Menstrual Function and Bone Mass in Elite Women Distance Runners

doi:10.1059/0003-4819-102-2-158

Menstrual Function and Bone Mass in Elite Women Distance Runners

Endocrine and Metabolic Features

ROBERT MARCUS, M. D.;
CHRISTOPHER CANN, Ph.D.;
PHILIP MADVIG, M.D.;
JEROME MINKOFF, M.D.;
MARY GODDARD, M.S., R.D.;
MONIKA BAYER, Ph.D.;
MARY MARTIN, M.D.;
LINDA GAUDIANI, M.D.;
WILLIAM HASKELL, Ph.D.; and
HARRY GENANT, M.D.

Palo Alto, Stanford, and San Francisco, California

Abstract

Bone mass and metabolic features were studied in 17 women distance runners. Eleven of the women had secondary amenorrhea for 1 to 7 years. Six women have maintained regular menses since menarche. Both groups were matched for aerobic capacity, body fat, exercise intensity, and age of menarche. Mineral density of lumbar spine in the amenorrheic runners was lower than that in the cyclic women and age-matched controls, but higher than that in runners with secondary amenorrhea who are less physically active. Mineral density of the radius was normal in both groups. Running-related fractures were more frequent in amenorrheic women. Metabolic assessment showed no differences between groups, except that serum triiodothyronine was lower in the amenorrheic group, perhaps reflecting low calorie intake. Intense exercise may reduce the impact of amenorrhea on bone mass; however, amenorrheic runners remain at high risk for exercise-related fractures.

Article and Author Information

▸From the Aging Study Unit, Geriatric Research, Education and Clinical Center, Veterans Administration Medical Center, Palo Alto, California; the Department of Medicine and Radiology, Stanford University School of Medicine, Stanford, California; and the Departments of Medicine, Radiology, and Obstetrics and Gynecology, University of California San Francisco, San Francisco, California.
Grant support: in part by the Research Service of the Veterans Administration, and grants AM27926, P3011979, and AGO1312 from the National Institutes of Health.
▸Requests for reprints should be addressed to Robert Marcus, M.D.; Geriatric Research, Education and Clinical Center 182-B, Veterans Administration Medical Center, 3801 Miranda Avenue; Palo Alto, CA 94304.