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Osteoporosis and osteopaenia in female athletes

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Osteoporosis or osteopaenia in female athletes

  • osteoporosis
    • defined as a bone mineral density more than 2.5 standard deviations below the average for young adults
    • associated with a reduction in bone mass with no alteration in the mineralisation of bone tissue
      • bone tissue responds well to mechanical stress, and thus exercise, alongside nutrition, is essential in the teenage years to attain peak bone mass
  • women with low energy availability and low oestrogen concentrations, however, have increased risk of becoming osteoporotic
    • oestrogen protects the skeleton from bone resorption
    • deficiencies in calcium, vitamin D, and other bone trophic substances from inadequate nutritional intake also lead to increased bone resorption
    • long term risk of osteoporosis seems to be reduced by attaining a good peak bone mineral density in early life and by lifelong exposure to oestrogen
      • therefore long periods of amenorrhoea may increase the long term risk of osteoporosis
  • ostoeopenia is much more common than osteoporosis in female athletes and associated with decalcification
    • osteopenia, a bone mineral density score between 1.0 and 2.5 SD for age, seems much more clinically relevant
    • there is evidence that only 10% of female distance runners had osteoporosis yet nearly 50% had osteopenia (2)

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