Exercise training, menstrual irregularities and bone development in children and adolescents

Area of Science:

• Pediatric Endocrinology
• Sports Medicine
• Bone Biology

Background:

• Weight-bearing physical activity is vital for bone development, with peak bone mass largely established by the end of adolescence.
• A critical window exists during early puberty for optimizing bone mineralization in response to exercise.
• Strenuous physical activity in female athletes can disrupt the reproductive system, leading to athletic amenorrhea.

Purpose of the Study:

• To highlight the importance of physical activity for bone health during childhood and adolescence.
• To examine the link between strenuous exercise, athletic amenorrhea, and bone demineralization in female athletes.
• To emphasize the critical period for bone development and the risks associated with menstrual abnormalities.

Main Methods:

• Literature review on bone development, physical activity, and athletic amenorrhea.
• Analysis of studies on the maturity-dependent effects of exercise on bone mineralization.
• Examination of the hormonal mechanisms underlying athletic amenorrhea and its impact on bone.

Main Results:

• Bone mineral density accrual is significant during adolescence, with a critical period for exercise benefits in early puberty.
• Athletic amenorrhea, prevalent in female athletes, is linked to hypothalamic suppression of reproductive hormones.
• Reduced energy availability is identified as a primary cause of the suppressed hypothalamic-pituitary-gonadal axis in athletes.

Conclusions:

• Optimizing nutrition and managing training load are crucial for preventing menstrual abnormalities and bone loss in female athletes.
• Interventions should focus on protecting bone health during the critical bone growth period in adolescence.
• Early identification and management of athletic amenorrhea are essential to mitigate long-term skeletal risks.