Primary Amenorrhea and Persistent Stress Fracture

Area of Science:

• Sports Medicine
• Endocrinology
• Orthopedics

Background:

• Female athletes are susceptible to the Female Athlete Triad, including amenorrhea and low bone mass.
• Stress fractures are common injuries in athletes, particularly in runners and skiers.
• Primary amenorrhea, the absence of menstruation, can indicate underlying hormonal imbalances.

Purpose of the Study:

• To present a case of a young female athlete with primary amenorrhea and a stress fracture.
• To explore the potential causes and diagnostic considerations for this presentation.
• To discuss the treatment and management of such cases.

Main Methods:

• Case report of a 16-year-old female athlete.
• Review of medical history, physical examination findings, and diagnostic workup.
• Assessment of treatment response.

Main Results:

• The athlete presented with primary amenorrhea and a right fourth metatarsal stress fracture.
• Hypothalamic dysfunction, potentially linked to inadequate nutrition, was suspected.
• Stress fracture resolved after 2 months of oral contraceptive therapy.

Conclusions:

• Amenorrhea in athletes can be multifactorial, involving hormonal and nutritional aspects.
• An individualized diagnostic and treatment approach is crucial for female athletes with these conditions.
• Oral contraceptives may play a role in managing stress fractures associated with amenorrhea.