title: Athletic amenorrhea and endothelial dysfunction.
abstract: OBJECTIVE
  To determine if menstrual status changed in amenorrheic college runners over a 2-year period and what effect this had on brachial artery flow-mediated dilation.
  
  
  METHODS
  Eighteen athletes first studied in our laboratory 2 years prior were available for follow-up. Nine of the 10 original women with athletic amenorrhea (mean +/- SE, age 21.3 +/- 1.2 yrs), and 9 of the 11 eumenorrheics/controls (age 20.1 +/- 0.5 yrs) were studied 2 years after baseline measurements.
  
  
  METHODS
  Questionnaires/personal interviews and blood draws were performed to determine menstrual status. A non-invasive ultrasound technique was used to determine brachial artery flow-mediated dilation (endothelium-dependent).
  
  
  RESULTS
  Menstrual status changed in 7 of 9 original amenorrheic subjects (2 were taking hormone replacement, 2 were taking oral contraceptives, 3 had a natural menstrual period prior to testing, and 2 remained amenorrheic). Endothelium-dependent brachial artery dilation, measured as the percent change in maximal brachial artery diameter from baseline during reactive hyperemia, was improved in the original amenorrheic subjects (a 1.1% +/- 1.0 increase in the original study versus 5.6% + 1.1 increase in the current study, P=0.01) while in the eumenorrheic/control group there was no change (6.3% +/- 1.7 versus 8.0% +/- 1.3, P=0.42).
  
  
  CONCLUSIONS
  Menstrual status changed in 7 of the 9 original amenorrheic athletes, and this change was associated with an improvement in brachial artery flow-mediated dilation.
authors.affiliation: Department of Orthopaedic Surgery/Cardiovascular Center, 9200 W Wisconsin Ave, Medical College of Wisconsin, Milwaukee 53226, USA. azeni@mcw.edu
authors.forename: Anne Z
authors.initials: AZ
authors.lastname: Hoch
authors.forename: Jason W
authors.initials: JW
authors.lastname: Jurva
authors.forename: Megan A
authors.initials: MA
authors.lastname: Staton
authors.forename: Robert
authors.initials: R
authors.lastname: Thielke
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Hoffmann
authors.forename: Nick
authors.initials: N
authors.lastname: Pajewski
authors.forename: David D
authors.initials: DD
authors.lastname: Gutterman
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D004108:Dilatation, Pathologic; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D007407:Interviews as Topic; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D012420:Running / Q000502:physiology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014664:Vasodilation; D014922:Wisconsin; D016387:Women's Health