In this study the effect of multiple follicular development on the endocrinology of the menstrual cycle was investigated. Normally ovulating women were studied during control spontaneous cycles and cycles superovulated with different treatment regimes. Although clomiphene induced an increase in basal secretion of both FSH and LH, superovulation induction with human gonadotrophins resulted in a marked reduction in basal gonadotrophin secretion. It is suggested that basal secretion of FSH and LH is regulated by two separate mechanisms. The occurrence of an endogenous LH surge in superovulated cycles is dependent on the treatment regimen. Both clomiphene and unspecified ovarian factors are important regulators. When in these cycles an LH surge occurs, it is markedly attenuated both in amplitude and duration. The attenuation is due to ovarian factors different from oestradiol and progesterone. Corpus luteum function in superovulated cycles is disrupted and this seems to be related to the marked reduction in pituitary LH secretion. Ovarian hyperstimulation is a potent stimulus of prolactin secretion and the effect seems to be mediated by oestradiol. Folliculogenesis in superovulated cycles is FSH dependent, however follicular growth rate is similar to that in spontaneous cycles. It is concluded that ovarian hyperstimulation in normally cycling women induces marked changes in endogenous gonadotrophin secretion characterized by an augmentation of the negative and an attenutation of the positive feedback mechanism. Both these effects are mediated by unspecified ovarian factors.

The female athlete triad (FAT or the TRIAD) is a complex syndrome arising from associations among the trio of energy availability (EA), menstrual function (MF) and bone mineral density (BMD) along their respective continuums from health to disease state. It has been recognized that women whose energy intake (EI) does not meet the energy requirements for physiological functions subsequent to participation in exercise and physical activity could have low EA. In the TRIAD, low EA, an initiator in menstrual dysfunction (MD) and concomitant hypoestrogenism, indirectly results in low BMD. Therefore, the purpose of this study was to: (i) establish the status of EA, MF and BMD among elite Kenyan female athletes and non-athletes, (ii) explore associations between EA and MF in elite Kenyan female athletes and non-athletes, (iii) determine the relationships of EA and MF to BMD in elite Kenyan female athletes and non-athletes, and (iv) to determine the profile of the female athlete triad in elite Kenyan distance athletes and in non-athletes. Measurements of EA, MF and BMD were undertaken in 39 female participants (Middle distance athletes =12, Long distance athletes=13, Non-athletes=14). Energy intake minus exercise energy expenditure (EEE) and the remnant normalized to fat free mass (FFM) determined EA. Energy availability was determined through weight of all food and liquid consumed over three consecutive days. Exercise energy expenditure was determined after isolating and deducting energy expended in exercise or physical activity above lifestyle level from the total energy expenditure output as measured by Actigraph GT3X+. Fat free mass and BMD were assessed using dual energy x-ray absorptiometry (DXA). A nine-month daily temperature-menstrual diary was used to evaluate menstrual status. In addition, since psychological eating behaviour practice (EBP) contributes to low EA, the Eating Disorder Examination Questionnaire (EDE-Q) was used to determine presence of such practice among the participants and their relationship to EA. Overall, EA below 45 kcal.kgFFM-1.d-1 was found in 61.53% of the participants (athletes=28.07±11.45kcal.kgFFM-1.d-1, non-athletes=56.97±21.38kcal.kgFMM-1.d-1). The ANOVA showed that there was a significant difference (p<0.001) in EA among the long and middle distance runners and non-athletes; and the Tukey‘s HSD revealed that the source of the difference were the non-athletes. Results of the EDE-Q showed almost negligible presence of psychopathological eating behaviour practice among the Kenyan participants. None of the TRIAD components showed significant relationship with EBP. Results of MF showed that whereas none of the athletes presented with amenorrhea, oligomenorrhea was present among 40% athletes and 14.3% non-athletes, and amenorrhea among 14.3% non-athletes. However, there was no significant difference between athletes and non-athletes in MF. Low BMD was seen in 76% of the athletes and among 86% of the non-athletes. The analysis did not show significant difference in BMD Z-scores between athletes and non-athletes. The analysis did not show any significant association between EA and MF among the participants. The only significant relation of EA to any BMD dimension measured was between EA and total BMD in the long distance runners (r=0.560; p=.046). Significant relationship (rho=0.497; p=.001) was found between MF and BMD Z-scores among the athletes with middle distance highlighting the relationship further (rho=0.632; p=.027). Overall, the binary logistic regression revealed that MF did not predict BMD (OR=4.07, 95% CI, 0.8-20.7, p=.091). Overall, 10% of the participants (athletes=4, long distance athletes =3, middle distance athletes=1, non-athletes=0) showed simultaneous presence of all three components of the TRIAD. The independent sample t-test showed a significant difference (t=5.860; p=<.001) in the prevalence of the TRIAD between athletes and non-athletes. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2014

