Does Supplemental Estrogen Improve Bone-Related Symptoms of Female Athlete Triad in Female Athletes? A Critically Appraised Topic

2021 ◽  
pp. 1-5
Author(s):  
Elizabeth Hollenczer ◽  
Angelica Esposito ◽  
Erin M. Moore
Keyword(s):  
Oral Contraceptive ◽  
Bone Health ◽  
Female Athlete ◽  
Female Athletes ◽  
Energy Levels ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Bottom Line ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills

Clinical Scenario: Due to the Female Athlete Triad (Triad) being a 3-pronged syndrome, treatments can vary depending on the symptoms that clinicians focus on. With reproductive and bone health compromised, assessment and recovery methods include monitoring menstrual regularity and dual-energy X-ray absorptiometry scans. Low levels of estrogen have demonstrated negative effects on bone mineral density (BMD). Clinical Question: Does supplemental estrogen improve BMD in athletes with Female Athlete Triad symptoms? Summary of Key Findings: Supplemental estrogen does improve BMD with estrogen patches demonstrating increased improvement compared with oral contraceptive pills. Clinical Bottom Line: Restoration of regular menstruation, improvement of BMD, and ensuring optimal energy levels is the best approach for treating Triad symptoms. Transdermal patches are a new treatment option that address both menstrual function and BMD but still require further research. Strength of Recommendation: Available studies demonstrated a level 2 evidence for supplemental estrogen (oral contraceptive pills and estrogen patches) providing improvements for bone health related to the Triad.

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

scholarly journals Energy Deficiency, Menstrual Disturbances, and Low Bone Mass: What Do Exercising Australian Women Know About the Female Athlete Triad?

2012 ◽  
Vol 22 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Stephanie M. Miller ◽  
Sonja Kukuljan ◽  
Anne I. Turner ◽  
Paige van der Pligt ◽  
Gaele Ducher
Keyword(s):  
Stress Fracture ◽  
Bone Health ◽  
Female Athlete ◽  
Female Athletes ◽  
Adult Women ◽  
Female Athlete Triad ◽  
Sports History ◽  
Menstrual Dysfunction ◽  
Energy Deficiency ◽  
History Of

Purpose:Prevention of the female athlete triad is essential to protect female athletes’ health. The aim of this study was to investigate the knowledge, attitudes, and behaviors of regularly exercising adult women in Australia toward eating patterns, menstrual cycles, and bone health.Methods:A total of 191 female exercisers, age 18–40 yr, engaging in ≥2 hr/wk of strenuous activity, completed a survey. After 11 surveys were excluded (due to incomplete answers), the 180 participants were categorized into lean-build sports (n = 82; running/athletics, triathlon, swimming, cycling, dancing, rowing), non-lean-build sports (n = 94; basketball, netball, soccer, hockey, volleyball, tennis, trampoline, squash, Australian football), or gym/fitness activities (n = 4).Results:Mean (± SD) training volume was 9.0 ± 5.5 hr/wk, with participants competing from local up to international level. Only 10% of respondents could name the 3 components of the female athlete triad. Regardless of reported history of stress fracture, 45% of the respondents did not think that amenorrhea (absence of menses for ≥3 months) could affect bone health, and 22% of those involved in lean-build sports would do nothing if experiencing amenorrhea (vs. 3.2% in non-lean-build sports, p = .005). Lean-build sports, history of amenorrhea, and history of stress fracture were all significantly associated with not taking action in the presence of amenorrhea (all p < .005).Conclusions:Few active Australian women are aware of the detrimental effects of menstrual dysfunction on bone health. Education programs are needed to prevent the female athlete triad and ensure that appropriate actions are taken by athletes when experiencing amenorrhea.

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

scholarly journals DOES THE FEMALE ATHLETE TRIAD REALLY EXIST?

2020 ◽  
pp. 037
Author(s):  
Ivana Petrović
Keyword(s):  
Female Athlete ◽  
Female Athletes ◽  
Medical Condition ◽  
Future Research ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Physically Active ◽  
Menstrual Dysfunction ◽  
High Level ◽  
Three Components

The Female Athlete Triad (Triad) is a medical condition of female athletes consisting of three components: low energy availability (EA), menstrual dysfunction (MD), and low bone mineral density (BMD). The prevalence of all three components of the Triad ranges from 1-14%. In last ten years, it has ranged from 1.3% up to 23% with 78% of female athletes having at least one of the three components of the Triad. The aim of this systematic review is to collect and analyze recent studies of the Female Athlete Triad. Based on an analysis of electronic databases and the inclusion criteria set, 20 studies were included in the analysis. The following conclusions are proposed based on their analysis: MD was the most prevalent among endurance athletes with ranges from 35.5% to 60.7%, with the presence of secondary amenorrhea and oligomenorrhea, 30% to 64.0% and 18% to 27.0% and with a very high level of cases with irregular menorrhea, 72.3%. Low/negative EA ranges from 19.8% among non-leanness athletes and up to 77%. The greatest proportion of athletes in moderate- and high-risk categories for expressing the Triad participated in sports that emphasize leanness, including cross-country, gymnastics running, and lacrosse. A recommendation for future research is that they should focus on enhanced monitoring of physically active women, and the prevention of the Triad, stress fractures and osteoporosis.

