Menstrual disorders and their association with stress, cortisol levels and physical activity in athletic and non-athletic girls

Background and Aims: Menstrual disorders contribute significantly to infertility.The relationship between psychological stress, cortisol levels, physical activity, and these disorders remains unclear.The aim of this study was to compare menstrual disorders and their association with stress, cortisol, and physical activity in female athletes and non-athletes. Materials and Methods:In this case-control study, a total of 60 young girls aged 18 to 25, each with at least two menstrual disorders, were evaluated in two groups: athletes (VO2max > 40, 30 participants) and nonathletes (30 participants).We assessed the type of menstrual disorder, level of physical activity, perception of stress using the Cohen scale, and salivary cortisol levels.Results: There was no significant difference in the prevalence of menstrual disorders between the two groups (P<0.05).Dysmenorrhea and menorrhagia were common in both groups.However, hypomenorrhea and amenorrhea were more common in athletic girls with high cortisol levels, while oligomenorrhea was more common in non-athletic girls with high stress (P<0.05).In non-athletic girls, a higher level of physical activity correlated with a decrease in dysmenorrhea, stress, and cortisol levels (P<0.05).In female athletes, longer daily training and higher training frequency were associated with an increased risk of amenorrhea and a reduced risk of metrorrhagia, respectively.Conversely, there was a significant negative correlation between a history of exercise and stress and cortisol levels (P<0.05). Conclusion:A high level of physical activity in non-athletic girls and a long history of sports in athletic girls may be effective in reducing cortisol and stress and thus reducing the incidence of some menstrual disorders.For female athletes, prolonged daily exercise should be more considered by coaches and athletes to prevent the occurrence of some menstrual disorders.