Menstrual Profiles and Cardiovascular Markers Among a Cohort of Female Adolescent Athletes

Abstract Amenorrhea in female athletes may be associated with cardiovascular disease risk factors. We aimed to implement a rigorous methodology to confirm menstrual status and examine differences in lipid and inflammatory markers between amenorrheic and eumenorrheic adolescent athletes. We included 13–18-year-old participants who were over 1-year post-menarchal and not using hormonal medications. Participants reporting≥9 menstrual periods in the prior year underwent a prospective methodology to be classified as eumenorrheic. Those reporting no menstrual period for more than three consecutive months prior to enrollment were classified as amenorrheic. We compared lipid and inflammatory markers between eumenorrheic and amenorrheic groups. There were 32 participants included (n=12 eumenorrheic; n=10 amenorrheic; n=4 anovulatory; and n=6 oligomenorrheic), with 96.5% adherence to the menstrual tracking protocol. The amenorrheic group demonstrated higher high-density lipoprotein levels (60.8 vs. 52.7; p=0.04) and trended toward lower C-reactive protein levels (0.43 vs. 1.53; p=0.07) than the eumenorrheic group. Amenorrheic athletes did not demonstrate cardiovascular disease risk factors compared with eumenorrheic athletes, contrary to what has been observed in prior studies of adult athletes. We demonstrated feasibility and success in implementing a rigorous methodology to classify and confirm menstrual status in an adolescent athlete population that can be replicated in future studies.