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Case study: Resumption of eumenorrhea in parallel with high training load after 4 years of menstrual dysfunction: a 5-year follow-up of an elite female cyclist

Areta, J Case study: Resumption of eumenorrhea in parallel with high training load after 4 years of menstrual dysfunction: a 5-year follow-up of an elite female cyclist. International Journal of Sport Nutrition and Exercise Metabolism. ISSN 1526-484X (Accepted)

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Abstract

The female athlete triad is a condition where low energy availability is typically observed together with menstrual dysfunction and/or low bone mineral density. How this condition affects maximal work capacity in endurance athletes is not clear and the recovery time-course of menses with increased energy availability with concomitant high training load is unknown. This case-study of an amenorrheic elite road-cyclist reports resumption of normal menstrual function after weight-gain during a 5-year period (2014-2019) while engaged in high training load and competition. The athlete (VO2max 3.54 L/min, 64 ml/min/kg, PPO 300 W, 5.4 W/kg) reported amenorrhea(2013-2015)/oligomenorrhea(2015-2018). Training load increased from 2014 to 2019 (584 to 818 h/year and 26707 to 41945 Training Stress Score/year). Regular menses (every 23-35 days) resumed in June 2018, ~5-6 months after a weight gain episode. During the period of menstrual dysfunction body mass was 51.3 ±2.25 kg (mean ±95% CL), and fat percentage 19% (Dual-energy X-ray Absorptiometry (DXA), 2016), and after weight gain, 56.8 ±2.63 kg and fat percentage 25% (DXA, 2019). Crank-based power-meter data showed absolute mean maximal power (MMP; watts) improvement over the 5s-4 h range through the 2014-2019 period, while relative MMP (watts/kg) likely peaked in the 2015-16 season for 5min, 20min and 30min but remained mostly unchanged across seasons. Results suggest that: 1)Best relative power-output associated with aerobic capacity (5min-1h) can be achieved during menstrual dysfunction, 2)High performance achieved despite an increase in body mass, and 3)Resumption of menses is achievable while maintaining high training loads when coupled with high energy availability.

Item Type: Article
Additional Information: Accepted author manuscript version reprinted, by permission, from International Journal of Sport Nutrition and Exercise Metabolism, 2020 (ahead of print). © Human Kinetics, Inc.
Uncontrolled Keywords: 1106 Human Movement and Sports Sciences
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
R Medicine > RG Gynecology and obstetrics
Divisions: Sports & Exercise Sciences
Publisher: Human Kinetics
Date Deposited: 28 Jan 2020 11:24
Last Modified: 28 Jan 2020 11:30
URI: http://researchonline.ljmu.ac.uk/id/eprint/12112

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