Diet-induced menstrual irregularities: effects of age and weight loss

Schweiger, Ulrich; Laessle, Reinhold G.; Pfister, Hildegard; Hoehl, C.; Schwingenschloegel, M.; Schweiger, Marion; Pirke, Karl‐Martin

doi:10.1016/s0015-0282(16)59523-5

Cited by 74 publications

(27 citation statements)

References 13 publications

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“…For example, when healthy Western women with a normal body-mass index follow weight-reducing diets, they often experience a reduction in reproductive hormone levels and disruption of their menstrual cycles. [83][84][85] This can affect their potential fertility. For example, Bates, Bates, and Whitworth 86 examined 47 underweight women with unexplained infertility, all of whom were dieting to maintain a low body weight.…”

Section: Humansmentioning

confidence: 99%

Aping our ancestors: Comparative aspects of reproductive ecology

Bentley

1999

Evol. Anthropol.

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There are many similarities among mammalian species in how ecological factors affect their reproductive potential and individual life histories. One of the most important limiting factors is the availability of sufficient resources to partition among essential growth, maintenance, and eventual reproduction.1–3 How each mammal juggles these constraints constitutes its unique life history and determines its success as a species. Yet, as Hill and Hurtado4 recently argued, life‐history analyses are rarely applied to human reproduction. In fact, despite the demonstrated significance of adequate nutrition for reproductive performance among most mammalian species that have been studied,1,3,5 many demographers, and even some biological anthropologists, have resisted the idea that humans, except under extreme famine conditions, might be subject to the same kinds of nutritional constraints that affect other mammals.6–9.

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Section: Humansmentioning

confidence: 99%

Aping our ancestors: Comparative aspects of reproductive ecology

Bentley

1999

Evol. Anthropol.

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“…Yet clinical studies of women from the United States indicate a sensitivity of ovarian function to both relatively low energy intake and͞or high energy expenditure. The most extreme response, failure to ovulate, may occur in the face of only moderate energetic stress (2)(3)(4) and, of course, reduces fecundity and fecundability to 0. Short of anovulation, milder disruptions of ovarian function may also reduce fecundability.…”

mentioning

confidence: 99%

Interpopulational differences in progesterone levels during conception and implantation in humans

Vitzthum

Spielvogel

Thornburg

2004

Proc. Natl. Acad. Sci. U.S.A.

102

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Clinical studies of women from the United States demonstrate a sensitivity of the ovarian system to energetic stress. Even moderate exercise or caloric restriction can lead to lower progesterone levels and failure to ovulate. Yet women in many nonindustrial populations experience as many as a dozen pregnancies in a lifetime despite poor nutritional resources, heavy workloads, and typical progesterone levels only about two-thirds of those of U.S. women. Previous cross-sectional studies of progesterone may, however, suffer from inadvertent selection bias. In a noncontracepting population, the most fecund women, who might be expected to have the highest progesterone, are more likely to be pregnant or breastfeeding and hence unavailable for a crosssectional study of the ovarian cycle. The present longitudinal study was designed to ascertain whether lower progesterone also characterizes conception, implantation, and gestation in women from nonindustrialized populations. We compared rural Bolivian Aymara women (n ‫؍‬ 191) to women from Chicago (n ‫؍‬ 29) and found that mean-peak-luteal progesterone in the ovulatory cycles of Bolivian women averaged Ϸ71% that of the women from Chicago. In conception cycles, progesterone levels in Bolivian women during the periovulatory period were Ϸ63%, and during the peri-implantation period were Ϸ50%, those of the U.S. women. These observations argue that lower progesterone levels typically characterize the reproductive process in Bolivian women and perhaps others from nonindustrialized populations. We discuss the possible proximate and evolutionary explanations for this variation and note the implications for developing suitable hormonal contraceptives and elucidating the etiology of cancers of the breast and reproductive tract.I n an evaluation of demographic data from populations worldwide, Bongaarts (1) concluded that, except in cases of famine, nutritional factors play a relatively minor role in determining human fecundity (capacity to conceive) or fertility (number of live births). Despite characteristically marginal nutritional status and the demands of arduous activities, women in less developed countries often average seven to eight pregnancies, some having 12 or more during a lifetime. Differences among populations, or reductions from a theoretical maximum, appear fully attributable to a limited set of behavioral and physiological proximate fertility determinants apparently little affected by nutritional factors. If neither fecundity nor fertility is thus significantly influenced, neither is fecundability (the monthly probability of conception). Yet clinical studies of women from the United States indicate a sensitivity of ovarian function to both relatively low energy intake and͞or high energy expenditure. The most extreme response, failure to ovulate, may occur in the face of only moderate energetic stress (2-4) and, of course, reduces fecundity and fecundability to 0. Short of anovulation, milder disruptions of ovarian function may also reduce fecundability. Why should o...

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“…Early clinical work focused on disruptions of cyclic ovarian activity associated with anorexia nervosa (Warren and Vande Wiele, 1973;Boyar et al, 1974; Es inosa-Campos More recent work has considered the effects of simple weight loss on female reproductive function (Lev-Ran, 1974;Bates et al, 1982;Bates, 1985;Pirke et al, 1985Pirke et al, , 1986Pirke et al, , 1989Schweiger et al, 1987) and weight loss in con'unction with exercise (Bullen et al, 1985). he sub'ects in 10-25% below ideal body weig a t (IBW), and/ or subject to rather extreme weight reducing women.…”

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confidence: 99%

Effect of moderate weight loss on ovarian function assessed by salivary progesterone measurements

Lager

Ellison

1990

American J Hum Biol

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The effects of moderate, voluntary weight loss on ovarian function are studied by monitoring the daily levels of salivary progesterone in 8 dieting women (18 cycles) and 9 age-matched controls (19 cycles). Both groups of women were within normal standards of weight for height, though the dieters were significantly heavier than the controls. Dieters lost weight at an average rate of 1.9 ± 0.3 kg/mo during the study. Dieters' cycles during periods of weight loss (weight loss cycles) have significantly lower peak levels of luteal progesterone (controls 655 ± 46 pmol/L, weight loss 461 ± 67 pmol/L; P < 0.005) and lower average levels of luteal progesterone (controls 287 ± 30 pmol/L, weight loss 214 ± 23 pmol/L; P < 0.005) than do controls. All control cycles were classified as ovulatory by virtue of at least one salivary progesterone reading ≥ 300 pmol/L. Only 62% of the weight loss cycles were classified as ovulatory by this criterion. Where longitudinal weight data are available both the magnitude and duration of progesterone elevation correlates significantly with net weight change during the preceding cycle and show no significant correlation with net weight change during the current cycle. Examination of individual profiles confirms that the most profound suppression of luteal activity usually occurs during post-loss rather than weight loss cycles, even if weight is stable or increasing during the post-loss cycle itself. These results, together with field studies of African horticultural populations, suggest that human ovarian function may be adapted to modulate waiting time to conception in response to trends in energetic balance.

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Diet-induced menstrual irregularities: effects of age and weight loss

Cited by 74 publications

References 13 publications

Aping our ancestors: Comparative aspects of reproductive ecology

Aping our ancestors: Comparative aspects of reproductive ecology

Interpopulational differences in progesterone levels during conception and implantation in humans

Effect of moderate weight loss on ovarian function assessed by salivary progesterone measurements

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