Body Mass-Related Predictors of the Female Athlete Triad Among Adolescent Athletes

2016 ◽  
Vol 26 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Katie J. Thralls ◽  
Jeanne F. Nichols ◽  
Michelle T. Barrack ◽  
Mark Kern ◽  
Mitchell J. Rauh
Keyword(s):  
Body Mass ◽  
Female Athlete ◽  
Female Athletes ◽  
Ideal Body Weight ◽  
Adolescent Female ◽  
Female Athlete Triad ◽  
Fat Percentage ◽  
Mineral Density ◽  
Anthropometric Measures ◽  
Menstrual Dysfunction

Early detection of the female athlete triad is essential for the long-term health of adolescent female athletes. The purpose of this study was to assess relationships between common anthropometric markers (ideal body weight [IBW] via the Hamwi formula, youth-percentile body mass index [BMI], adult BMI categories, and body fat percentage [BF%]) and triad components, (low energy availability [EA], measured by dietary restraint [DR], menstrual dysfunction [MD], low bone mineral density [BMD]). In the sample (n = 320) of adolescent female athletes (age 15.9± 1.2 y), Spearman’s rho correlations and multiple logistic regression analyses evaluated associations between anthropometric clinical cutoffs and triad components. All underweight categories for the anthropometric measures predicted greater likelihood of MD and low BMD. Athletes with an IBW ≤85% were nearly 4 times more likely to report MD (OR = 3.7, 95% CI [1.8, 7.9]) and had low BMD (OR = 4.1, 95% CI [1.2, 14.2]). Those in <5th percentile for their age-specific BMI were 9 times more likely to report MD (OR 9.1, 95% CI [1.8, 46.9]) and had low BMD than those in the 50th to 85th percentile. Athletes with a high BF% were almost 3 times more likely to report DR (OR = 2.8, 95% CI [1.4, 6.1]). Our study indicates that low age-adjusted BMI and low IBW may serve as evidence-based clinical indicators that may be practically evaluated in the field, predicting MD and low BMD in adolescents. These measures should be tested for their ability as tools to minimize the risk for the triad.

scholarly journals Alteration in Metabolic Cost of Blood Urea, Serum Albumin and Oxidative Stress Induced by Oral Contraceptive Pills (OCP) among Elite Females

2021 ◽  
pp. 77-84
Author(s):  
Aftab Ahmad Jan ◽  
Alamgir Khan ◽  
Muhammad Zafar Iqbal Butt ◽  
Samiullah Khan ◽  
Ejaz Asghar ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Oral Contraceptive ◽  
Female Athletes ◽  
Mean Value ◽  
Frap Assay ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Elite Level ◽  
The Mean ◽  
Experimental Group

Background: For controlling unwilling pregnancy, sustaining gorgeousness and good health, among the elite level female athletes the use of contraceptive pills is quite common.                                                                                                                         Objective: Oxidative stress in female athletes is understudied. This research study was carried out in order to assess the alteration in metabolic rate of blood urea, bilirubin and oxidative stress induced by Levonorgestrel and Ethinylestradiol (oral contraceptive pills). The outcome of the study will reveal the impact of oral contraceptive pills on the overall health of the females.   Methods: User and non-user of oral contraceptive pills were included as participants of the study. Sixty elite level female athletes using Levonorgestrel and Ethinylestradiol were recruited as experimental group and twenty four female (non-users) as a control group were taken as sample of the study. Blood sample (5ml) was taken from all the subjects. Blood urea and bilirubin metabolism were estimated through kidney functional test and for the measurement of oxidative stress FRAP assay was used. The data obtained through kidney functional tests and FRAP assay were processed through statistical package for social sciences (SPSS, Version 23.0) Results: A significant difference was found between control and experimental subjects in FRAP values because (t (82) = 3.236, P <0.05). The mean value of subject was 110.54 and control was 137.95 in FRAP the mean value of subject is less than the mean value of control (509.3 <700.7). In case of bilirubin and serum albumin no difference was noted between control and experimental group as the value of significance is greater than 0.05. Conclusion: Based on the analysis, the researcher concluded that oral contraceptive pills produced significant rise in oxidative stress, thus affecting the overall health of elite female athletes.

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