amenorrhea primary
absence of menstrual cycles by age 15 in previously non-menstruating girls, even when other normal post-pubertal development is present
amenorrhea secondary
when menstrual bleeding has not occurred for at least 3-6 consecutive menstrual cycles in women who have already had at least one previously menstruation
possible causes for amenorrhea
low body weight or fat; intense training before menarche; increased psychological stress; low energy availability
osteoporosis
a decrease in bone density that enhances bone fragility and increases the risk of fractures
how can exercise affect osteoporosis
mechanical loading effect of exercise training on BMD may be considered a protective factor
dysmenorrhea
painful menstruation without pelvic abnormalities, often with vomiting, headaches, back pain, diarrhea, and dizziness
how does a female’s thermoregulatory response differ
more body fat; lower fitness level; higher skin/core temp; higher HR; lower sweat rate; beneficial in cold, detrimental in heat
FITT principle for pregnant women
F - 3-4 d/wk; I - moderate (40-60% VO2R, 12-14 RPE) if BMI<25, light if >25; T - ≥15 min progressing to 30 min/day; T - dynamic, rhythmic, large muscle groups; P - after 1st trimester
reasons for modification/termination of exercise for pregnant women
calf pain/swelling, chest pain, muscle weakness, decreased fetal movement, vaginal bleeding, dyspnea, dizziness, preterm labor, abdominal/pelvic pain, fluid leakage
special considerations for pregnant women
gradual activity increase; consult doctor if obese or diabetic; avoid contact/balance-risk sports; avoid supine after 1st trimester; no Valsalva; thermoneutral environment; +300 kcal/day
why do females have increased risk for knee injuries
greater pelvic width, increased tibial rotation, knee instability, increased Q angle, weaker quads, hormonal changes
how is depression diagnosed
depressed mood most days; diminished interest; appetite/weight change; insomnia/hypersomnia; agitation; fatigue; guilt; poor concentration; suicidal thoughts
cognitive behavioral therapy
focuses on modifying maladaptive thoughts and addressing behavior deficits that lead to and maintain depression
special considerations for depression
depression may interfere with exercise; recognize comorbidities; affects chronic disease; linked to unhealthy lifestyle
FITT principle for depression
F - 5x/wk; I - 60-75% HRR; T - 40-60 min; T - gross motor activities like walking or biking
how does depression affect adherence
depression is associated with decreased adherence
recommendations for adherence
expect nonadherence; avoid blame; use it as a learning opportunity; know depression symptoms; express care with boundaries
diabetes
metabolic diseases characterized by inability to produce or properly use insulin, resulting in hyperglycemia
insulin
hormone from pancreatic beta cells required for glucose uptake in fat, muscle, and liver cells
hyperglycemia
high blood glucose increasing risk of vascular disease and neuropathies
symptoms of diabetes
polydipsia, polyuria, unexplained weight loss, slow healing, blurry vision, fatigue, polyphagia
type 1 diabetes
immune-mediated destruction of pancreatic beta cells; childhood onset; 5-10% of diabetics; requires insulin; ketoacidosis possible
PICK 1 mnemonic
P - pancreas no insulin; I - insulin required; C - childhood; K - ketoacidosis; 1 - type 1
GARROT mnemonic
G - genetics; A - adults; R - resistance to insulin; R - risk factors (SHADO); O - obesity; T - treatment (diet, meds, exercise)
