Bone mineral loss in young women with amenorrhoea.

Abstract

offered exposure to positive suggestions during general anaesthesia. This would give patients the beneficial effect of the positive suggestions and protect them from the negative effects of "hearing" adverse or negative comments. Main outcome measure-Bone mineral density in the lumbar spine (L1-L4) as measured by dual energy x ray absorptiometry.Results-The amenorrhoeic group showed a mean reduction in bone mineral density of 15% (95% confidence interval 12% to 18%) as compared with controls (mean bone mineral density 0-89 (SD 0-12) g/cm2 v 1.05 (0-09) g/cm2 in controls). Bone loss was related to the duration of amenorrhoea and the severity of oestrogen deficiency rather than to the underlying diagnosis. Patients with a history of fracture had significantly lower bone density than those without a history of fracture. Ten patients had suffered an apparently atraumatic fracture.Conclusions-Amenorrhoea in young women should be investigated and treated to prevent bone mineral loss. Menopausal women with a past history of amenorrhoea should be considered to be at high risk of osteoporosis. IntroductionOsteoporosis is a major cause of morbidity and indirectly of mortality in Western women. It has been estimated that 40% of postmenopausal women sustain at least one osteoporotic fracture' 2 and that the cost to the NHS of treating hip fractures alone is £160m a year.' Loss of bone mineral is a major risk factor for fracture.4 Demineralisation is related to age, but women have accelerated bone loss with loss of ovarian function at the menopause.5 Osteoporotic fractures are rare in young women. Vertebral crush fractures and histologically proved osteoporosis have, however, been reported in young women with anorexia nervosa and amenorrhoea.6

Poor Compliance to Hormone Therapy and Decreased Bone Mineral Density in Women with Premature Ovarian Insufficiency

“…Late menarche and menstrual irregularity are also been showed to be important risk factors for osteoporosis development [25]. In our study, we highlighted a reduction in bone mineral density during following up of POI women.…”

Bone mineral density in adolescent females using injectable or oral contraceptives: a 24-month prospective study

“…Because statistical analysis elsewhere has yielded a clinically significant increased risk for fracture with a discrepancy of 7% among postmenopausal women (14), our observed magnitude of difference in BMD among adolescent DMPA users, if irreversible, may increase eventual risk for fractures. No studies to date have evaluated DMPA use and fracture risk in adolescent girls.…”

A prospective investigation of injury incidence and injury risk factors among army recruits in military police training

“…In past basic training studies, menstrual irregularities have also been shown to increase injury risk [29,43,96]. Investigations of female athletes have also indicated that those with menstrual irregularities have a higher injury incidence of musculoskeletal injuries [97], especially with bone stress injuries [97-99], and that these athletes take longer to recover from their injuries [100]. It has been hypothesized that amenorrhea results in hormonal changes, especially lower estrogen levels, which leads to a reduction in bone mineral density and increasing likelihood of fracture [97,99-101].…”