Over the past two decades women have increased their presence in male dominated sports (football-5x, wrestling-14x, baseball and weightlifting-4x in high school athletics). Studies suggest that high intensity vs lower intensity exercise pose specific endocrine and metabolic risks to the female athlete, which gynecologists should address during office visits.METHODS:
A PubMed review of articles and web reports was conducted on adverse medical consequences occurring to female athletes engaged in high intensity activities.RESULTS:
Weight fluctuations, such as in wrestling or weight lifting, commonly occur. Low energy intake from high protein, low carbohydrate diets for required muscle mass retention and growth may lead to increased risks of developing exercise-related delayed menarche, menstrual dysfunction (ExMD), poor bone health, muscle damage and changes in muscle repair processes, lipid and leptin changes and other adverse endocrine and metabolic changes. Additionally, ExMD has been linked to health consequences such as cardiovascular dysfunction, endothelial dysfunction, and abnormal metabolic hormonal profile. Of greatest immediate concern is the potential muscle damage and alterations in the muscle repair process caused by low estrogen levels, which can hinder athletes from obtaining their highest level of sports performance.CONCLUSION:
With several adverse consequences to female athletes resulting from high intensity sports, gynecologists should inquiry about sports participation to determine the type of sport (whether it is high impact, non-contact, etc.) dietary restrictions, body mass, menstrual issues, previous fracture and use of performance-enhancing drugs, hormones and anabolic steroids.