Table 1.
Summary of changes in BMD among amenorrheic athletes who gained weight and/or resumed menses
| Reference | Participants
|
Duration of follow-up | Results
|
||||
|---|---|---|---|---|---|---|---|
| Sample | Age (years) | BMI (kg/m2) | Change in body weight or BMI | Resumption of menses | Change in BMD | ||
| Case reports | |||||||
| Zanker et al83 | Triathlete with primary amenorrhea | 24.8 | 16.3 | 12 years | +8.1 kg over 3 years | N/A; OCs | LS: +0.8% over 3 years Hip: +16.9% over 3 years |
| Fredericson and Kent82 | Distance runner with primary amenorrhea | 22.9 | 15.8 | 8 years | +16.9 kg | OCs for 5 years followed by regular menstrual cycles for 3 years | LS: +25.5% Hip:+19.5% |
| Mallinson et al84 | Two female athletes with secondary amenorrhea | 19 | 20.4 | 12 months | +4.2 kg | 74 days into intervention | LS: +0.8% FN: −4.3% Hip: −2.0% |
| 24 | 19.7 | +2.8 kg | 23 and 144 days into intervention | LS: +2.0% FN:+1.4% Hip:+1.9% |
|||
| Follow-up studies | |||||||
| Drinkwater et al86 | 7 AA | 26.7±2.l** | 19.9 | 15 months | +1.9 kg | 4.7 months after baseline | LS: +6.3% |
| 7 EA | 26.9±2.5** | 20.6 | −0.2 kg | N/A | LS: −0.3% | ||
| Jonnavithula et al87 | 5 AA | 20.4±5.7* | NR | 2 years | +5.4 kg | Resumed, n=3 | LS: + 13.3% |
| 12 EA | 23.5±5.l* | NR | −0.2 kg | N/A | LS: +3.2% | ||
| Keen and Drinkwater85 | 11 O/A | 30.3+1.8** | 19.1±0.5** | 6–10 years | 1.1 kg | Resumed, n=6 OCs, n=4 Amen, n=1 |
No change relative to R/R group; BMD remained significantly below R/R group and R/O/A group for LS and FN, respectively |
| 9 R/O/A | 31.4±1.7** | 20.3±0.6** | +0.5 kg | R, n=6 OCs, n=3 |
No change relative to R/R group | ||
| 9 R/R | 31.0+.1.1** | 20.1±0.4** | +4.6 kg | N/A | N/A | ||
| Warren et al88 | 10 AA | NR | NR | 2 years | NR | Resumed, n=3 | LS: +12.0% |
| 17 EA | NR | NR | NR | N/A | LS: +2.3% | ||
| Hind et al89 | 12 AA | 22.0±3.6* | 18.1±1.0* | 5 years | +1.8 kg/m2 | Resumed; n=10 | LS Z-score: ↑ from −1.5 to −0.9 Hip Z-score: ↑ from 0.3 to 0.6 |
| 6 EA | 27.4±3.3* | 19.0+1.2* | +0.8 kg/m2 | N/A | LS Z-score: ↑ from −0.1 to 0.2 Hip Z-score: no change from 0.7 |
||
Notes:
*
mean±SD;
**
mean±SE.
Abbreviations: BMD, bone mineral density; OCs, oral contraceptives; LS, lumbar spine; FN, femoral neck; AA, amenorrheic athlete; EA, eumenorrheic athlete; O/A, had always been and were currently oligomenorrheic or amenorrheic; R/O/A, regularly menstruating with episodes of amenorrhea or oligomenorrhea; R/R, had always menstruated regularly; R, regularly menstruating at baseline and remained regularly menstruating during follow-up; Amen, amenorrheic at baseline and remained amenorrheic during follow-up; N/A, not applicable; NR, not reported.