Hormonal
Hormone Replacement Therapy (HRT) or oral contraceptives in hypoestrogenic amenorrheic athletes may prevent further bone loss but are often insufficient to stimulate bone growth or replace bone lost prior to intervention; correcting metabolic abnormalities is more effective for bone health.
If you are an amenorrheic athlete with low bone density, taking estrogen or birth control might stop your bones from getting worse, but it likely won't rebuild the bone you've already lost. The most effective way to improve bone health is to fix the underlying energy deficit and metabolic issues (eating more, training less intensely). HRT should be used cautiously and likely only after bone growth is complete in younger athletes.
Treatment with exogenous estrogen may help to curb further bone loss in the hypoestrogenic amenorrheic athlete, but may not be sufficient to stimulate bone growth. Treatment aimed at correcting metabolic abnormalities may in fact prove more effective than that aimed at correcting estrogen deficiencies.
Why this rating
The paper cites multiple studies (Emans, Hergenroeder, Klibanski, Warren) showing HRT prevents loss but doesn't restore bone, and that metabolic markers correlate with bone formation.
Source
The effects of intense exercise on the female reproductive system
M.P. Warren et al. · Journal of Endocrinology · 2001
DOI 10.1677/joe.0.1700003
More from this paper
- In female athletes engaged in sports emphasizing leanness, energy drain (energy expenditure exceeding dietary intake) is the primary causal factor for hypothalamic suppression of GnRH, leading to hypoestrogenism, menstrual dysfunction, and compromised bone density.Good
- In female athletes engaged in sports emphasizing strength over leanness (e.g., swimming, rowing), reproductive dysfunction is characterized by hyperandrogenism (elevated DHEA-S) rather than hypoestrogenism, potentially due to adrenal axis activation or self-selection of high androgens for performance.Moderate
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