1
|
Popp KL, Bozzini BN, Reynoso M, Coulombe J, Guerriere KI, Proctor SP, Castellani CM, Walker LA, Zurinaga N, Kuhn K, Foulis SA, Bouxsein ML, Hughes JM, Santoro N. Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training. Br J Sports Med 2024; 58:1052-1060. [PMID: 39043442 DOI: 10.1136/bjsports-2023-107716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression. METHODS In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT. RESULTS Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m2). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity. CONCLUSIONS Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.
Collapse
Affiliation(s)
- Kristin L Popp
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- TRIA Orthopaedic Center, HealthPartners Institute, Bloomington, Minnesota, USA
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Brittany N Bozzini
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Marinaliz Reynoso
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Jennifer Coulombe
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Department of Orthopedic Surgery, Harvard Medical School and Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Katelyn I Guerriere
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Susan P Proctor
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Colleen M Castellani
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Leila A Walker
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Nicholas Zurinaga
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Katherine Kuhn
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stephen A Foulis
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Mary L Bouxsein
- Department of Orthopedic Surgery, Harvard Medical School and Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Endcrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Julie M Hughes
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| |
Collapse
|
2
|
Jiang WJ, Jiang XF, Hu WM, Wang HF. Tao-Hong-Si-Wu-Tang Improves the Depressive-like Behaviors in Mice Experiencing Perimenopausal Depression Through Modulating Activity of the Hypothalamic-Pituitary-Adrenal-Ovary Axis and Activating the BDNF-TrkB-CREB Signaling Pathway. J Med Food 2024; 27:669-680. [PMID: 38682284 DOI: 10.1089/jmf.2023.k.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Tao-Hong-Si-Wu-Tang (THSWT), a traditional Chinese herbal remedy, is commonly utilized for the treatment of female perimenopausal depression through regulating menstruation, but the mechanism remains unknown. In this study, ICR mice were randomly divided into six groups: low, medium, and high dose of THSWT (0.5, 1.5, and 4.5 g/kg), soy isoflavone (250 mg/kg), ovariectomy group, and control group. All mice, except the control group, had ovaries removed and were exposed to hypoxic stimulation for 28 days to establish a perimenopausal depression mice model. The mice, having unrestricted access to food and water, were administered THSWT treatment for a duration of 14 days. The Western blotting and Enzyme linked immunosorbent assay kits were used to determine protein and hormone levels, respectively. Experimental results showed that THSWT reduced the immobility time of mice from 150.8 s to 104.9 s in the tail suspension test, and it decreased the immobility time of mice from 165.7 s to 119.0 s in the forced swimming test, outperforming the results obtained with soy isoflavones. In addition, THSWT upregulated the protein expression of follicle-stimulating hormone receptor and downregulated the protein expression of corticotropin-releasing hormone-receptor 1 in the hippocampus. Compared with the oophorectomized group, treatment with THSWT decreased the levels of corticosterone and adrenocorticotropic hormone in serum by 173.7 and 23.4 ng/mL, respectively. These findings showed that THSWT could stimulate the perimenopausal nerve tissue and regulate the level of serum hormones in mice. THSWT exhibited promising potential as a viable alternative drug for hormone treatment of perimenopause in clinical use.
