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Comorbid nature of AA The discussion below explores the causes of AA, with particular attention to telomere shortening, COVID-19 immunisation, AA caused by cancer, FA, and the relationship to chronic gut inflammation
This may manifest as: Hypothalamic amenorrhoea: Cessation of menstrual periods due to suppressed GnRH pulsatility Luteal phase defects: Shortened or inadequate progesterone production after ovulation Reduced oestrogen levels: Leading to vaginal dryness, reduced arousal, and decreased sexual interest Research in female athletes has identified that energy availability below approximately 30 kcal per kilogram of fat-free mass daily is associated with menstrual disturbances and reduced libido, though individual thresholds vary and this finding may not generalise to all populations
It mimics the action of the naturally occurring hormone GLP-1, which regulates appetite and food intake by slowing gastric emptying, enhancing satiety, and reducing hunger signals in the brain
Tong, K