Bone parameters of elite athletes with oligomenorrhea and prevalence seeking medical attention: a cross-sectional study.


Journal

Journal of bone and mineral metabolism
ISSN: 1435-5604
Titre abrégé: J Bone Miner Metab
Pays: Japan
ID NLM: 9436705

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 11 03 2021
accepted: 28 04 2021
pubmed: 9 6 2021
medline: 26 11 2021
entrez: 8 6 2021
Statut: ppublish

Résumé

Since the definition of secondary amenorrhea is cessation of regular menses for more than 3 months, it is likely that athletes with irregular menstrual cycles, including oligomenorrhea, do not consider the condition as serious. However, the consequences of untreated oligomenorrhea have not been investigated in elite track and field athletes. The cohort consisted of 91 elite-level track and field athletes. Body compositions, including bone parameters and bone turnover markers (BTMs), were measured. Among the 91 participants, 52 were eumenorrheic and 33 were oligomenorrheic. The eumenorrheic athletes had significantly higher bone mineral density (BMD) and bone mineral content (BMC) of the lumbar spine, lower extremities, and whole body than had the oligomenorrheic athletes (p < 0.01). There were no significant differences in BTMs between the two groups, but oligomenorrheic athletes had significantly lower percent body fat. More than 40% of the elite-level female track and field athletes in this study reported menstrual disorders with oligomenorrhea as the most common. However, none sought medical attention. As compared to the eumenorrheic athletes, the oligomenorrheic athletes had lower BMC and BMD. Hence, if an athlete is oligomenorrheic, bone parameter measurements are considerably important.

Identifiants

pubmed: 34101019
doi: 10.1007/s00774-021-01234-1
pii: 10.1007/s00774-021-01234-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1009-1018

Informations de copyright

© 2021. The Japanese Society Bone and Mineral Research.

