Effects of sports training in adolescence on growth, puberty and bone health

Abstract

Athletic training in adolescent females is important for their well-being; indeed, it may have both positive and negative effects on some physiological processes, as growth, reproductive axis and bone health. Adequate physical activity likely exerts neither a positive nor a negative effect on growth. By contrast, intensive training and insufficient diet may have a negative influence on growth, probably due to energy deficiency and impairment of the growth hormone-insulin-like growth factor-I axis; net long term-effects of such alterations remain to be established. Adolescents who perform regular athletic training present with normal or slightly advanced sexual maturation, because increased strength and power associated with earlier maturation advantage them. However, intensive training and inadequate energy intake may induce delayed menarche and menstrual dysfunctions. The consequent hypoestrogenism, in association with the nutritional deficiencies, may affect bone health. On the contrary, regular physical activity increases the amount of bone mass gained during childhood and adolescence mainly at the bone sites which are trained. Since the number of adolescent females involved in strenuous sports from an early age is increasing, physicians must be aware of such effects, explain to girls and their parents the 'right' sports training and appropriate dietary regimens, and recognize problems due to excessive training as soon as possible. These issues should not be a cause of lesser involvement in athletic participation of young people.

Delayed menarche in young German women with type 1 diabetes mellitus: recent results from the DPV diabetes documentation and quality management system

“…Depending on the nature of a sport and a girl's genetic descent, competitive sports lead to late menarche, especially when the kind of sport chosen requires much energy relative to body mass [18]. In girls who, in addition to having T1DM as a primary disease, practice their sport excessively, great ambition paired with a focus on attaining optimum weight for athletic competitions can increase the menarche-delaying effect of sports, which later manifests as impaired growth, menstrual dysfunction and low bone mass, known as the female athlete triad syndrome [4].…”

The relation between athletic sports and prevalence of amenorrhea and oligomenorrhea in Iranian female athletes

“…As in our study, they showed that onset of menarche was later in the group with amenorrhea/oligomenorrhea than in the group with regular menstruation. Menstrual disorders and late onset menarche both seem to have caused by intensive training and inadequate energy intake [ 12 ]…”

Eating Disorders in the Obstetric and Gynecologic Patient Population

“…35,36 While there has been concern related to the effects of strenuous activity on bone density, studies have shown that regular weight-bearing activity actually increases the amount of bone mass gained during childhood, mainly at the bone sites which are trained. 37,38 Instead, the problem appears to be in young women in whom the combination of intensive training and inadequate energy intake lead to menstrual dysfunction. These girls manifest the "female athlete triad": 1) low energy availability, 2) amenorrhea, and 3) low bone mineral density.…”