Menstrual history as a determinant of current bone density in young athletes

Abstract

The relationship of prior menstrual irregularities and current menstrual status to the bone density of 97 young athletes was determined at seven sites using single- and dual-photon absorptiometry. Menstrual patterns were ranked on a scale of 1 to 9 in terms of their potential adverse affect on bone. Only vertebral density was significantly related to menstrual patterns (r = -.43). Women who had always had regular cycles had higher lumbar densities (1.27 g/cm2) than those with a history of oligomenorrhea/amenorrhea interspersed with regular periods (1.18 g/cm2). The lumbar density of both groups exceeded that of women who had never had regular cycles (1.05 g/cm2). Body weight became more important as a predictor variable as the severity of menstrual irregularities increased. The combination of menstrual pattern and body weight predicted 43% of the total variation in lumbar density. These data suggest that extended periods of oligomenorrhea/amenorrhea may have a residual effect on lumbar bone density.

A tríade da atleta: posicionamento oficial

“…A principal causa de osteoporose pré-menopausa em mulheres ativas é uma redução da produção de hormônios ovarianos e hipoestrogenemia em conseqüência de uma amenorréia hipotalâmica 23,[26][27][28][29][30]32,33 .…”

“…Pesquisadores 27,29,32,33,129 relatam que uma história menstrual prévia é o melhor preditor da DMO atual. Mulheres com história de amenorréia têm uma DMO mais baixa do que aquelas cujos ciclos sempre foram regulares.…”

“…Atletas amenorréicas que utilizam terapia de reposição hormonal em doses utilizadas para mulheres pós-menopausa demonstraram manutenção da DMO mas nenhum ganho 135 . Mulheres com amenorréia e perdas ós-seas mais leves podem preferir ajustar o treinamento e os padrões nutricionais para retornar ao seu ciclo reprodutivo normal 15,18,27,113,114,136 .…”

“…A amenorréia hipotalâ-mica resulta em uma produção reduzida de hormônios ovarianos e hipoestrogenemia semelhantes à menopausa. Tanto a amenorréia hipotalâmica quanto a menopausa estão associadas com uma redução densidade mineral óssea 3,[23][24][25][26][27][28][29][30] . 3.…”

Current and past menstrual status is an important determinant of femoral neck geometry in exercising women

“…Functional hypothalamic amenorrhea, defined as the absence of menses for greater than 90 days (secondary amenorrhea) [16] or the failure to attain menarche by age 15 (primary amenorrhea) [17] which cannot be explained by other underlying pathology [17], and oligomenorrhea, defined as irregular and inconsistent menses at intervals of 36 to 90 days [16], are the most severe presentations of menstrual cycle disturbances and are linked to poor skeletal health [3,5,8]. Low BMD in female athletes is defined as a Z-score between −1.0 and −2.0 in combination with a history of inadequate nutrition, hypoestrogenism, and stress fractures; whereas, the term "osteoporosis" is reserved for a BMD Z-score ≤ −2.0 with secondary risk factors for fracture [18].…”