Research progress of the mechanisms of low body fat influencing female menstruation and rehabilitative therapeutic strategies

The status of energy availability deficiency caused by deficient energy intake and(or) excessive energy expend, would irreversibly inhibit the hypothalamic-pituitary axis's endocrine activity and function, resulting in hypogonadotropic hypogonadism. The drop of body fat and the inhibition of reproductive axis fall behind the change of energy metabolism, but the adaptive adjustment under negative energy imbalance for long term. The early "critical fat hypothesis" considered a threshold of body fat or weight is necessary for puberty initiation and menstrual cycle maintenance while later researches held that body fat and reproduction have no critical correlation. However, it should not deny that there be certain relationship between body fat and female reproductive hormone, menstruation and ovulation function, and the former could impact reproductive function by playing key role in interaction between adipose tissue, adipokines(leptin, adiponectin) and reproductive axis and hormones. This review will focus on the mechanism that low body fat influencing menarche and normal menstruation, and the function of adipose tissue and adipokines, and the rehabilitative therapeutic strategies.