Obstacles in the optimization of bone health outcomes in the female athlete triad

Ducher, Gaele, Turner, Anne I., Kukuljan, Sonja, Pantano, Kathleen J., Carlson, Jennifer L., Williams, Nancy I. and De Souza, Mary Jane 2011, Obstacles in the optimization of bone health outcomes in the female athlete triad, Sports medicine, vol. 41, no. 7, pp. 587-607, doi: 10.2165/11588770-000000000-00000.

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Title Obstacles in the optimization of bone health outcomes in the female athlete triad
Alternative title Review : Obstacles in the optimization of bone health outcomes in the female athlete triad
Author(s) Ducher, Gaele
Turner, Anne I.ORCID iD for Turner, Anne I. orcid.org/0000-0002-0682-2860
Kukuljan, Sonja
Pantano, Kathleen J.
Carlson, Jennifer L.
Williams, Nancy I.
De Souza, Mary Jane
Journal name Sports medicine
Volume number 41
Issue number 7
Start page 587
End page 607
Total pages 21
Publisher Adis International Ltd.
Place of publication Auckland, New Zealand
Publication date 2011-07-01
ISSN 0112-1642
Keyword(s) Bone
Bone health
Summary Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the ‘female athlete triad’. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture.
This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging.
Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.

Language eng
DOI 10.2165/11588770-000000000-00000
Field of Research 110604 Sports Medicine
Socio Economic Objective 920116 Skeletal System and Disorders (incl. Arthritis)
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2011, Adis Data Information BV
Persistent URL http://hdl.handle.net/10536/DRO/DU:30036751

Document type: Journal Article
Collections: Faculty of Health
Institute for Physical Activity and Nutrition
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Created: Tue, 30 Aug 2011, 14:05:16 EST by Jane Moschetti

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