Références

Ravi S, Kujala UM, Tammelin TH, Hirvensalo M, Kovanen V, Valtonen M, Waller B, Aukee P, Sipilä S, Laakkonen EK (2020) Adolescent sport participation and age at menarche in relation to midlife body composition, bone mineral density, fitness, and physical activity. J Clin Med 9:3797
pmcid: 7760316
Gibbs JC, Nattiv A, Barrack MT, Williams NI, Rauh MJ, Nichols JF, De Souza MJ (2014) Low bone density risk is higher in exercising women with multiple triad risk factors. Med Sci Sports Exerc 46:167–176
pubmed: 23783260
Loucks AB, Verdun M, Heath EM (1998) Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol 1985:37–46
Ackerman KE, Singhal V, Baskaran C, Slattery M, Campoverde Reyes KJ, Toth A, Eddy KT, Bouxsein ML, Lee H, Klibanski A, Misra M (2019) Oestrogen replacement improves bone mineral density in oligo-amenorrhoeic athletes: a randomised clinical trial. Br J Sports Med 53:229–236
pubmed: 30301734
Pollock N, Grogan C, Perry M, Pedlar C, Cooke K, Morrissey D, Dimitriou L (2010) Bone-mineral density and other features of the female athlete triad in elite endurance runners: a longitudinal and cross-sectional observational study. Int J Sport Nutr Exerc Metab 20:418–426
pubmed: 20975110
Exupério IN, Agostinete RR, Werneck AO, Maillane-Vanegas S, Luiz-de-Marco R, Mesquita EDL, Kemper HCG, Fernandes RA (2019) Impact of artistic gymnastics on bone formation marker, density and geometry in female adolescents: ABCD-growth study. J Bone Metab 26:75–82
pubmed: 31223603 pmcid: 6561856
Andersen OK, Clarsen B, Garthe I, Mørland M, Stensrud T (2018) Bone health in elite Norwegian endurance cyclists and runners: a cross-sectional study. BMJ Open Sport Exerc Med 4:e000449
Bailey DA, McKay HA, Mirwald RL, Crocker PR, Faulkner RA (1999) A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the university of Saskatchewan bone mineral accrual study. J Bone Miner Res 14:1672–1679
pubmed: 10491214
Nichols JF, Rauh MJ, Lawson MJ, Ji M, Barkai HS (2006) Prevalence of the female athlete triad syndrome among high school athletes. Arch Pediatr Adolesc Med 160:137–142
pubmed: 16461868
Tsujioka M et al (2003) Secondary amenorrhea in high school girls. Bull Keio 21:27–31
Riaz Y, Parekh U (2020) Oligomenorrhea. StatPearls Publishing
Maïmoun L, Paris F, Coste O, Sultan C (2016) Intensive training and menstrual disorders in young female: impact on bone mass. Gynecol Obstet Fertil 44:659–663
pubmed: 27751748
Snow-Harter CM (1994) Bone health and prevention of osteoporosis in active and athletic women. Clin Sports Med 13:389–404
pubmed: 8013040
Singhal V, Maffazioli GD, Cano Sokoloff N, Ackerman KE, Lee H, Gupta N, Clarke H, Slattery M, Bredella MA, Misra M (2015) Regional fat depots and their relationship to bone density and microarchitecture in young oligo-amenorrheic athletes. Bone 77:83–90
pubmed: 25868796 pmcid: 4447547
Ackerman KE, Davis B, Jacoby L, Misra M (2011) DXA surrogates for visceral fat are inversely associated with bone density measures in adolescent athletes with menstrual dysfunction. J Pediatr Endocrinol Metab 24:497–504
pubmed: 21932588 pmcid: 3652985
Sutter T, Toumi H, Valery A, El Hage R, Pinti A, Lespessailles E (2019) Relationships between muscle mass, strength and regional bone mineral density in young men. PLoS ONE 14:e0213681
pubmed: 30849119 pmcid: 6407768
Christo K, Prabhakaran R, Lamparello B, Cord J, Miller KK, Goldstein MA, Gupta N, Herzog DB, Klibanski A, Misra M (2008) Bone metabolism in adolescent athletes with amenorrhea, athletes with eumenorrhea, and control subjects. Pediatrics 121:1127–1136
pubmed: 18519482
Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Hingle MD, Lee VR, Roe DJ, Wheeler MD, Lohman TG, Going SB (2018) Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls. Bone 113:144–150
pubmed: 29800691 pmcid: 6008243
Jørgensen HS, Winther S, Bøttcher M, Hauge E, Rejnmark L, Svensson M, Ivarsen P (2017) Bone turnover markers are associated with bone density, but not with fracture in end stage kidney disease: a cross-sectional study. BMC Nephrol 18:284
pubmed: 28874132 pmcid: 5586067
Ueda M, Inaba M, Okuno S, Maeno Y, Ishimura E, Yamakawa T, Nishizawa Y (2005) Serum BAP as the clinically useful marker for predicting BMD reduction in diabetic hemodialysis patients with low PTH. Life Sci 77:1130–1139
pubmed: 15978265
Tsukahara Y, Torii S, Yamasawa F, Iwamoto J, Otsuka T, Goto H, Kusakabe T, Matsumoto H, Akama T (2020) Changes in body composition and its relationship to performance in elite female track and field athletes transitioning to the senior division. Sports (Basel) 8:115
Rebar R (2000) Evaluation of amenorrhea, anovulation, and abnormal bleeding. In: Feingold KR, et al. eds. Endotext. Available from: MDText.com, Inc., Inc.: South Dartmouth (MA) Copyright. vol. 2020
Kindler JM, Lappe JM, Gilsanz V, Oberfield S, Shepherd JA, Kelly A, Winer KK, Kalkwarf HJ, Zemel BS (2019) Lumbar spine bone mineral apparent density in children: results from the bone mineral density in childhood study. J Clin Endocrinol Metab 104:1283–1292
pubmed: 30265344
Hangartner TN (2007) A study of the long-term precision of dual-energy X-ray absorptiometry bone densitometers and implications for the validity of the least-significant-change calculation. Osteoporos Int 18:513–523
pubmed: 17136486
Sygo J, Coates AM, Sesbreno E, Mountjoy ML, Burr JF (2018) Prevalence of indicators of low energy availability in elite female sprinters. Int J Sport Nutr Exerc Metab 28:490–496
pubmed: 29757049
Ikedo A, Ishibashi A, Matsumiya S, Kaizaki A, Ebi K, Fujita S (2016) Comparison of site-specific bone mineral densities between endurance runners and sprinters in adolescent women. Nutrients 8:781
pmcid: 5188436
Troy K, Hoch AZ, Stavrakos JE (2006) Awareness and comfort in treating the Female Athlete Triad: are we failing our athletes? WMJ 105:21–24
pubmed: 17163082
Otis CL, Drinkwater B, Johnson M, Loucks A, Wilmore J (1997) American College of Sports Medicine position stand The Female Athlete Triad. Med Sci Sports Exerc 29:i–ix
pubmed: 9140913
Matzkin E, Curry EJ, Whitlock K (2015) Female athlete triad: past, present, and future. J Am Acad Orthop Surg 23:424–432
pubmed: 26111876
Rich BS (1993) All physicians are not created equal’. understanding the educational background of the sports medicine physician. J Athl Train 28:177–179
pubmed: 16558224 pmcid: 1317701
Bodden-Heidrich R, Walter S, Teutenberger S, Küppers V, Pelzer V, Rechenberger I, Bender HG (2000) What does a young girl experience in her first gynecological examination? Study on the relationship between anxiety and pain. J Pediatr Adolesc Gynecol 13:139–142
pubmed: 10989332
Namba S (2012) Medical support for female athletes; gynecological support. J Clin Sports Med 20: P. 256. Article in Japanese
Nose S (2019) Amenorrhea and osteoporosis of adolescent female athlete. J Jpn Pediatr Assoc. 58:51–53
Drinkwater BL, Nilson K, Chesnut CH, Bremner WJ, Shainholtz S, Southworth MB (1984) Bone mineral content of amenorrheic and eumenorrheic athletes. N Engl J Med 311:277–281
pubmed: 6738640
Maïmoun L, Coste O, Philibert P, Briot K, Mura T, Galtier F, Mariano-Goulart D, Paris F, Sultan C (2013) Peripubertal female athletes in high-impact sports show improved bone mass acquisition and bone geometry. Metabolism 62:1088–1098
pubmed: 23490587
Barrow GW, Saha S (1988) Menstrual irregularity and stress fractures in collegiate female distance runners. Am J Sports Med 16:209–216
pubmed: 3381976
Misra M, Prabhakaran R, Miller KK, Tsai P, Lin A, Lee N, Herzog DB, Klibanski A (2006) Role of cortisol in menstrual recovery in adolescent girls with anorexia nervosa. Pediatr Res 59:598–603
pubmed: 16549537
Ackerman KE, Pierce L, Guereca G, Slattery M, Lee H, Goldstein M, Misra M (2013) Hip structural analysis in adolescent and young adult oligoamenorrheic and eumenorrheic athletes and nonathletes. J Clin Endocrinol Metab 98:1742–1749
pubmed: 23476076 pmcid: 3615200
Kim JH, Choi HJ, Kim MJ, Shin CS, Cho NH (2012) Fat mass is negatively associated with bone mineral content in Koreans. Osteoporos Int 23:2009–2016
pubmed: 22006041
Crabtree NJ, Kibirige MS, Fordham JN, Banks LM, Muntoni F, Chinn D, Boivin CM, Shaw NJ (2004) The relationship between lean body mass and bone mineral content in paediatric health and disease. Bone 35:965–972
pubmed: 15454104
Zhao LJ, Jiang H, Papasian CJ, Maulik D, Drees B, Hamilton J, Deng HW (2008) Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res 23:17–29
pubmed: 17784844
Hirsch KR, Smith-Ryan AE, Trexler ET, Roelofs EJ (2016) Body composition and muscle characteristics of division I Track and field athletes. J Strength Cond Res 30:1231–1238
pubmed: 27100166 pmcid: 4843842
Janicka A, Wren TA, Sanchez MM, Dorey F, Kim PS, Mittelman SD, Gilsanz V (2007) Fat mass is not beneficial to bone in adolescents and young adults. J Clin Endocrinol Metab 92:143–147
pubmed: 17047019
Schenck PA et al (2006) Chapter 6. Disorders of calcium: hypercalcemia and hypocalcemia. In: Dibartola SP (ed) Fluid, electrolyte, and acid–base disorders in small animal practice, 3rd edn. W.B. Saunders, Saint Louis, pp 122–194
Takada H, Washino K, Hanai T, Iwata H (1998) Response of parathyroid hormone to exercise and bone mineral density in adolescent female athletes. Environ Health Prev Med 2:161–166
pubmed: 21432535 pmcid: 2723353
Kota S, Jammula S, Kota S, Meher L, Modi K (2013) Correlation of vitamin D, bone mineral density and parathyroid hormone levels in adults with low bone density. Indian J Orthop 47:402–407
pubmed: 23960286 pmcid: 3745696
Bai XL, Liang TB, Wu LH, Li DL, Geng L, Wang WL, Shen Y, Zhang M, Zheng SS (2007) Elevation of intact parathyroid hormone level is a risk factor for low bone mineral density in pretransplant patients with liver diseases. Transplant Proc 39:3182–3315
pubmed: 18089348
Negri AL, Barone R, Bogado CE, Zanchetta JR (2005) Relationship between weight, body composition and bone mass in peritoneal dialysis. Nefrologia 25:269–274
pubmed: 16053008
Buchanan JR, Santen RJ, Cavaliere A, Cauffman SW, Greer RB, Demers LM (1986) Interaction between parathyroid hormone and endogenous estrogen in normal women. Metabolism 35:489–494
pubmed: 3754923
Muia EN, Wright HH, Onywera VO, Kuria EN (2016) Adolescent elite Kenyan runners are at risk for energy deficiency, menstrual dysfunction and disordered eating. J Sports Sci 34:598–606
pubmed: 26153433

