Hip Structural Analysis in Adolescent and Young Adult Oligoamenorrheic and Eumenorrheic Athletes and Nonathletes

Abstract

In an eugonadal state, athletic activity confers benefits for hip structure independent of aBMD. This advantage is lost in AAs, who do not differ from nonathletes for most parameters and fare worse than EAs for cross-sectional area.

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

“…Studies to date, however, have failed to definitively determine the impact of menstrual cycle disturbances among athletes on femoral neck geometry. Duckham et al [7] and Ackerman et al [6] reported smaller femoral neck CSA among amenorrheic athletes compared with eumenorrheic athletes when categorized according to current self-reported menstrual status. However, similar to the findings presented herein, we previously reported no difference in femoral neck CSA and CSMI between amenorrheic and eumenorrheic exercising women who were categorized according to current menstrual status [12].…”

“…Historically, the majority of studies focusing on the effects of menstrual cycle disturbances have naturally focused on BMD, the bone health variable clinically used to diagnose osteoporosis. However, with technological advances in bone health imaging, such as HSA, and greater accessibility to other modes of bone imaging, such as QCT, there has been an additional focus on bone geometry among female athletes with menstrual disturbances [5][6][7]12,27,50]. These advancements in the field of women's bone health are important due to the major influence that bone geometry has on overall bone health.…”

“…Further, our results demonstrate that LMI was a significant predictor of low femoral neck CSMI and BMD after adjusting for menstrual status and body size. The influence of muscle forces and therefore lean mass on BMD and bone geometry is well-established [1, 5,6,12,[56][57][58]. The mechanisms underlying the tight link between muscle and bone involve both biomechanical and endocrine factors [59]; however, the myriad pathways that link the two organs are complex and remain to be fully elucidated.…”

“…(1) between 18 and 35 years of age; (2) good health status; (3) body mass index (BMI) between 16 and 25 kg/m 2 ; (4) participated in at least two hours per week of purposeful exercise; (5) non-smoker; (6) no hormonal therapy for the past six months; (7) not pregnant or lactating; (8) no medication use that would alter metabolism or skeletal health; and (9) no other contraindications that would prevent study participation.…”

“…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.…”