SynthesisJournal of the American Heart Association2024
Impact of Secondary Amenorrhea on Cardiovascular Disease Risk in Physically Active Women: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Benchmarking machine learning architectures for menstrual recovery prediction using physiologically informed synthetic wearable data.Scientific reports · 2026Article
- An Overarching Conceptual Framework for Menstrual Health in Sport Research: Theory, Causality and Validation.Sports medicine (Auckland, N.Z.) · 2026Review
- Evidence of early subclinical atherosclerosis in women with exercise-induced hypothalamic amenorrhea.Human reproduction open · 2026Article
- Endocrine enigmas: vascular health in females throughout the lifespan.American journal of physiology. Heart and circulatory physiology · 2025Review
- The effect of transient sex hormone fluctuations on vascular endothelial function.American journal of physiology. Heart and circulatory physiology · 2025Review
- Effectiveness of Interventions to Improve Cardiovascular Perturbations in Women with Exercise-Associated Amenorrhea: A Systematic Review.Women's health reports (New Rochelle, N.Y.) · 2025Review
- The Effects of Previous Amenorrhea on Endothelial and Vascular Function.International journal of endocrinology · 2025Article
- Vascular adaptation in elite female and male rowers across a competitive season.Current research in physiology · 2025Article
- The burden of menstrual irregularities among women living with HIV in Nigeria: a comprehensive review.Reproductive health · 2024Review
- Changes in the prevalence of menstrual-related symptoms and menstrual cycle abnormalities among Japanese Summer and Winter Olympic athletes over the past seven Olympic Games.Women's health (London, England)Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExercise-associated secondary amenorrhea results in estrogen deficiency, which may lead to dysfunction in estrogen's normal cardioprotective pathways. Estrogen may be essential in a woman's endothelial adaptations to exercise. The objective of this review was to assess the association between secondary amenorrhea in physically active women and cardiovascular disease (CVD) risk. METHODS AND
resultsA literature search was performed in January 2023 and updated in August 2023 of the Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations. Citation chaining was done to screen for additional studies. Eight sources were searched for gray literature. Studies that compared physically active women with amenorrhea to physically active women with eumenorrhea aged 18 to 35 years with evidence of CVD, alterations to cardiovascular physiology, or CVD risks were included. Eighteen observational studies from 3 countries were included. Overall, the quality of evidence was good. A meta-analysis was performed. Physically active women with secondary amenorrhea had significantly lower estradiol, flow-mediated dilation, resting heart rate, systolic blood pressure, and diastolic blood pressure and higher total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein cholesterol.
conclusionsEstrogen deficiency resulting from exercise-associated secondary amenorrhea in physically active women may impact cardiovascular physiology and certain CVD risk factors. The research in this area is observational; therefore, findings should be interpreted cautiously. However, as exercise-associated secondary amenorrhea is reversible and the primary prevention of CVD is important for public health, it may be important to treat secondary amenorrhea and restore estrogen levels.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.