Bone mineral density levels in elite female athletes
Article Abstract:
People who exercise may develop changes in bone mineral density (BMD) for several reasons. Exercise itself can directly affect bone structure due to the stress exerted on bones by muscles and by gravity. Athletes may ingest drugs, such as steroids or growth hormone, in an effort to improve performance, and this practice also can affect BMD. Exercise may also modify the hormonal status of women. The association between exercise, amenorrhea (lack of menstruation), low estrogen status, and changes in bone mineral density of female athletes is reviewed in this article. The relationship between weight-bearing (working against gravity) and bone mass is discussed, as are studies reporting higher levels of BMD at sites of maximum stress in athletes. Amenorrhea has increased in frequency as female athletes have begun to train to the same extent as men. Amenorrhea occurs in athletes training for endurance rather than power, and is related to the intensity of training. Energy-restricted diets may also contribute to amenorrhea as seen in ballerinas and female rowers. Athletes' ages may affect whether lack of menses is manifested as delayed menarche (start of menstruation), or as secondary amenorrhea. Estrogen is well recognized as being important in protecting premenopausal women from low BMD. Nonathletes with amenorrhea develop decreased BMD, establishing the relationship of these factors, but the duration of amenorrhea leading to irreversible losses of BMD is uncertain. Amenorrheic athletes tend to have lower BMD. The major health consequences of this appear to be an increase in stress fractures and a higher risk for osteoporosis. Although spinal BMD below the fracture level has been observed in some athletes, an increase in the incidence of spinal or other fractures has not yet been observed. Athletes tend to resist reductions of their training mileage, and alternative treatments have consisted of hormone replacement and diet therapy. Further study of female athletes and their training habits is needed as a means of improving strategies to reduce the incidence of osteoporosis later in life. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1990
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Prediction of fractures in perimenopausal women: a comparison of dual energy x ray absorptiometry and broadband ultrasound attenuation
Article Abstract:
Measurements of bone mineral density (BMD) including dual energy x ray absorptiometry (DXA) and broadband ultrasound attenuation (BUA) may have some value in predicting bone breakage in women close to menopause age. BMD is a measurement of mineral concentration in bone. Researchers scanned various bone sites of 1000 women (ages 45 to 49 years) with DXA and BUA and polled these women two years later about any bone breaks due to either falls or traumatic injury. Of the 790 respondents to the survey, only 2% of these women reported any bone breaks during this time period. There was a tendency for women who had bone breaks to have lower BMD measurements, particularly in the spine. These women also tended to be further from the beginning of their menopause (3.6 years) as compared to women who did not have any bone breaks (1.7 years).
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1996
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Clinical usefulness of risk factors for osteoporosis
Article Abstract:
Risk factors for osteoporosis do not appear to provide a useful means for determining who should have bone mineral densitometry studies. Bone densitometry studies are the best means of identifying persons who could benefit from treatments to improve bone density. However, they are are costly and are not readily available, so a means of identifying persons at highest risk would be useful. Known risk factors are being thin, low calcium and vitamin D intake, lack of exercise, smoking, corticosteroid treatment, previous low trauma fracture, years since menopause, tooth loss, high alcohol intake, and genetic predisposition.
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1996
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