Is there an association between athletic amenorrhea and endothelial cell dysfunction?

Purpose: To test the hypothesis that young females with athletic amenorrhea and oligomenorrhea show signs of early cardiovascular disease manifested by decreased endothelium-dependent dilation of the brachial artery. Methods: Ten women with athletic amenorrhea (mean ± SE, age 21.9 ± 1.2 yr), 11 with oligomenorrhea (age 20.8 ± 1.1 yr), and 11 age-matched controls (age 20.2 ± 1.1 yr) were studied. Study subjects were amenorrheic an average of 2.3 (range 0.6-5) yr and oligomenorrheic an average of 6.2 yr. All ran a minimum of 25 miles·wk^-1. They were nonpregnant and free of metabolic disease. Brachial artery flow-mediated dilation (endothelium-dependent) was measured with a noninvasive ultrasound technique in each group. Results: Endothelium-dependent brachial artery dilation was reduced in the amenorrheic group (1.08 ± 0.91%) compared with oligomenorrheic (6.44 ± 1.3%; P < 0.05) and eumenorrheic (6.38 ± 1.4%; P < 0.05) groups. Conclusion: Athletic amenorrhea is associated with reduced endothelium-dependent dilation of the brachial artery. This may predispose to accelerated development of cardiovascular disease.