Bone Metabolism Markers in Sportswomen with Menstrual Cycle Dysfunctions (original) (raw)
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Menstrual status and bone mineral density among female athletes
Nursing and Health Sciences, 2005
The present study investigated the relationship between menstrual status and bone mineral density (BMD). Sixty-three elite female athletes competing at the regional level participated. Selfreported menstrual status, stress during the past 6 months, dietary intake of calcium, blood samples for hormonal study, mid-thigh skinfold thickness, triceps, iliac crest, spine and femoral neck BMD were determined. It was found that more than half of the athletes were eumenorrheic while almost half were menstrually dysfunctional. The bone mineral density at the lumbar spine and the femoral neck were within normal ranges. Menstrual dysfunction in female athletes was related to a low BMD at the lumbar spine but not at the femoral neck. Delayed menarche and menstrual dysfunction during the first 2 years after menarche were related to current menstrual dysfunction, but low percent body fat was not related to menstrual dysfunction. This study suggests that exercise in elite female athletes might be an underlying cause of menstrual dysfunction and that there is a relationship between lumbar spine BMD and menstrual dysfunction. The assessment of menstrual history and percent body fat could be used as a screening tool for menstrual dysfunction.
Asian journal of sports medicine, 2012
Oligo/amenorrhea, as a part of the Female Athlete Triad has adverse effects on the athlete's bone mineral density (BMD) and cardiovascular system. Hypoestrogenism, due to suppression of hypothalamus-pituitary axis (HPA) as a result of energy imbalance, is the possible cause of the Triad. This study was designed based on following up and reassessment of elite female athletes who were diagnosed as menstrual dysfunction about two years ago. THIS STUDY WAS CONDUCTED IN THREE PHASE SECTIONS: 1) Reassess the pattern of menstrual cycle among athletes who reported menstrual dysfunction about two years ago; 2) Bone mineral density was measured twice in the same machine and same center with a two-year interval; 3) The laboratory data including blood glucose, lipid profile and inflammatory markers was assessed in phase 3. BMD of athletes did not change significantly after 25.5 months of oligomenorrhea P (spine) = 0.2, P (femur)=0.9. Mean of all cardiovascular factors was in the normal rang...
Nutrición hospitalaria
The female athlete triad (FAT) is a serious health-related problem that threatens women who exercise. This condition is an interrelated multifactorial syndrome which includes low energy availability, menstrual cycle disturbances and decreased bone mineral density. To review the major components of the FAT and their relationships, as well as strategies for diagnosis and treatment. Articles related to the topic were reviewed through PubMed and SportDiscus databases. Interrelationship between components of the FAT may result in clinical manifestations, including eating disorders, amenorrhea and osteoporosis. Clinical conditions are not always exhibited simultaneously. Prevention is important to minimize complications. Diagnosis and treatment is complicated and often must involve an interdisciplinary therapeutic approach. Understanding of the disease may be facilitated by a unified framework focusing on energy deficiency. Preventive or early interventions require to increase energy avai...
Bone mineral loss related to menstrual history
Acta Orthopaedica, 1989
We measured the bone mineral content (BMC) of the forearm in 173 normal postmenopausal women. We also examined the relation between BMC and the chronologic age, the numberof years elapsed sincemenopause, and the total number of menstrualcycles during thereproductive years. BMC had a better linear relation to the total number of menstrual cycles than with the years elapsed since menopause or with chronologic age. Acta Orthop Downloaded from informahealthcare.com by 23.21.125.161 on 05/20/14 For personal use only.
