Impact of Physical Activity and Exercise on Female Reproductive Potential

  • Rebecca J. Mallinson
  • Jenna C. Gibbs
  • Mary Jane De SouzaEmail author


Although exercise among girls and women is beneficial for overall health and well-being, the development of an energy deficiency as a result of inadequate energy intake to compensate for exercise energy expenditure can lead to menstrual dysfunction. It has been established that it is not the stress of exercise that causes reproductive dysfunction; rather, in an attempt to conserve energy, metabolic adaptations triggered by an energy deficiency alter the normal production and pulsatility of reproductive hormones at all levels of the hypothalamic–pituitary–ovarian (HPO) axis. As such, estrogen and progesterone concentrations decline, resulting in a spectrum of exercise-associated menstrual disturbances (EAMD). The spectrum of EAMD includes the severe menstrual disturbances, amenorrhea and oligomenorrhea, which are easily detected by the absence of menses for at least 3 months or long and inconsistent cycles of 36–90 days, respectively. Less severe EAMD include luteal phase defects and anovulation which typically occur within regular intermenstrual intervals, thereby causing these disturbances to often remain undetected. Suppressed follicular growth and oocyte maturation, poor endometrial quality, spontaneous abortion, and infertility are all clinical reproductive consequences of EAMD. However, EAMD can be prevented by maintaining a healthy body weight and an energy replete state. Likewise, effective nonpharmacological treatment of EAMD includes an increase in caloric intake and weight gain to reverse the energy deficiency and promote recovery of normal menstrual function. Upon recovery and/or maintenance of an energy replete state, regular exercise among girls and women is encouraged.


Exercise-associated menstrual disturbances Amenorrhea Oligomenorrhea Anovulation Luteal phase defects Energy deficiency Infertility Prevalence Treatment 



Bone Mineral Density


Energy availability


Exercise-associated menstrual disturbances


Functional hypothalamic amenorrhea


Follicle-stimulating hormone


Gonadotropin-releasing hormone


Human chorionic gonadotropin






Lean body mass


Luteinizing hormone


Luteal phase defects


Polycystic ovarian syndrome


Pregnanediol glucuronide




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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Rebecca J. Mallinson
    • 1
  • Jenna C. Gibbs
    • 1
  • Mary Jane De Souza
    • 1
    Email author
  1. 1.Department of KinesiologyPennsylvania State UniversityUniversity ParkUSA

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