With the summer Olympics of 2012 just around the corner, all eyes will be on the finest athletes in the world. As you watch the women compete in the running, gymnastics and swimming events, you might be surprised to know that many are at risk of developing osteoporosis. These elite women athletes might be experiencing a condition commonly referred to as the "Female Athletic Triad", a combination of amenorrhea, osteoporosis and an eating disorder. Sometimes exercise and competitive sports can be too much of a good thing.
The "Female Athletic Triad" is ultimately a result of too much physical stress from high amounts of training and poor nutrition. Too much stress causes the reproductive system to shut down; thus, the female athlete will stop menstruating and have low estrogen levels. Call it a premature menopause with potential devastating effects on the bones.
Reduction of bone mass and failure to reach peak bone mass in these young female athletes amounts to osteoporosis at a very young age. Hormonal supplementation does not seem to reverse these bone changes1 which leads researchers to believe that nutrition and restoring energy balance are the keys to treating the Female Athletic Triad. It is well known that those who are not eating enough will lose bone mass. Anorexia is often associated with osteoporosis. And eating disorders are common in those who are trying to maintain a certain competitive weight. Look at some of those elite long-distance runners, you will probably be able to pick out the ones who are not getting enough nutrition to keep up with their training schedule. Those women are the ones who likely have osteoporosis too.
Runners are not the only competitors to watch. The Olympic gymnasts are also at risk for bone problems. Each time a young elite competitor stresses her bones, the bone should respond by getting stronger in a process called "mineralization". However, the bones of a woman experiencing the Female Athletic Triad do not strengthen in response to stress. Elite gymnasts and dancer who are not keeping up with their body's energy demands may start experiencing problems with stress fractures as a result of the poor bone quality.
Any woman who places huge physical demands on her body and does not eat properly can develop amenorrhea and osteoporosis. These young, highly trained female athletes are all at risk if they are not taking steps to prevent the Female Athletic Triad2 from occurring in the first place. All should be educated about proper nutrition and safe training schedules in order to keep the energy intake in balance with the energy demands. An overall energy drain and a negative energy balance is the primary cause of the amenorrhea and osteoporosis. Those athletes who are at high risk should also consider periodic bone scans3 to ensure that the young bones are staying healthy. Those Olympic athletes may look like a picture of perfect health from the outside, but inside might be an entirely different story. One of those young female athletes might have osteoporosis too.
- Ann N Y Acad Sci. 2010 Sep;1205:45-50
- Pediatr Endocrinol Rev. 2009 Dec;7(2):43-9
- Int J Sport Nutr Exerc Metab. 2010 Oct;20(5):418-26