Bone Geometry According to Menstrual Function in Female Endurance Athletes

Current and past menstrual status is an important determinant of femoral neck geometry in exercising women

“…As hypothesized, geometrical and strength measures of the femoral neck were similar among menstrual groups, supporting the findings of Duckham et al [7] who reported similar femoral neck CSA, width, section modulus, and SI between women with and without a history of menstrual irregularity. It should be noted that the population of female endurance athletes in the aforementioned study [7] demonstrated greater mean femoral neck CSA, Z, and SI than our population of physically-active women when evaluated according to menstrual function.…”

“…It should be noted that the population of female endurance athletes in the aforementioned study [7] demonstrated greater mean femoral neck CSA, Z, and SI than our population of physically-active women when evaluated according to menstrual function. Studies to date, however, have failed to definitively determine the impact of menstrual cycle disturbances among athletes on femoral neck geometry.…”

“…Less consistently, lower BMD at the femoral neck and/or total hip has also been observed [4,5,14,15]. In addition, investigators have recently demonstrated that bone geometry and microarchitecture may also be compromised in amenorrheic athletes [5][6][7], providing further evidence for compromised bone strength in these athletes. However, results for BMD and bone geometry at weight-bearing sites, such as the femoral neck and total hip, have not been consistently reported.…”

“…Several contemporary studies [7,8,[27][28][29][30] and classic studies [31,32] have explored the impact of past menstrual status, i.e., menstrual history, on bone health. Investigators of these studies reported that, in female athletes, self-reported history of irregular menstrual cycles since menarche was associated with low BMD (Z-score ≤ −1) [29] or with lower BMD compared with a history of regular menses [7,28,31,32] and was also associated with history of stress fracture [8]; however, geometric measures of the femoral neck were similar between those with a history of regular vs. irregular menses since menarche [7].…”

“…Investigators of these studies reported that, in female athletes, self-reported history of irregular menstrual cycles since menarche was associated with low BMD (Z-score ≤ −1) [29] or with lower BMD compared with a history of regular menses [7,28,31,32] and was also associated with history of stress fracture [8]; however, geometric measures of the femoral neck were similar between those with a history of regular vs. irregular menses since menarche [7]. Results from Ducher et al [27], who used peripheral quantitative computed tomography (pQCT) to assess bone health, revealed that retired gymnasts with a history of amenorrhea had significantly lower trabecular volumetric BMD and estimated bone strength but greater total bone area at the distal radius when compared with retired gymnasts with a history of regular menses.…”