Effect of transdermal estradiol therapy on bone mineral density of amenorrheic female athletes.
amenorrhea
bone mineral density
female athlete
spontaneous menstruation
transdermal estradiol therapy
Journal
Scandinavian journal of medicine & science in sports
ISSN: 1600-0838
Titre abrégé: Scand J Med Sci Sports
Pays: Denmark
ID NLM: 9111504
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
12
10
2019
revised:
01
02
2020
accepted:
27
03
2020
pubmed:
15
4
2020
medline:
10
2
2021
entrez:
15
4
2020
Statut:
ppublish
Résumé
The effects of transdermal estradiol treatment (HT) in amenorrheic athletes (AA) with low body weight (BW) and low bone mineral density (BMD) are unknown. To investigate whether HT increases BMD in AA with low BW and to compare the results with levels in AA who have recovered spontaneous menstruation (SM). Female athletes (n = 151) were recruited at the Japan Institute of Sports Sciences and the University of Tokyo. All participants were divided into four groups: an AA group (untreated group) (n = 36), a HT group (n = 55), a SM group (n = 21), and an eumenorrheic athletes (EA) group (n = 39). Height, body weight, blood tests, and dual-energy X-ray absorptiometry were measured at baseline and after 12 months. The HT group was treated daily for 12 months with transdermal estrogen therapy. In addition, participants received oral progestin for 7 days once every 3 months. After 12 months, BMD in the AA group was significantly lower than at baseline; however, BMD in the other three groups was significantly higher than at baseline. The ratio of the change in BMD values before and after 12 months was -1.6 ± 3.2% for the AA group, 5.3 ± 8.7% for the HT group, 11.1 ± 8.9% for the SM group, and 2.3 ± 5.7% for the EA group. The rate of change in BMD values in the SM group was greater than that in the HT group. HT increased BMD in AA with low BW, and the increase in those with SM was greater than that in those treated with HT.
Sections du résumé
BACKGROUND
BACKGROUND
The effects of transdermal estradiol treatment (HT) in amenorrheic athletes (AA) with low body weight (BW) and low bone mineral density (BMD) are unknown.
PURPOSE
OBJECTIVE
To investigate whether HT increases BMD in AA with low BW and to compare the results with levels in AA who have recovered spontaneous menstruation (SM).
METHODS
METHODS
Female athletes (n = 151) were recruited at the Japan Institute of Sports Sciences and the University of Tokyo. All participants were divided into four groups: an AA group (untreated group) (n = 36), a HT group (n = 55), a SM group (n = 21), and an eumenorrheic athletes (EA) group (n = 39). Height, body weight, blood tests, and dual-energy X-ray absorptiometry were measured at baseline and after 12 months. The HT group was treated daily for 12 months with transdermal estrogen therapy. In addition, participants received oral progestin for 7 days once every 3 months.
RESULTS
RESULTS
After 12 months, BMD in the AA group was significantly lower than at baseline; however, BMD in the other three groups was significantly higher than at baseline. The ratio of the change in BMD values before and after 12 months was -1.6 ± 3.2% for the AA group, 5.3 ± 8.7% for the HT group, 11.1 ± 8.9% for the SM group, and 2.3 ± 5.7% for the EA group. The rate of change in BMD values in the SM group was greater than that in the HT group.
CONCLUSION
CONCLUSIONS
HT increased BMD in AA with low BW, and the increase in those with SM was greater than that in those treated with HT.
Substances chimiques
Biomarkers
0
Estrogens
0
Estradiol
4TI98Z838E
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1379-1386Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
De Souza MJ, Nattiv A, Joy E, et al. 2014 female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad: 1st international conference held in San Francisco, California, May 2012 and 2nd international conference held in Indianapolis, Indiana, May 2013. Br J Sports Med. 2014;48:289.
Gibbs JC, Nattiv A, Barrack MT, et al. Med low bone density risk is higher in exercising women with multiple triad risk factors. Sci Sports Exerc. 2014;46:167-176.