Collapse
Affiliation(s)
- Wen-Jing Jiang
- Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, P. R. China
| | - Xue-Fan Jiang
- Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, P. R. China
| | - Wei-Ming Hu
- Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, P. R. China
| | - Hong-Fa Wang
- Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, P. R. China
| |
Collapse
|
3
|
Fouks Y, Hamilton E, Cohen Y, Hasson J, Kalma Y, Azem F. In-vitro maturation of oocytes recovered during cryopreservation of pre-pubertal girls undergoing fertility preservation. Reprod Biomed Online 2020; 41:869-873. [PMID: 32843309 DOI: 10.1016/j.rbmo.2020.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/28/2022]
Abstract
RESEARCH QUESTION In-vitro maturation (IVM) of oocytes recovered during ovarian tissue cryopreservation (OTC) is often practised, although it is still considered experimental. To date, only a few studies have examined the success of this maturation process in pre-menarche girls. The aim of this study was to examine the outcomes of IVM of oocytes recovered during OTC in pre-menarche patients scheduled for onco-therapy. DESIGN A retrospective cohort study in a tertiary university-affiliated hospital. A total of 93 patients aged 0-25 years who underwent OTC as part of onco-fertility preservation between 2007 and 2019 were included in the study. Oocytes were recovered from the medium after OTC and matured over 48 h. Oocyte development and maturation rate were recorded and compared between different age groups. RESULTS Patient's age was not correlated linearly with the total number of mature oocytes R = 0.2. The absolute maturation rate in post-menarche and pre-menarche patients differed significantly (38.0% versus 25.3%, respectively; P > 0.001), whereas the degeneration rate of the oocytes did not (39.8% versus 33.5%; P = 0.167). The pre-menarche group had significantly lower mean number of metaphase II oocytes compared with the post-menarche group (2.8 [±2.3] versus 5.6 [±4.6]; P = 0.01; 95% CI -4.62 to -0.46). Oocytes recovered from patients aged 1-5 years demonstrated low maturation rate. CONCLUSIONS Oocytes recovered from pre-menarche girls, and especially those younger than the age of 5 years who undergo fertility preservation, have a lower chance of reaching maturity in IVM compared with older women. This may indicate a need for alternative methods for preserving fertility in these young patients.
Collapse
Affiliation(s)
- Yuval Fouks
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel.
| | - Emily Hamilton
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel
| | - Yoni Cohen
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel
| | - Joseph Hasson
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel
| | - Yael Kalma
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel
| | - Foad Azem
- Lis Maternity Hospital, Department of Obstetrics and Gynecology, Fertility Division, Tel-Aviv Medical Center affiliated to the Sackler Faculty of Medicine, 6 Weizmann Street, Tel-Aviv 6423906, Israel
| |
Collapse
|
4
|
Sun BZ, Kangarloo T, Adams JM, Sluss PM, Welt CK, Chandler DW, Zava DT, McGrath JA, Umbach DM, Hall JE, Shaw ND. Healthy Post-Menarchal Adolescent Girls Demonstrate Multi-Level Reproductive Axis Immaturity. J Clin Endocrinol Metab 2019; 104:613-623. [PMID: 30289507 PMCID: PMC6325170 DOI: 10.1210/jc.2018-00595] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/01/2018] [Indexed: 12/24/2022]
Abstract
Context Menstrual irregularity after menarche has been attributed to immature estrogen positive feedback activity (E+FB) but data are conflicting. Objective To determine the hypothalamic-pituitary-ovarian contributions to menstrual irregularity in adolescents. Methods Twenty-three healthy girls [aged 12.8 to 17.6 years; 0.4 to 3.5 years postmenarche; body mass index (BMI) percentile, 41.0 to 99.3] underwent serial hormone measurements and pelvic ultrasounds during two consecutive menstrual cycles. Hormones and follicle growth were compared with 65 adult historic controls with ovulatory cycles (OVs). Results Girls had anovulatory cycles (ANOVs; 30%), OVs with a short luteal phase (short OVs; 22%), or OVs with normal luteal phase (normal OVs; 48%) without differences in cycle length, chronologic or gynecologic age, or BMI. Adolescents showed a spectrum of E+FB [midcycle LH adjusted for preovulatory estradiol (E2)]; only normal OV girls were comparable to adults. All OV girls had lower E2, progesterone, and gonadotropins during the luteal phase and luteal-follicular transition compared with adults. Normal OV girls also had lower follicular phase LH and FSH levels, a longer follicular phase, a slower dominant follicle growth rate, and smaller estimated preovulatory follicle size than adults. Follicular phase E2 and inhibin B levels were lower in normal OV girls than in adults even after adjusting for differences in FSH and follicle size. Conclusions Early postmenarchal girls with normal OVs demonstrate mature E+FB but continue to have lower gonadotropin levels, diminished ovarian responsiveness, and decreased corpus luteum sex steroid synthesis compared with adults, indicating that reproductive axis maturity requires coordinated development of all components of the hypothalamic-pituitary-ovarian axis.
Collapse
Affiliation(s)
- Bob Z Sun
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Tairmae Kangarloo
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Judith M Adams
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Patrick M Sluss
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Corrine K Welt
- Department of Endocrinology, Metabolism, and Diabetes, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - John A McGrath
- Social & Scientific Systems, Inc., Durham, North Carolina
| | - David M Umbach
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Janet E Hall
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Natalie D Shaw
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|