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

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 Sacral Stress Fractures: A Rare but Curable Cause of Back Pain in Athletes

2019 ◽  
Vol 11 (5) ◽  
pp. 446-452 ◽  
Author(s):  
Sravya Vajapey ◽  
George Matic ◽  
Clinton Hartz ◽  
Timothy L. Miller
Keyword(s):  
Back Pain ◽  
Disordered Eating ◽  
Female Athlete ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Case Series ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density

Background: Stress fractures of the sacrum are an uncommon cause of low back and buttock pain in athletes. They have been described in a few case reports, with the injury occurring most often in female distance runners. Given the rarity of this condition, there is a general lack of awareness of this injury, which may lead to a missed or delayed diagnosis. Study Design: Case series. Level of Evidence: Level 5. Methods: The 5 cases were identified by performing a medical records search within the practices of the senior authors over a 3-year period from January 2016 to December 2018. Results: Three of 5 patients (1 male, 2 females) returned to regular activity after diagnosis and treatment. Two (1 male, 1 female) have yet to return to regular activity. Magnetic resonance imaging was the key modality in all diagnoses. All 3 female patients had components of the female athlete triad—menstrual irregularity, disordered eating, and decreased bone mineral density. Conclusion: A high index of suspicion is required to make the correct diagnosis and initiate treatment for this rare condition given its association with low body mass index, vitamin D insufficiency, disordered eating, and malabsorption disorders. Appropriate treatment includes rest from the causative activity, nutritional support, and biomechanical optimization. In severe, chronic, or recurrent cases, referral for nutritional counseling, hormonal replacement therapies, and mental health support may be necessary. Clinical Relevance: Sacral stress fractures, though uncommon, should be included prominently in the differential diagnosis for runners with low back pain, especially if the athlete has a history of prior stress fracture or the female athlete triad.

Musculoskeletal Problems in the Female Athlete

2013 ◽  
Author(s):  
Irfan M Asif ◽  
Emily Edwards ◽  
Kimberly Harmon
Keyword(s):  
Female Athlete ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Adhesive Capsulitis ◽  
Stress Fractures ◽  
Pubic Ramus ◽  
Male Athletes ◽  
Acl Injuries ◽  
Musculoskeletal Problems ◽  
Anterior Cruciate

Musculoskeletal injuries in the female athlete are, for the most part, similar to those in the male athlete. However, there are differences in the incidence of these injuries and in the sports in which they tend to occur. Stress fractures are more common in the female athlete because of the higher prevalence of disordered eating and subsequent energy imbalance that leads to detrimental effects on bone. In addition, female athletes have a higher rate of noncontact anterior cruciate ligament (ACL) injuries than male athletes. Other musculoskeletal problems are also more common in females, such as multidirectional instability of the shoulder, adhesive capsulitis, and patellofemoral pain. Finally, as a function of greater participation by females in certain sports, such as dance and gymnastics, injuries specific to those sports are more common in females. This chapter addresses injuries that are seen commonly in the female athlete and reviews unique issues related to exercise and the female reproductive system. Figures depict the management of stress fractures, a stress fracture of the inferior pubic ramus, the tension aspect of the femoral neck, stress fractures of the rib, multidirectional shoulder instability, adhesive capsulitis, spondylolysis, proper squat landing technique, and the female athlete triad. A table outlines the recommended intake of both calcium and vitamin D for bone health at various ages.This chapter contains 9 figures, 1 table, 59 references, and 5 Board-styled MCQs.

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.

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.

The Female Athlete Triad: Is the Triad a Problem Among Division I Female Athletes?

2007 ◽  
Vol 1 (4) ◽  
pp. 358-370 ◽  
Author(s):  
Justine J. Reel ◽  
Sonya SooHoo ◽  
Holly Doetsch ◽  
Jennifer E. Carter ◽  
Trent A. Petrie
Keyword(s):  
Eating Disorders ◽  
Disordered Eating ◽  
Female Athlete ◽  
Female Athletes ◽  
Division I ◽  
Female Athlete Triad ◽  
Muscle Injuries ◽  
Menstrual Dysfunction ◽  
Eating Disordered ◽  
Menstrual History

The purpose of the study was to determine prevalence rates of the female athlete triad (Triad), differences by sport category (aesthetic, endurance, and team/anaerobic), and the relationship between each of the components of the Triad. Female athletes (N= 451) from three Division I universities with an average age of 20 years completed the Menstrual History Questionnaire, Injury Assessment Questionnaire, and the Questionnaire for Eating Disorder Diagnoses (Q-EDD; Mintz, O’Halloran, Mulholland, & Schneider, 1997). Almost 7% of female athletes reported clinical eating disorders, and 19.2% reported subclinical disordered eating. Disordered eating was prevalent in all three sport categories with no significant differences between groups. Muscle injuries were more prevalent in team/anaerobic sports (77.4%) than the aesthetic (68.1%) and endurance groups (58.1%). Furthermore, those athletes with menstrual dysfunction more frequently reported clinical eating disorders (1.4%) and sustained more skeletal injuries (51%) during their athletic career than athletes with regular menstrual function. Clinical implications and further research directions are addressed.

The Female Athlete Triad

2004 ◽  
Vol 20 (4) ◽  
pp. 197-202 ◽  
Author(s):  
Roberta Trattner Sherman ◽  
Ron A. Thompson
Keyword(s):  
Disordered Eating ◽  
Female Athlete ◽  
Female Athletes ◽  
Small Body ◽  
Female Athlete Triad ◽  
School Age ◽  
Small Body Size ◽  
Sport Competition ◽  
Sport Activities ◽  
Women In Sports

The Female Athlete Triad is a syndrome of the interrelated components of disordered eating, amenorrhea, and osteoporosis. Sometimes inadvertently, but more often by willful dietary restriction, many female athletes do not ingest sufficient calories to adequately fuel their physical or sport activities, which can disrupt menstrual functioning, thereby increasing their risk of bone loss. Although its prevalence is unknown, the Female Athlete Triad is believed to affect many athletes at all ages and all sport competition levels. Even though the Triad affects athletes in all sports, girls and women in sports that emphasize a thin or small body size or shape appear to be most at risk. This article focuses on the risks of the Female Athlete Triad for middle-and high-school-age female athletes as well as the unique issues related to the identification, management, and treatment of the various components of the Triad in this special adolescent subpopulation.

The Female Athlete Triad

2018 ◽  
pp. 288-301
Author(s):  
Jennifer L. Carlson ◽  
Katherine B. Hill
Keyword(s):  
Bone Mineral Density ◽  
Disordered Eating ◽  
Female Athlete ◽  
Low Energy ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Menstrual Dysfunction ◽  
Bone Acquisition ◽  
Low Energy Availability

In 2007, the female athlete triad was redefined to include (1) low energy availability with or without disordered eating; (2) menstrual dysfunction; and (3) decreased bone mineral density. Components of the triad are common during adolescence, a critical period for bone acquisition and growth, but the prevalence varies among athlete populations based on several factors. Screening for the triad should be a routine part of the preparticipation physical examination of adolescent athletes, and new recommendations exist for the screening and management of athletes at risk for complications from the triad. Awareness and education are critical for prevention and early intervention.

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.

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