Менструальна функція та жіноча спортивна тріада

Abstract

Менструальна функція як компонент жіночої спортивної тріади включає широкий спектр порушень та представлена у вигляді дефектів лютеїнової фази, ановуляції, олігоменореї та аменореї різної тяжкості. Представлено огляд наукових статей, котрі характеризують вивчення порушень менструальної функції у спортсменок. Проаналізовано важливість підвищення освіченості майбутніх фахівців фізичного виховання та спорту з цієї проблеми.

Menstrual dysfunction in the female athlete includes a wide spectrum of disorders. The most commonly discussed is amenorrhea, or absence of menstrual cycle, that can be divided into primary and secondary. Primary amenorrhea, or delayed menarche, may be present in female athletes who begin training before puberty, and is defined in an athlete with absence of menstruation by the age of 15. Secondary amenorrhea occurs in postmenarchal athletes who lack three or more consecutive cycles after menarche. In female athletes is also frequent the occurrence of irregular cycles or oligomenorrhea (six or fewer cycles per year). Anovulation and luteal phase deficiency, with ovulation but inadequate progesterone support for endometrial development, may also occur. Menstrual cycle problems result from the suppression of the pulsatile secretion of hypothalamic gonadotrophin-releasing hormone (GnRH), which leads to a reduced secretion of luteinizing hormone and follicle stimulating hormone, thus preventing ovarian stimulation, and causing a fall in the levels of estrogens and progesterone. The aethiology of functional hypothalamic amenorrhea associated with exercise and stress could be mainly a consequence of the inhibition of GnRH release and the loss of luteinizing hormone pulsatility, dependent on low leptin levels. Menstrual dysfunction is not caused by stress or a low proportion of body fat, but results from the disruption of the GnRH pulse generator as a consequence of low energy availability. For prevention and early intervention, education of athletes, parents, coaches, trainers, judges, and administrators is a priority. All must understand that the body has no mechanisms for automatically adjusting energy intake to energy expenditure by the working muscle. Preventive measures should include optimization of energy availability and counseling on nutritional requirements according to age. Sport administrators should also consider rule changes to discourage unhealthy weight loss practices. The first aim of treatment for any Triad component is to increase energy availability by increasing energy intake and/or reducing exercise energy expenditure. The review of scientific articles that describe the study of the problem of menstrual function. Analyzed the importance of improving education of future specialists in physical education and sport on this issue.