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[Sports, bones and hormones. Multiple interactions]

Y Maugars, S Lalande, J M Berthelot

    Presse Medicale (Paris, France : 1983)
    |September 30, 1995
    PubMed
    Summary
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    High-level athletic training impacts bone health through mechanical stimulation and hormonal changes. While exercise strengthens bones, hormonal imbalances like hypoestrogenism can cause bone loss, especially in female athletes.

    Area of Science:

    • Endocrinology
    • Sports Medicine
    • Bone Physiology

    Background:

    • Traditionally, sports are viewed as beneficial for bone health.
    • Recent advancements in bone densitometry and neuroendocrinology offer deeper insights into the complex relationship between physical activity and bone tissue.
    • High-level training presents unique physiological demands on athletes.

    Discussion:

    • Mechanical loading from sports stimulates bone formation, particularly in stressed areas like lower limbs for runners and upper limbs for tennis players.
    • Conversely, hormonal disruptions, such as hypoestrogenism (low estrogen levels), common in athletes with anorexia nervosa-like symptoms, lead to generalized bone loss and increased osteoporosis risk.
    • Simultaneous mechanical stress and hormonal imbalance can result in reduced cancellous bone mass, though mechanically stressed bones may show relative protection.

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    Key Insights:

    • Female athletes, particularly long-distance runners training over 30 km weekly, often experience amenorrhea (cessation of menstruation) due to central neuroendocrine dysfunction.
    • This dysfunction involves reduced pulsatile secretion of luteinizing hormone-releasing hormone (LHRH), leading to hypogonadism.
    • Delayed menarche and dysmenorrhea (painful menstruation) are also prevalent, with potential underlying mechanisms involving beta-endorphins or catelestrogens affecting hypothalamic receptors.

    Outlook:

    • Understanding these dual effects of mechanical loading and hormonal changes is crucial for effective athlete management.
    • Further research into the neuroendocrine pathways modulating bone health in athletes is warranted.
    • Developing targeted interventions to mitigate bone loss and hormonal disruptions in high-level athletes is essential for long-term health and performance.