Energetic factors and seasonal changes in ovarian function in women from rural Poland.

Female mammals can optimize their fitness by temporal suppression of reproductive function in response to unfavorable environmental conditions. Since reproduction is energetically demanding for a human female, ovarian function is expected to be sensitive to factors influencing energy availability and metabolism. Dieting and exercise in women from industrial countries, and low-calorie diet and workload in women from developing countries, are often associated with ovarian suppression. This study shows that in Polish rural women seasonal changes in workload correlate with seasonal changes in indices of ovarian function (progesterone measured in saliva samples collected daily for six menstrual cycles for each subject). Mean levels of energy expenditure of the most work demanding weeks of the summer exceeded mean levels of energy expenditure during winter by 37%. Energy intake in this population was sufficient throughout the year. During the summer, when physical work was most intense, low values of progesterone levels were observed (178.2 pmol/L in July and 182.2 pmol/L in August), indicating ovarian suppression. Mean progesterone levels rose to 234.6 pmol/L in October when levels of energy expenditure were lower due to cessation of harvest-related activities. As indicated by several causal models tested through path analysis, energy expenditure was the only variable responsible for suppressed progesterone levels during the summer. Variables describing the nutritional status and energy balance did not correlate significantly with progesterone levels; neither body weight nor body fat or seasonal changes of these variables seem to influence ovarian function in this population. Thus work-related energy expenditure does not need to lead to negative energy balance in order to cause suppression of reproductive function in women. Copyright 2004 Wiley-Liss, Inc.