Trabecular bone density and menstrual function in women runners
The American Journal of Sports Medicine, 1987
Osteoporosis results in decreased bone mineral mass and reduced trabecular bone density. Although its etiology remains unknown, studies have revealed differential changes in the bone mineral densities of postmenopausal women, anorexic women, and amenorrheic female athletes. Correlations have also been made between estrogen deficiency and osteoporosis in both premenopausal and postmenopausal women. In order to examine the possibility of osteopenia, a group of 36 female runners between the ages of 15 and 44 years were evaluated for bone mineral density, menstrual function, and dietary habits. Serum calcium, phosphorus, and parathyroid hormone (PTH) levels were also determined for each participant, as were complete blood counts. Using dual photon absorptiometry, all participants underwent a 20 minute scan of the lumbar spine with specificity to the L1-14 vertebrae. The 36 subjects included 19 oligomenorrheic and 17 eumenorrheic women. Results of bone density analyses revealed that the oligomenorrheic runners had significantly lower calibrated bone mineral density (CBMD) than their eumenorrheic counterparts (P ≦ 0.01). Likewise, the PTH levels of the oligomenorrheic runners were also significantly lower (P ≦ 0.01). Analysis of dietary logs revealed no significant differences between the dietary habits, the calcium intake, or the caloric
Bone, 2007
During adolescence, skeletal integrity of girls is largely dependent on menstrual function and impact exercise, yet currently there is limited research regarding the interaction between menstrual status and type of mechanical loading associated with various high school sports. Our purpose was to examine associations of menstrual status, type of mechanical loading, and bone mineral density (BMD) in female high school athletes participating in high/odd impact or repetitive/non-impact sport. Participants were 161 female high school athletes (15.7 ± 1.3 years; 165.3 ± 6.9 cm; 59.4 ± 8.7 kg) representing high/odd impact (n = 93, including soccer, softball, volleyball, tennis, lacrosse, and track sprinters and jumpers), or repetitive/non-impact sports (n = 68, including swimmers, cross-country and track distance runners who participated in events ≥ 800 m). Areal BMD was measured by DXA at the spine (L1-L4), proximal femur, and total body. Menstrual status was determined by selfreport. Athletes with primary, secondary or oligomenorrhea were combined into a single group (oligo/amenorrheic) and compared to eumenorrheic athletes. Analysis of covariance (ANCOVA) with Bonferroni post hoc comparisons adjusted for age, BMI, and gynecological age were used to compare BMD of athletes in combined mechanical loading and menstrual status groups. We found significantly greater total hip (p = 0.04) and trochanter (p = 0.02) BMD (g cm − 2 ) among eumenorrheic high/odd impact compared to eumenorrheic repetitive/non-impact athletes, and greater spine (p = 0.01) and trochanter (p = 0.04) BMD among high/odd impact eumenorrheic athletes compared to repetitive/nonimpact oligo/amenorrheic athletes. Chi-squared analysis of BMD Z-scores adjusted for gynecological age showed a significantly greater percentage of repetitive/non-impact athletes (33.9%) compared to high/odd impact athletes (11.8%) with low spine BMD for their age (BMD Z-score ≤ −1 SD) (p = 0.001), indicating that a high percentage of female high school athletes participating in repetitive loading sports, and especially those with oligo/amenorrhea, may not be accruing bone at the expected rate. Female adolescent athletes should be evaluated periodically and advised of the possible negative effects of oligo/amenorrhea on bone health.
Ovarian aging and bone metabolism in menstruating women aged 35–50 years
Maturitas, 2005
Objectives: The aim of this study was to investigate the relationships between the levels of gonadotrophins, estradiol, inhibin-b and bone mass and turn-over in regularly menstruating women aged 35-50 years. Methods: The study group included 87 healthy volunteers from the community aged 35-50 years. Bone mineral density of lumbar vertebras, wards triangle, throchanter, femur neck, bone resorption and formation markers were studied as well as the serum levels of gonadotrophins, estradiol and inhibin-b on the day 3 of menstrual cycle. Results: The gonadotrophin levels showed significant positive relation with age, whereas inhibin-b and estradiol levels showed significant negative correlation with age. The gonadotrophins and estradiol levels had no significant association with bone mass and bone formation markers. Increased gonadotrophin (p < 0.001) levels and decreased inhibin-b (p < 0.01) levels independent from age were correlated with increased bone resorption. Gonadotrophins, estradiol, age, inhibin-b, body mass index (BMI) were the confounding factors for bone resorption (p = 0.015, R 2 = 0.190) and lumbar bone mass (p = 0.041, R 2 = 0.148). Multivariate analysis showed an independent contribution of inhibin-b and BMI in the prediction of lumbar bone mass. Conclusion: This findings suggested that estradiol was not the only factor responsible for bone loss and decrease in reproductive function because increased gonadotrophins and decreased inhibin-b levels might trigger some changes in bone metabolism prior to the menopause.
