Key result
Functional hypothalamic amenorrhea was associated with lower baseline flow-mediated dilation (2.8%) vs active ovulatory controls (8.8%, P<.05), which improved after acute exercise.
Why the study?
Does an acute bout of moderate-intensity exercise improve vascular function in physically active premenopausal women with functional hypothalamic amenorrhea?
Observational (n=41)
Does an acute bout of moderate-intensity exercise improve vascular function in physically active premenopausal women with functional hypothalamic amenorrhea?
Absolute Event Rate: 2.8% vs 8.8%
p-value: p=<.05
Acute dynamic exercise improves vascular function in premenopausal women with functional hypothalamic amenorrhea, suggesting that low shear rate and increased vasoconstrictor tone contribute to their impaired basal vascular function.
Acute exercise may improve FMD in FHA; hypothesis-generating and requires prospective confirmation before practice change.
INTRODUCTION: Exercise-trained hypoestrogenic premenopausal women with functional hypothalamic amenorrhea (ExFHA) exhibit impaired endothelial function. The vascular effects of an acute bout of exercise, a potent nitric oxide stimulus, in these women are unknown. METHODS: Three groups were studied: recreationally active ExFHA women (n = 12; 24.2 ± 1.2 years of age; mean ± SEM), and recreationally active (ExOv; n = 14; 23.5 ± 1.2 years of age) and sedentary (SedOv; n = 15; 23.1 ± 0.5 years of age) ovulatory eumenorrheic women. Calf blood flow (CBF) and brachial artery flow-mediated dilation (FMD) were evaluated using plethysmographic and ultrasound techniques, respectively, both before and 1 hour after 45 minutes of moderate-intensity exercise. Endothelium-independent dilation was assessed at baseline using glyceryl trinitrate. Calf vascular resistance (CVR) and brachial peak shear rate, as determined by the area under the curve (SRAUCpk), were also calculated. RESULTS: FMD and glyceryl trinitrate responses were lower (P < .05) in ExFHA (2.8% ± 0.4% and 11.6% ± 0.7%, respectively) than ExOv (8.8% ± 0.7% and 16.7% ± 1.3%) and SedOv (8.0% ± 0.5% and 17.1% ± 1.8%). SRAUCpk was also lower (P < .05) in ExFHA. Normalization of FMD for SRAUCpk (FMD/SRAUCpk) did not alter (P > .05) the findings. CBF was lower (P < .05) and CVR higher (P < .05) in ExFHA. After exercise, FMD and SRAUCpk were augmented (P < .05), but remained lower (P < .05), in ExFHA. FMD/SRAUCpk no longer differed (P > .05) between the groups. CBF in ExFHA was increased (P < .05) and CVR decreased (P < .05) to levels observed in ovulatory women. CONCLUSIONS: Acute dynamic exercise improves vascular function in ExFHA women. Although the role of estrogen deficiency per se is unclear, our findings suggest that low shear rate and increased vasoconstrictor tone may play a role in impaired basal vascular function in these women.
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O’Donnell et al. (2014) conducted an observational in Functional hypothalamic amenorrhea (n=41). Functional hypothalamic amenorrhea (ExFHA) and acute moderate-intensity exercise vs. Ovulatory eumenorrheic women (active and sedentary) was evaluated on Brachial artery flow-mediated dilation (FMD) (p=<.05). Functional hypothalamic amenorrhea was associated with lower baseline flow-mediated dilation (2.8%) vs active ovulatory controls (8.8%, P<.05), which improved after acute exercise.
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