Effectiveness of Interventions to Improve Cardiovascular Perturbations in Women with Exercise-Associated Amenorrhea: A Systematic Review
Bibliographic record
Abstract
Objectives: Women with exercise-associated amenorrhea demonstrate cardiovascular perturbations such as endothelial dysfunction and altered lipid profiles. The objective of this systematic review was to assess the effectiveness of pharmacological/nutraceutical and non-pharmacological interventions for improving these cardiovascular perturbations. Design Data Sources and Eligibility Criteria: A literature search was performed in October 2023 and updated in July 2024 of CINAHL (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations and four sources of gray literature. Experimental and quasi-experimental pre-post studies of women with exercise-associated amenorrhea, using pharmacological/nutraceutical or non-pharmacological intervention, were included. Results and Summary: Three studies from three countries were included. Interventions included 9 months of low-dose oral contraceptives and 4 weeks of folic acid (10 mg/day). Both interventions improved endothelial function in women experiencing exercise-associated amenorrhea, from 1.42% to 4.88% and 3.0% to 7.7%, respectively. The impact of oral contraceptives on lipids was conflicting, and increases were seen in select inflammatory markers, including high-sensitivity C-reactive protein and tumor necrosis factor. Conclusion: Oral contraceptives or folic acid may improve the endothelial dysfunction associated with exercise-associated amenorrhea. As cardiovascular disease remains a global cause of mortality for women, further investigation into the long-term cardiovascular consequences of impaired vascular and lipid profiles of exercise-associated amenorrhea is warranted.
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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 | 0.006 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.009 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".