Auteurs

Yuka Tsukahara (Y)

Waseda Institute for Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan. yuka.voila@gmail.com.
Institute for Integrated Sports Medicine, Keio University, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-0016, Japan. yuka.voila@gmail.com.

Suguru Torii (S)

Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.

Fumihiro Yamasawa (F)

Marubeni Health Promotion Center, 7-1, Nihonbashi 2-chome, Chuo-ku, Tokyo, 103-6060, Japan.

Jun Iwamoto (J)

Bone and Joint Disease Center, Keiyu Orthopaedic Hospital, 2267 Akoudacho, Tatebayashi, Gunma, 374-0013, Japan.

Takanobu Otsuka (T)

School of Education, Tokai Gakuen University, 901 Nakahira Tempakuku, Nagoya, 468-8514, Japan.

Hideyuki Goto (H)

Department of Health and Fitness, Faculty of Wellness, Shigakkan University, 55 Nakoyama Yokonemachi, Obu, 474-8651, Japan.

Torao Kusakabe (T)

Department of Orthopedic Surgery, Japanese Red-Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto, 602-8026, Japan.

Hideo Matsumoto (H)

Public Interest Incorporated Foundation, Sports Medicine Foundation, 8-1-9 Nishishinjyuku, Shinjyukuku, Tokyo, 160-0023, Japan.

Takao Akama (T)

Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH