":"Kristin L Popp, Brittany N Bozzini, Marinaliz Reynoso, Jennifer Coulombe, Katelyn I Guerriere, Susan P Proctor, Colleen M Castellani, Leila A Walker, Nicholas Zurinaga, Katherine Kuhn, Stephen A Foulis, Mary L Bouxsein, Julie M Hughes, Nanette Santoro","doi":"10.1136/bjsports-2023-107716","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression.</p><p><strong>Methods: </strong>In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT.</p><p><strong>Results: </strong>Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m<sup>2</sup>). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity.</p><p><strong>Conclusions: </strong>Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1052-1060"},"PeriodicalIF":11.6000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Sports Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bjsports-2023-107716","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression.

Methods: In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT.

Results: Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m2). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity.

Conclusions: Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.

下丘脑-垂体-卵巢轴抑制在美国陆军基础战斗训练期间的女性中很常见。
目的:不到一半的女军人报告在初始军事训练期间月经消失。然而,自我报告的月经状况可能无法准确反映下丘脑-垂体-卵巢(HPO)轴的抑制情况,并可能低估军事训练对生殖健康的影响。我们的目的是描述未使用激素避孕药的女性在美国陆军基础作战训练(BCT)期间的 HPO 轴功能,并探索 HPO 轴抑制的潜在因素:在这项为期 10 周的前瞻性观察研究中,我们招募了参加 BCT 的多种族女性。受训者在 BCT 期间提供每日清晨排空的尿液和每周的血液样本。通过化学发光测定法(西门子 Centaur XP)测量尿液中的黄体生成素、卵泡刺激素、雌二醇和孕酮代谢物,以确定激素模式和黄体活动。我们在 BCT 开始和结束时通过双能 X 射线吸收测定法测量了身体成分:受训人员(55 人)都很年轻(平均年龄(95% CI):22(22,23)岁),平均体重指数(23.9(23.1,24.7)千克/平方米)。大多数学员(78%)在 BCT 前月经周期规律。在 BCT 期间,23 名学员(42%)报告月经规律。但是,只有 7 名学员(12.5%)的月经周期有黄体活动证据(ELA)(即推测排卵),所有学员的黄体期都缩短了。41 名学员(75%)没有黄体活动迹象(NELA),7 名学员(12.5%)的黄体活动迹象不确定。总体而言,在 BCT 期间,女性的体重和瘦肉量增加,但脂肪量减少。体重和组成的变化似乎与黄体活动无关:我们的研究结果表明,在 BCT 期间,大多数妇女的 HPO 轴受到 NELA 的严重抑制。这种 HPO 轴抑制发生在月经周期正常的女性中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
27.10
自引率
4.90%
发文量
217
审稿时长
3-8 weeks
期刊介绍: The British Journal of Sports Medicine (BJSM) is a dynamic platform that presents groundbreaking research, thought-provoking reviews, and meaningful discussions on sport and exercise medicine. Our focus encompasses various clinically-relevant aspects such as physiotherapy, physical therapy, and rehabilitation. With an aim to foster innovation, education, and knowledge translation, we strive to bridge the gap between research and practical implementation in the field. Our multi-media approach, including web, print, video, and audio resources, along with our active presence on social media, connects a global community of healthcare professionals dedicated to treating active individuals.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信