Oestrogen replacement may reduce disordered eating in athletes with irregular periods
Giving oestrogen replacement to female athletes with menstrual irregularities caused by the amount they exercise reduces drive for thinness, body dissatisfaction, and uncontrolled eating, a new study has found.
The findings underscore the relationship between oestrogen and disordered eating, and highlight the potential of oestrogen replacement as a treatment in other conditions characterised by abnormal eating and menstrual dysfunction, such as anorexia nervosa.
The study found that female athletes with exercise-induced irregular menstrual periods report more disordered eating behaviour than athletes and non-athletes getting regular periods.
Lead researcher Professor Madhusmita Misra said: “Female athletes with exercise-induced menstrual dysfunction (associated with low oestrogen levels) often have disordered eating behaviour, which may impact their reproductive and bone health.
“In particular, female athletes tend to restrain their eating, display a stronger desire to become or stay thin, and have a higher level of dissatisfaction with their bodies compared to athletes and non-athletes with normal menstrual cycles.”
Researchers compared 109 female athletes with exercise-induced menstrual irregularities with 50 female athletes with normal menstrual cycles, and 39 female non-athletes.
All of the study subjects were 14-25 years old and in the normal weight range. Their eating behaviour and mental health was evaluated with self-report assessments and questionnaires.
Athletes with irregular periods reported a higher drive for thinness and more mental control over their food intake compared with athletes with regular periods and non-athletes. They also had higher mean body dissatisfaction scores than athletes with regular periods.
Athletes who had irregular menstrual periods were randomly assigned to receive either oestrogen replacement through a patch at a dose that resulted in oestrogen levels seen with normal menstrual cycles, a commonly used combined oral contraceptive pill containing oestrogen, or no oestrogen for 12 months.
Athletes randomised to oestrogen replacement as a patch also received cyclic progesterone.
Over one year, the groups that received oestrogen showed reductions in drive for thinness, body dissatisfaction and uncontrolled eating, compared with those who didn’t receive oestrogen.
The patch was the most effective form of oestrogen replacement, leading to significant decreases in body dissatisfaction and uncontrolled eating.
Professor Misra said: “These results highlight the importance of normalising oestrogen levels in female athletes with irregular menstrual periods.
“This not only improves their bone health (as we have previously reported), but may also improve their eating behaviour. More studies are necessary to confirm these findings.”
The research results were presented on Saturday March 17 at ENDO 2018, the annual scientific meeting of the Endocrine Society in Chicago.