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Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women

  • Nutrition, Exercise and Lifestyle in Osteoporosis (S Shapses and J Lappe, Section Editors)
  • Published:
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Abstract

Purpose of Review

The review aims to summarize our current knowledge surrounding treatment strategies aimed at recovery of bone mass in energy-deficient women suffering from the Female Athlete Triad.

Recent Findings

The independent and interactive contributions of energy status versus estrogen status on bone density, geometry, and strength have recently been reported, highlighting the importance of addressing both energy and estrogen in treatment strategies for bone health. This is supported by reports that have identified energy-related features (low body weight and BMI) and estrogen-related features (late age of menarche, oligo/amenorrhea) to be significant risk factors for low bone mineral density and bone stress injury in female athletes and exercising women.

Summary

Nutritional therapy is the recommended first line of treatment to recover bone mass in energy-deficient female athletes and exercising women. If nutritional therapy fails after 12 months or if fractures or significant worsening in BMD occurs, pharmacological therapy may be considered in the form of transdermal estradiol with cyclic oral progestin (not COC).

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Authors and Affiliations

  1. Women’s Health and Exercise Laboratory, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA

    Emily A. Southmayd & Adelaide C. Hellmers

  2. Women’s Health and Exercise Laboratory, 104 Noll Laboratory, Department of Kinesiology and Physiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA

    Mary Jane De Souza

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This article is part of the Topical Collection on Nutrition, Exercise, and Lifestyle in Osteoporosis

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Southmayd, E.A., Hellmers, A.C. & De Souza, M.J. Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women. Curr Osteoporos Rep 15, 459–472 (2017). https://doi.org/10.1007/s11914-017-0393-9

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