Role of Energy Balance in Athletic Menstrual Dysfunction

Dueck, C. A.; Manore, Melinda M.; Matt, Kathleen S.

doi:10.1123/ijsn.6.2.165

Cited by 48 publications

(30 citation statements)

References 71 publications

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“…Mulheres amenorréicas devem ser estimuladas a ingerir pelo menos 1.500mg de cálcio elementar por dia para assegurar um equilíbrio do cálcio 18,36 . A reversão da amenorréia já foi relatada após uma lesão, durante uma redução do treinamento e com um aumento da ingestão calórica 84,[112][113][114][115][116] . Entretanto, não há dados epidemiológicos disponíveis sobre a taxa de sucesso de qualquer alteração do estilo de vida ou tratamento para reverter a amenorréia, aumentar a massa óssea ou a fertilidade 97 .…”

Section: Amenorréiaunclassified

“…Atletas amenorréicas que utilizam terapia de reposição hormonal em doses utilizadas para mulheres pós-menopausa demonstraram manutenção da DMO mas nenhum ganho 135 . Mulheres com amenorréia e perdas ós-seas mais leves podem preferir ajustar o treinamento e os padrões nutricionais para retornar ao seu ciclo reprodutivo normal 15,18,27,113,114,136 .…”

Section: Osteoporoseunclassified

See 1 more Smart Citation

A tríade da atleta: posicionamento oficial

Otis¹,

Drinkwater²,

Johnson³

et al. 1999

Rev Bras Med Esporte

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o desempenho, provocar amenorréia e até mesmo aumentar a mortalidade [11][12][13][14] . Amenorréia.A amenorréia primária (retardo da menarca) é a ausência de menstruação em uma menina de 16 anos com caracteres sexuais secundários 15 . A amenorréia secundá-ria é a ausência de três ou mais ciclos menstruais consecutivos após a menarca [15][16][17][18][19] . A amenorréia associada com o exercício ou com anorexia nervosa é de origem hipotalâmica [20][21][22] . A amenorréia hipotalâ-mica resulta em uma produção reduzida de hormônios ovarianos e hipoestrogenemia semelhantes à menopausa. Tanto a amenorréia hipotalâmica quanto a menopausa estão associadas com uma redução densidade mineral óssea 3,[23][24][25][26][27][28][29][30] . 3. Osteoporose. A osteoporose é uma doença caracterizada por uma massa óssea reduzida e uma deterioração da microarquitetura do tecido ósseo, o que leva a uma maior fragilidade esquelética e um maior risco de fraturas 24 . Um painel de especialistas promovido pela Organização Mundial da Saú-de estabeleceu os seguintes critérios diagnósticos 31 : a. Normal: densidade mineral óssea (DMO) que não esteja mais do que um Desvio Padrão (DP) abaixo da média de adultos jovens.b. Osteopenia: DMO entre 1 e 2,5 DP abaixo da média de adultos jovens. c. Osteoporose: DMO mais de 2,5 DP abaixo da média de adultos jovens.d. Osteoporose grave: DMO mais de 2,5 DP abaixo da mé-dia de adultos jovens mais uma ou mais fraturas.A principal causa de osteoporose pré-menopausa em mulheres ativas é uma redução da produção de hormônios ovarianos e hipoestrogenemia em conseqüência de uma amenorréia hipotalâmica 23,[26][27][28][29][30]32,33 . POSICIONAMENTO OFICIALCom base em uma abrangente revisão da literatura, em estudos de pesquisa, relatos de casos e no consenso de especialistas 4 , é posição oficial do Colégio Americano de Medicina do Esporte que:1. A Tríade da Atleta é uma síndrome importante que consiste de distúrbios alimentares, amenorréia e osteoporose. Os RESUMO A tríade da atleta é uma síndrome que ocorre em adolescentes e mulheres fisicamente ativas. Os seus componentes inter-relacionados são distúrbios alimentares, amenorréia e osteoporose. A pressão à qual adolescentes e mulheres jovens são submetidas para atingir ou manter um peso corporal irrealmente baixo está por trás dessa síndrome. Possuem maior risco as adolescentes e mulheres que praticam esportes nos quais um baixo peso corporal é importante para o desempenho ou por razões estéticas. As jovens e mulheres com um dos componentes dessa tríade devem ser investigadas para os outros. INTRODUÇÃOA maioria das adolescentes e mulheres podem obter benefícios importantes em termos de saúde advindos de uma práti-ca regular de exercícios sem estar submetidas a riscos para a saúde 1-3 . Elas devem ser estimuladas a serem fisicamente ativas em todas as fases de suas vidas. Se ocorrerem lesões ou problemas clínicos, estes devem ser rapidamente identificados e tratados por profissionais especialistas e com experiên-cia com mulheres fisicamente ativas.Em 1992 a Tríade...