The female athlete triad (FAT or the TRIAD) is a complex syndrome arising from associations among the trio of energy availability (EA), menstrual function (MF) and bone mineral density (BMD) along their respective continuums from health to disease state. It has been recognized that women whose energy intake (EI) does not meet the energy requirements for physiological functions subsequent to participation in exercise and physical activity could have low EA. In the TRIAD, low EA, an initiator in menstrual dysfunction (MD) and concomitant hypoestrogenism, indirectly results in low BMD. Therefore, the purpose of this study was to: (i) establish the status of EA, MF and BMD among elite Kenyan female athletes and non-athletes, (ii) explore associations between EA and MF in elite Kenyan female athletes and non-athletes, (iii) determine the relationships of EA and MF to BMD in elite Kenyan female athletes and non-athletes, and (iv) to determine the profile of the female athlete triad in elite Kenyan distance athletes and in non-athletes. Measurements of EA, MF and BMD were undertaken in 39 female participants (Middle distance athletes =12, Long distance athletes=13, Non-athletes=14). Energy intake minus exercise energy expenditure (EEE) and the remnant normalized to fat free mass (FFM) determined EA. Energy availability was determined through weight of all food and liquid consumed over three consecutive days. Exercise energy expenditure was determined after isolating and deducting energy expended in exercise or physical activity above lifestyle level from the total energy expenditure output as measured by Actigraph GT3X+. Fat free mass and BMD were assessed using dual energy x-ray absorptiometry (DXA). A nine-month daily temperature-menstrual diary was used to evaluate menstrual status. In addition, since psychological eating behaviour practice (EBP) contributes to low EA, the Eating Disorder Examination Questionnaire (EDE-Q) was used to determine presence of such practice among the participants and their relationship to EA. Overall, EA below 45 kcal.kgFFM-1.d-1 was found in 61.53% of the participants (athletes=28.07±11.45kcal.kgFFM-1.d-1, non-athletes=56.97±21.38kcal.kgFMM-1.d-1). The ANOVA showed that there was a significant difference (p<0.001) in EA among the long and middle distance runners and non-athletes; and the Tukey‘s HSD revealed that the source of the difference were the non-athletes. Results of the EDE-Q showed almost negligible presence of psychopathological eating behaviour practice among the Kenyan participants. None of the TRIAD components showed significant relationship with EBP. Results of MF showed that whereas none of the athletes presented with amenorrhea, oligomenorrhea was present among 40% athletes and 14.3% non-athletes, and amenorrhea among 14.3% non-athletes. However, there was no significant difference between athletes and non-athletes in MF. Low BMD was seen in 76% of the athletes and among 86% of the non-athletes. The analysis did not show significant difference in BMD Z-scores between athletes and non-athletes. The analysis did not show any significant association between EA and MF among the participants. The only significant relation of EA to any BMD dimension measured was between EA and total BMD in the long distance runners (r=0.560; p=.046). Significant relationship (rho=0.497; p=.001) was found between MF and BMD Z-scores among the athletes with middle distance highlighting the relationship further (rho=0.632; p=.027). Overall, the binary logistic regression revealed that MF did not predict BMD (OR=4.07, 95% CI, 0.8-20.7, p=.091). Overall, 10% of the participants (athletes=4, long distance athletes =3, middle distance athletes=1, non-athletes=0) showed simultaneous presence of all three components of the TRIAD. The independent sample t-test showed a significant difference (t=5.860; p=<.001) in the prevalence of the TRIAD between athletes and non-athletes. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2014

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Title: Menstrual Disorders in Ballet Dancers and Orienteering Runners Objectives: The aim of this thesis is to determine prevalence of selected menstrual disorders in ballet dancers and orienteering runners. The data were analyzed and compared to available literature. Methods: The theoretical part of this thesis is a summary of available literature. The data for the research were collected by anonymous non-standardized questionnaire and processed by descriptive analysis, which was proceeded in Microsoft Excel 2010, Statistika and NCSS free version. Qualitative data were evaluated by qualitative analysis. Results: A total of 103 women participated in the research, 57 women from general population (control group), 24 ballet dancers and 22 orienteering runners. The significant higher age at menarché was found in ballet dancers group (Chi square, p = 0,038; p < 0,05) as well in group of orienteering runners (Chi square, p = 0,032; p < 0,05) compared to cotrol group. There was proved a significant deviation of prevalence of secondary amenorrhea in ballet dancers group compared to orienteering runners (Chi square, p = 0,024; p < 0,05). There was no significant difference in prevalence of dysmenorrhea among groups. We found a mild positive correlation between hours of training per week and intensity of...