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Osteopenia in exercise-associated amenorrhea using ballet dancers as a model: a longitudinal study
Michelle P Warren1, Jeanne Brooks-Gunn, Richard P Fox
1Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center and the Columbia College of Physicians and Surgeons, 622 West 168th Street, New York, NY 10032, USA. mpw1@columbia.edu
The Journal of Clinical Endocrinology and Metabolism
|July 11, 2002
Summary
Young women with amenorrhea, whether dancers or not, experience reduced bone mineral density (BMD). Delayed menarche is linked to stress fractures, highlighting risks to bone health.
Area of Science:
- Bone Biology
- Reproductive Endocrinology
- Sports Medicine
Background:
- Longitudinal studies on amenorrhea and bone mineral density (BMD) in young women are scarce.
- Hypothalamic amenorrhea is a condition affecting young women, particularly athletes, with potential implications for bone health.
Purpose of the Study:
- To compare BMD changes over two years in amenorrheic and non-amenorrheic dancers and non-dancers.
- To investigate the role of hypothalamic amenorrhea and delayed menarche on bone health in young women.
Main Methods:
- A two-year longitudinal study comparing 111 young women (dancers and non-dancers) with and without hypothalamic amenorrhea.
- Collection of detailed hormonal, nutritional, and bone mineral density (BMD) data, including measurements of spine, wrist, and foot BMD.
- Assessment of stress fractures and analysis of dieting and nutritional patterns using the Eating Attitudes Test.
Main Results:
- Amenorrheic groups (dancers and non-dancers) exhibited reduced BMD across multiple sites compared to controls throughout the study.
- Amenorrheic dancers showed a significant decrease in spine BMD, with delayed menarche predicting stress fractures.
- Subjects who resumed menses demonstrated increased BMD, though not to normal levels, indicating potential for recovery.
Conclusions:
- Young women experiencing amenorrhea and/or delayed menarche are at risk for low bone mass, irrespective of exercise levels.
- Reproductive and nutritional factors significantly impact bone mass accretion in this demographic.
- Early identification and intervention are crucial for mitigating long-term skeletal health risks associated with amenorrhea.