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Section: Amenorréiaunclassified

Section: Osteoporoseunclassified

A tríade da atleta: posicionamento oficial

Otis¹,

Drinkwater²,

Johnson³

et al. 1999

Rev Bras Med Esporte

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show abstract

“…Exercise-induced amenorrhoea is now recognized as a multifactorial disorder in which several factors collectively suppress reproductive function. Amenorrhoea is just a symptom associated with low body weight, low body fat, physical stress, low energy and nutrient intake, energy drain and chronic hormonal alterations (Dueck et al, 1996;Marcos et al, 1998;West, 1998).…”

Section: Eating Disorders In Sportsmentioning

confidence: 99%

“…Contrary to popular belief, menstrual irregularities do not indicate optimal body fat or training levels. While cessation of menstruation may be viewed by some as convenient, it can be detrimental to bone health and may have long-term consequences resulting in infertility and other reproductive problems, impaired immune function, and an increased risk for cardiovascular diseases (Dueck et al, 1996).…”

Section: Eating Disorders In Sportsmentioning

confidence: 99%

The implication of the binomial nutrition-immunity on sportswomen's health

et al. 2002

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The diet of many athletes is inadequate due to overly restrictive habits and an obsession with losing weight in order to maintain a particular level of body weight. Many female athletes, particularly those who participate in sports that emphasize leanness (gymnastics, distance running, diving, figure skating and classical ballet), have suboptimal energy and nutrient intakes and are at risk of compromised nutritional status, including fatigue, dehydration, nutrient inadequacies, delayed growth and an impaired immunocompetence. It is very well known that active women and girls who are driven to excel in sports may develop the so-called female athlete triad in which malnutrition, amenorrhoea and osteoporosis appear as typical signs of medical complications, frequently linked to serious psychological alterations. This outcome is mainly related to that found in eating disorders -syndromes in which athletes have been defined to be at increased risk. As a consequence of all these alterations, the immune system may be affected in athletes, and subsequently they might be more prone to infections. As there is a lack of knowledge about how the immune system may be affected in basal conditions of athletes, the study of immunocompetence as an index of the nutritional status is reviewed. In summary, it is necessary to encourage all professionals surrounding athletes to be aware of the importance of taking care of their nutritional status in order not only to avoid physical and psychological complications but also to improve performance and, thus, to achieve sporting goals.

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“…This lack of knowledge or awareness may explain why many athletes inadvertently develop a negative calorie balance and amenorrhea. Dueck et al 14 reported that the average calorie difference between amenorrheic and eumenorrheic athletes was only a deficit in caloric balance of 250 kcal per day. This is the caloric equivalent of 3 glasses of skim milk or a single candy bar, and represents less than 10% of total caloric intake for an active athlete.…”

Section: Physiological Consequences Of Low Caloric Intakementioning

confidence: 99%

The Female Athlete Triad: An Emerging Role for Physical Therapy

Papanek¹

2003

J Orthop Sports Phys Ther

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Over the last thirty years, participation by girls and women in organized athletics has increased dramatically. This presents unique challenges in the area of sports medicine, orthopaedics, and pediatrics. While the benefits of participation in sports and exercise vastly outweigh the risks of permanent injury, an evolving concern is the number of stress fractures in active women. The female athlete triad (''triad'') describes the coexistence of 3 distinct medical conditions that may occur in athletic girls and women. Originally, the triad included eating disorders, amenorrhea, and osteoporosis. Presently, it includes eating disorders/disordered eating behavior, amenorrhea/ oligomenorrhea, and decreased bone mineral density (osteoporosis and osteopenia). Briefly, when coupled with inadequate nutrition, the high caloric expenditure of exercise training results in a sustained negative caloric balance or low energy availability, which is exquisitely sensed by the hypothalamus, initiating a complex neuroendocrine adaptive cascade. This cascade is associated with changes in the hypothalamic-pituitary-ovarian axis, such that estrogen levels are decreased, resulting in reproductive dysfunction that may include amenorrhea, oligomenorrhea, or anovulation. Low estrogen in otherwise young healthy women, like menopause, is associated with decreased bone mineral density and increased risk of fractures. The triad is not an inevitable consequence of participation in sports or physical activity at any level, however, exercise may contribute to the disruption of caloric balance. The triad is a complex disorder that requires intervention by a multidisciplinary team. Physical therapists bring a unique expertise to the team. The present review summarizes each component of the triad, component linkage, and the role of physical therapy in prevention, assessment, and intervention. J Orthop Sports Phys Ther 2003;33:594-614. Key Words: amenorrhea, eating disorders, osteopenia, women athletes A t the 1996 Summer Olympics, 76 000 fans saw the United States women's soccer team defeat China for the gold medal. This was the largest crowd to ever witness a women's sporting event in this country. Four years later, this attendance record was shattered as the United States hosted the Women's World Cup final. Over the last 12 years, the number of women participating in the Olympic Games has more than doubled, demonstrating a dramatic increase in the number of women competing at the very elite level in sports in the United States and around the world. The increase in elite participation has been paralleled by an increase in opportunities for women participating in all levels of sport and physical activity. We should recognize these important gains and embrace the changes as we celebrate the 30th anniversary of Title IX.The new and increasing opportunities in women's athletics are important because a wide variety of health benefits for girls and women result from participation in sports and exercise. Epidemiology studies 6,30,38 have reported an...

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Role of Energy Balance in Athletic Menstrual Dysfunction

Cited by 48 publications

References 71 publications

A tríade da atleta: posicionamento oficial

A tríade da atleta: posicionamento oficial

The implication of the binomial nutrition-immunity on sportswomen's health

The Female Athlete Triad: An Emerging Role for Physical Therapy

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