Menstrual Dysfunction and Hyperandrogenism Linked to Competitive Adolescent Swimmers

The intense training programs found in elite youth athletics today prior to, and during puberty, may have a significant effect on the sexual maturation of female athletes.

The intense training programs found in elite youth athletics today prior to and during puberty may have a significant effect delayed menstruation, menstrual irregularities, and sexual maturation of female athletes. Menstrual conditions may be influenced by the intensity and volume present in particular sports training programs, as well as already existing genetic factors. Current research is finding more and more that menstrual dysfunction and amenorrhea are becoming more problematic among elite female athletes today.

New research in the Journal of Fertility and Sterility, assessed eighteen elite swimmers in an intensive swimming program. Researchers reviewed clinical hormonal and pubertal development, and found a significant percentage of swimmers’ had hyperandrogenism and oligomenorrhea, which is usually associated with polycystic ovary syndrome.

Another somewhat older yet similar study, in the Journal of Clinical Endocrinology & Metabolism, examined the menstrual history of 69 competitive youth swimmers. Results indicated that first menstruation was significantly delayed in the these elite swimmers. Researchers found that a staggering 82% of the swimmers studied had long-term, serious menstrual irregularities. To further validate and understand these findings, researchers extensively studied a selected group of 24 of the original 69 swimmers. Measurements were taken examining body composition, pubertal stage, and reproductive hormone levels. Research results indicated these selected competitive swimmers were much more vulnerable to delayed puberty and irregular menstrual cycles. Researchers noted that the hormonal dysfunction found in elite female swimmers was a different dysfunction than that found in hypothalamic amenorrhea, which is associated with Female Athlete Triad and other sports.

Although it is not is not clear from the research the exact etiology of the hyperandrogenism and menstrual dysfunction present in swimmers, researchers suggest that delayed menstruation might also be the result of genetic factors. They assert that possibly these athletes might be recruited by coaches or select sports that are associated with their body composition. Researchers explain that body composition is strongly associated with delayed menstruation and menstrual irregularities, especially in elite athletes. Researchers hypothesize that possibly an intensive swimming regime along with genetic factors may in turn, facilitate the expression of hyperandrogenism.

More in-depth research should be conducted to determine if a reduction in intensive training alters the menstrual cycle and changes the endocrine and metabolic levels of elite female swimmers. Researchers should also examine and compare a larger demographic of swimmers with other elite female sports associated with hyperandrogensim and menstrual dysfunction.