International SportMed Journal - Volume 5, Issue 1, 2004
Volume 5, Issue 1, 2004
Source: International SportMed Journal 5, pp 1 –25 (2004)More Less
Selected comments are provided on the medical aspects of the female adolescent athlete. After considering basic physiologic issues, the review turns to iron deficiency anemia, stress urinary incontinence and injury patterns in the female adolescent athlete. Breast problems, menstrual dilemmas, the Female Athletic Triad, and the issue of exercise during pregnancy are also considered. There is much that the clinician can do to enhance the benefits of sports play for this unique athlete.
Source: International SportMed Journal 5, pp 26 –36 (2004)More Less
Introduction : Premenstrual syndrome (PMS) is defined as a recurrent luteal-phase condition characterised by physical, psychological, and behavioural changes of sufficient severity to result in deterioration of interpersonal relationships and normal activity. Several treatments appear to be effective. Among these are increased physical activity, dietary change, mineral salt supplementation, ovulation inhibitors, and some anxiolytic drugs.
Objective : Review of the literature to evaluate the effects of exercise on PMS.
Methods : A MEDLINE/EMBASE search for all studies published between 1970 and 2003 was performed.
Results : Three prospective studies were included. The largest study reported significant differences between the exercise (n=97) and the non-exercise group (n=159). The results revealed a significant positive effect of exercise on negative mood states and physical symptoms. In the second study (n=15), the exercisers experienced decreases in physical and emotional symptoms over time with no changes in the non-exercise group (n=6). The third study (n=23) evaluated the effects of aerobic exercise and strength training on premenstrual symptoms. There was a general improvement in several premenstrual symptoms, particularly in depressed mood.
Conclusions : The limited data available on exercise and PMS show a significant improvement in the symptomatology of the disorder and suggest a benefit from regular exercise. Aerobic exercise should be recommended as first-line therapy because of the large number of other health benefits. However, the impact of exercise on PMS needs to be assessed in greater detail with rigorous methodology to draw firm conclusions.
Author Tina DusekSource: International SportMed Journal 5, pp 37 –44 (2004)More Less
Objective : This study reviewed the current literature about epidemiology, aetiology and treatment of menstrual cycle disorders in athletes.
Data sources : Literature from the past 25 years on menstrual cycle disorders in athletes using MEDLINE and library searches was combined with the author's research.
Study selection : Journal articles, abstracts and books were reviewed, and selected on their relevant contribution to data on epidemiology, pathogenesis, diagnostic tests, preventive strategies and management protocols.
Data extraction : From these investigations the analysed variables and the main outcomes were extracted.
Data synthesis : Disorders of menstrual function, including amenorrhea, oligomenorrhea and delayed menarche are recognised to occur more frequently in female athletes than in the general population. Amenorrhea that is related to athletic training is mainly caused by changes in hypothalamus. These changes result in the decrease in oestrogen level, which can cause serious damage to the bones. There appears to be two major influences on the changes in hypothalamus : a critical level of body fat and the effect of stress.
Conclusions : Menstrual disorders should be promptly recognised and adequately treated because of their long-term consequences on bone health.
Author Melinda M. ManoreSource: International SportMed Journal 5, pp 45 –55 (2004)More Less
Objective : This article reviews the role of energy and diet in the aetiology, treatment and prevention of athletic menstrual dysfunction.
Data sources and extraction : Research reviewed was derived from English language journals.
Data synthesis : Although a number of factors may contribute to the development of athletic menstrual dysfunction, negative energy balance while participating in strenuous physical activity, appears to be the primary factor. Numerous studies have compared the energy intakes of athletes with and without menstrual dysfunction, but only 4 studies have carefully measured energy balance using 7-day diet and activity records. In all 4 of these studies, a negative energy balance was reported in active women with menstrual dysfunction. Only 2 studies have attempted to reverse menstrual dysfunction by improving energy balance, but these studies were too short and had small sample sizes. Thus it is not known what level of negative energy balance triggers the development of this disorder. The primary nutrition related health consequences of athletic menstrual dysfunction are suppressed reproductive hormones, the potential for poor bone health, low nutrient intakes (protein, carbohydrate, essential fatty acids, calcium, B vitamins, iron and zinc), and the risk of developing disordered eating behaviours.
Conclusions : A growing body of research indicates that a negative energy balance is the primary factor contributing to athletic menstrual dysfunction. Treatment and prevention of this disorder need to focus on improving energy balance, while allowing for sport participation and the maintenance of a competitive body weight and composition (n=240).
Author Vicki J. HarberSource: International SportMed Journal 5, pp 56 –66 (2004)More Less
Secondary amenorrhea, luteal phase defects and delayed menarche, are the most common types of menstrual dysfunction documented in athletes. While amenorrhea is more easily detected, luteal phase defects are asymptomatic and athlete perception of menstrual disruption is minimal. The prevalence of amenorrhea in the athletic population is well above that found in the general population. The occurrence of less symptomatic menstrual problems (e.g. luteal phase deficiency) among highly active women is likely much higher. This paper will briefly review these forms of menstrual irregularities, provide definitions and their assessment markers and a summary of the factors predisposing athletes to reproductive dysfunction.
A critical review of exercise training effects on bone mineral density (BMD) in early postmenopausal women : article reviewSource: International SportMed Journal 5, pp 67 –77 (2004)More Less
Objectives : To review evidence of positive exercise effects on BMD in early postmenopausal women (0.5-8 years postmenopausal) by summarising existing studies in this area.
Data sources : MEDLINE search using the terms "exercise" AND "BMD" AND "osteoporosis", later than 1970, plus the bibliographies of the studies identified by the MEDLINE search.
Study selection : Nine studies were identified and included in this review. All the studies included a non-training control group, half of them were randomised.
Data extraction : Exercise effects on bone mineral density at the hip and the spine were qualitatively compared predominantly based on the type of exercise and study duration. A quantitative analysis was not possible due to the inhomogeneity of the studies.
Data synthesis : 5 out of 7 studies (6 out of 9 exercising subgroups) demonstrated significant positive exercise effects defined as BMD differences in the exercise versus control group at the lumbar spine, and 3 out of 6 at the proximal femur. Intervention periods of all studies showing no positive results were shorter than nine months. However, only 3 studies showed significant positive BMD changes in the exercise group alone. All of these studies used mixed exercise regimes using high impact exercises and resistance training.
Conclusion : The results suggest that in particular exercise programmes with high impact and resistance training lasting longer than a year help to maintain or even improve BMD at the lumbar spine and hip in early postmenopausal women.
Exercise and female adolescents : effects on the reproductive and musculoskeletal systems : review articleSource: International SportMed Journal 5, pp 78 –88 (2004)More Less
Intense exercise in the absence of proper nutritional intake presents many serious problems for the female adolescent. In terms of the reproductive system, these adolescents may suffer from primary amenorrhea and delayed pubertal progression, including slowed or stunted bone growth. Intense exercise without commensurate caloric intake severely affects the female adolescent skeletal system, which can induce early onset osteoporosis and osteopenia. Several hypotheses have attempted to account for these reproductive and skeletal abnormalities, as well as the role of oestrogen and leptin. Treatment of these pathologies often involves nutritional rehabilitation, in addition to counselling for any concomitant psychological disorders such as anorexia nervosa, or sub-clinical eating disorders.