Female Adolescent Athletes’ Awareness of the Connection between Menstrual Status and Bone Health
Journal of Pediatric and Adolescent Gynecology, 2011
Study Objective: The aims of this study are to determine among female high school track athletes: (1) knowledge of the association between menstrual irregularity and bone health; (2) attitudes toward amenorrhea, specifically if amenorrhea is seen as a sign of athletic success; (3) the association between knowledge and attitudes based on athlete menstrual status. Design: Cross-sectional survey. Setting: Five public high schools in Texas. Participants: 103 female high school track athletes ages 14e18 years. Intervention: Participants completed a questionnaire that addressed menstrual history, details of track participation, knowledge of bone mineral density (BMD)/ menstrual status connection, and attitudes about the desirability of oligo/amenorrhea. Outcome Measures: Frequencies of attitude and knowledge replies, summative knowledge score, and correlations between attitudes, knowledge, and menstrual status. Results: Sixteen subjects (16.7%) met criteria for amenorrhea, 16 for oligomenorrhea (16.7%). Median summative knowledge score was one of six. Menstrual irregularity was associated with lower knowledge (P 5 0.035). Incorrect answers about consequences of bone loss and the link to menstrual irregularity were given by $90% of respondents. Lower knowledge was associated with a greater number of "don't know" replies to attitude questions (P 5 0.002). Among more knowledgeable participants endorsing opinions, menstrual irregularity was not seen as a sign of athletic success. Conclusions: The prevalence of irregular menses is high among adolescent track athletes and a larger-scale inquiry to clarify adolescent athletes' knowledge of and attitudes about the link between menstrual patterns and BMD is indicated. Education may provide one key to improved health behavior among this at-risk population.
Nutrients, 2014
Exercise-related menstrual dysfunction (ExMD) is associated with low energy availability (EA), decreased bone mineral density (BMD), and increased risk of musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein (CHO-PRO) supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day) intervention would improve energy status and musculoskeletal health and restore menses in female athletes (n = 8) with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone health (BMD, bone mineral content, bone markers), muscle strength/power and protein metabolism markers, profile of mood state (POMS), and energy intake (EI)/energy expenditure (7 day food/activity records) were measured. Eumenorrheic athlete controls with normal menses (Eumen); n = 10) were measured at baseline. Multiple linear regressions were used to evaluate differences between groups and pre/post-intervention blocking on participants. Improvements in EI (+382 kcal/day; p = 0.12), EA (+417 kcal/day; p = 0.17) and energy balance (EB; +466 kcal/day; p = 0.14) were observed with the intervention but were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses; 3.5 ± 1.9 cycles); one remaining anovulatory with menses. Female athletes with ExMD for >8 months took longer to resume menses/ovulation and had lower BMD (low spine (ExMD = 3; Eumen = 1); low hip (ExMD = 2)) than those with ExMD for <8 months; for 2 ExMD the intervention improved spinal BMD. POMS fatigue scores were 15% lower in
The Journal of Clinical Endocrinology & Metabolism, 2013
Context: Regular physical activity during puberty improves bone mass acquisition. However, it is unknown whether extreme intense training has the same favorable effect on the skeleton. Objective: We evaluated the bone mass acquisition in a unique cohort of world-class rhythmic gymnasts. Study participants: A total of 133 adolescent girls and young women with a mean age of 18.7 Ϯ 2.7 (14.4-26.7) years participated in this study: 82 elite rhythmic gymnasts (RGs) and 51 controls (CONs). Main Outcome Measures: Anthropometric variables and body composition were assessed, and all participants completed questionnaires on their general medical, menstrual, and training histories. Broadband ultrasound attenuation (BUA in decibels per megahertz) was determined by quantitative ultrasound at the heel. Results: RGs presented lower weight (Ϫ8.5%, P Ͻ .001), body mass index (Ϫ11.7%, P Ͻ .001), and body fat mass (Ϫ43%, P Ͻ .001) and higher muscle mass (6.3%, P Ͻ .01) and height (ϩ2.8 cm, P Ͻ .01). RGs presented an age of menarche significantly delayed compared with CONs (15.6 Ϯ 1.6 vs 12.7 Ϯ 1.7 years; P Ͻ .001) and a high prevalence of menstrual disorders (64%). BUA values were higher in RGs vs CONs (68.6 Ϯ 4.6 and 65.4 Ϯ 3.3 dB/Mhz, respectively; P Ͻ .001). This difference was exacerbated when BUA was adjusted for age and body weight. BUA values in RGs were not affected by menstrual or training status. Among RGs with menarche, BUA was higher (71.5 Ϯ 4.1 and 67.9 Ϯ 3.5 dB/Mhz) for delayed (14.4 Ϯ 0.8 years) vs severely delayed (17.3 Ϯ 1.4 years) menarcheal age. BUA was positively correlated with body weight and body mass index and tended to be correlated with age. Conclusion: Conversely to expectations for adolescents and young women with a high prevalence of menstrual disorders and/or delayed menarche, intense training in rhythmic gymnastics appeared to have a beneficial effect on the bone health of a weight-bearing site. This effect was nevertheless modulated by the age of menarche. The high mechanical loading generated by this activity may counterbalance the negative effect of menstrual disorders.