Torstveit MK, Sundgot-Borgen J. The female athlete triad: are elite athletes at increased risk? Med Sci Sports Exerc. 2005;37:184-193.
Mallinson RJ, De Souza MJ. Current perspectives on the etiology and manifestation of the "silent" component of the Female Athlete Triad. Int J Womens Health. 2014;6:451-467.
Rauh MJ, Nichols JF, Barrack MT. Relationships among injury and disordered eating, menstrual dysfunction, and low bone mineral density in high school athletes: a prospective study. J Athl Train. 2010;45:243-252.
Barrack MT, Gibbs JC, De Souza MJ, et al. Higher incidence of bone stress injuries with increasing female athlete triad-related risk factors: a prospective multisite study of exercising girls and women. Am J Sports Med. 2014;42:949-958.
Soleimany G, Dadgostar H, Lotfian S, Moradi-Lakeh M, Dadgostar E, Movaseghi S. Bone mineral changes and cardiovascular effects among female athletes with chronic menstrual dysfunction. Asian J Sports Med. 2012;3:53-58.
De Souza MJ, Williams NI, Nattiv A, et al. Misunderstanding the female athlete triad: refuting the IOC consensus statement on Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48:1461-1465.
Miller SM, Kukuljan S, Turner AI, van der Pligt P, Ducher G. Energy deficiency, menstrual disturbances, and low bone mass: what do exercising Australian women know about the female athlete triad? Int J Sport Nutr Exerc Metab. 2012;22:131-138.
Ducher G, Turner AI, Kukuljan S, et al. Obstacles in the optimization of bone health outcomes in the female athlete triad. Sports Med. 2011;41:587-607.
Mountjoy M, Sundgot-Borgen J, Burke L, et al. additions to the IOC consensus statement: Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2015;49(2015):417-420.
Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad-Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48:491-497.
Torstveit MK, Sundgot-Borgen J. Participation in leanness sports but not training volume is associated with menstrual dysfunction: a national survey of 1276 elite athletes and controls. Br J Sports Med. 2005;39:141-147.
Nose-Ogura S, Yoshino O, Dohi M, et al. Risk factors of stress fractures due to the female athlete triad: Differences in teens and twenties. Scand J Med Sci Sports. 2019;00:1-10.
Bachrach LK, Gordon CM. Bone densitometry in children and adolescents. Pediatrics. 2016;127:189-194.
Mazzarino M, Braganò MC, de la Torre X, Molaioni F, Botrè F. Relevance of the selective oestrogen receptor modulators tamoxifen, toremifene and clomiphene in doping field: endogenous steroids urinary profile after multiple oral doses. Steroids. 2011;76:1400-1406.
Ackerman KE, Singhal V, Baskaran C, et al. Oestrogen replacement improves bone mineral density in oligo-amenorrhoeic athletes: a randomised clinical trial. Br J Sports Med. 2019;53:229-236.
Misra M, Katzman D, Miller KK, et al. Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res. 2011;26:2430-2438.
Nabhan ZM, Dimeglio LA, Qi R, Perkins SM, Eugster EA. Conjugated oral versus transdermal estrogen replacement in girls with Turner syndrome: a pilot comparative study. J Clin Endocrinol Metab. 2009;94:2009-2014.
Nose-Ogura S, Yoshino O, Dohi M, et al. Low bone mineral density in elite female athletes with a history of secondary amenorrhea in their teens. Clin J Sport Med. 2018;1-6.
Abdi F, Mobedi H, Bayat F, Mosaffa N, Dolatian M, Ramezani TF. The effects of transdermal estrogen delivery on bone mineral density in postmenopausal women: a meta-analysis. Iran J Pharm Res. 2017;16:380-389.
Fournier A, Fritel X, Panjo H, Zins M, Ringa V. Health characteristics of women beginning postmenopausal hormone therapy: have they changed since the publication of the Women›s Health Initiative? Menopause. 2014;21:687-693.
Sanders S, Geraci SA. Osteoporosis in postmenopausal women: considerations in prevention and treatment: (women’s health series). South Med J. 2013;106:698-706.