Effects of physical exercise on the female reproductive system

Minerva Endocrinol. 2013 Sep;38(3):305-19.


The excess in physical activity could be closely linked to considerable negative consequences on the whole body. These dysfunctions called as "female athlete triad"' by the American College of Sports Medicine (ACSM) include amenorrhea, osteoporosis and disorder eating. The female athlete triad poses serious health risks, both on the short and on the long term, to the overall well-being of affected individuals. Sustained low energy availability can impair health, causing many medical complications within skeletal, endocrine, cardiovascular, reproductive and central nervous system. On the contrary, several studies have shown, that physical activity improves cardiovascular risk factors, hormonal profile and reproductive function. These improvements include a decrease in abdominal fat, blood glucose, blood lipids and insulin resistance, as well as improvements in menstrual cyclicity, ovulation and fertility, decreases in testosterone levels and Free Androgen Index (FAI) and increases in sex hormone binding globulin (SHBG). Other studies reported that physical activity improved self-esteem, depression and anxiety. Thus, the aim of this review is to elucidate the effect of physical exercise on female reproductive system and viceversa the impact of hormonal status on physical activity and metabolism. In addition this review supports the idea that physical exercise is a helpful tool for the management of obesity, prevention of cardiovascular, metabolic diseases and female reproductive organs related diseases (e.g. breast cancer). When the excess in physical activity leads up to the female athlete triad, it is imperative to treat each component of the triad by employing both pharmacological and non pharmacological treatments.

Publication types

  • Review

MeSH terms

  • Amenorrhea / etiology
  • Amenorrhea / physiopathology
  • Athletes
  • Body Weight
  • Breast Neoplasms / prevention & control
  • Exercise / physiology*
  • Exercise / psychology
  • Feeding and Eating Disorders / etiology
  • Feeding and Eating Disorders / physiopathology
  • Female
  • Gonadal Steroid Hormones / metabolism
  • Gonadal Steroid Hormones / physiology*
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / physiopathology
  • Menstrual Cycle / physiology*
  • Menstruation Disturbances / etiology
  • Menstruation Disturbances / physiopathology
  • Obesity / physiopathology
  • Obesity / prevention & control
  • Osteoporosis / etiology
  • Osteoporosis / physiopathology
  • Polycystic Ovary Syndrome / physiopathology
  • Premenstrual Syndrome / etiology
  • Premenstrual Syndrome / physiopathology
  • Reproduction / physiology*
  • Risk


  • Gonadal Steroid Hormones