Potential Impact of Exercise-Associated Amenorrhea and Subsequent Estrogen Therapy on Cardiovascular Disease Risk Factors in Pre-Menopausal Athletes: A Research Protocol
Bibliographic record
Abstract
Introduction: Women with exercise-associated amenorrhea (EAA) have impaired pulsatile gonadotropin-releasing hormone (GnRH) release that disrupts sufficient estrogen secretion, causing hypoestrogenism. As there is limited research on the influence of hypoestrogenism on cardiovascular health in pre-menopausal women, the purpose of this study is to assess its effect on the concentrations of estrogen and early cardiovascular diseases (CVD) risk factors – nitric oxide, endothelin-1 (ET-1), and E-selectin – in women with EAA.Methods: A total of 90 participants between the ages of 18-35 will be selected based on the inclusion criteria of athleticism status (8 hours of structured physical activity/week) and body mass index (BMI) range of 18.5-24.5. Out of the 90 participants, 45 will have EAA and 45 will have regular menstrual status. Exclusion criteria: Smokers, women on contraceptives and those with pre-existing CVD and respiratory health conditions/family history of these conditions. Baseline data of estrogen and CVD risk factor concentrations will be obtained from all 90 participants through bi-weekly blood draws and serum analysis in the first month of the 7-month study. The amenorrheic, athletes (n=45) will receive 0.025 mg of 17-β estradiol transdermally via estrogen patches daily for months 2-7 of the study. Blood will be collected bi-weekly from these amenorrheic, athletes (n=45) during months 2-7 to quantify estrogen and CVD risk factor concentrations during the intervention. Statistical analysis: 2-way ANOVA (analysis of variance) test to compare the levels of E2 and CVD risk factors prior to and following estrogen treatment of amenorrheic, athletic subjects.Discussion: Although there are many cardiovascular risk factors which can be used as markers to determine the effect of EAA on cardiovascular health, nitric oxide, ET-1, and E-selectin may serve to provide more accurate analysis due to less present confounding factors as other markers. Anticipated results include increased nitric oxide and decreased ET-1 and E-selectin concentrations following estrogen therapy.Conclusion: Diagnosis and management of menstrual irregularities like EAA is imperative for maintaining good cardiovascular health. Further research to determine whether estrogen therapy can be used as a long-term solution for women with EAA, and whether it should be provided in conjunction with nutritional intervention is recommended.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.029 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".