The effect of oral contraceptives on bone mass and stress fractures in female runners
To determine the effect of oral contraceptives (OC) on bone mass and stress fracture incidence in young female distance runners. One hundred fifty competitive female runners ages 18-26 yr were randomly assigned to OC (30 microg of ethinyl estradiol and 0.3 mg of norgestrel) or control (no interventi...
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| Veröffentlicht in: | Medicine and science in sports and exercise 2007-09, Vol.39 (9), p.1464-1473 |
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| creator | COBB, Kristin L BACHRACH, Laura K SOWERS, Maryfran NIEVES, Jeri GREENDALE, Gail A KENT, Kyla K BROWN, Byron W PETTIT, Kate HARPER, Diane M KELSEY, Jennifer L |
| description | To determine the effect of oral contraceptives (OC) on bone mass and stress fracture incidence in young female distance runners.
One hundred fifty competitive female runners ages 18-26 yr were randomly assigned to OC (30 microg of ethinyl estradiol and 0.3 mg of norgestrel) or control (no intervention) for 2 yr. Bone mineral density (BMD) and content (BMC) were measured yearly by dual x-ray absorptiometry. Stress fractures were confirmed by x-ray, magnetic resonance imaging, or bone scan.
Randomization to OC was unrelated to changes in BMD or BMC in oligo/amenorrheic (N=50) or eumenorrheic runners (N=100). However, treatment-received analyses (which considered actual OC use) showed that oligo/amenorrheic runners who used OC gained about 1% per year in spine BMD (P |
| doi_str_mv | 10.1249/mss.0b013e318074e532 |
| format | Article |
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One hundred fifty competitive female runners ages 18-26 yr were randomly assigned to OC (30 microg of ethinyl estradiol and 0.3 mg of norgestrel) or control (no intervention) for 2 yr. Bone mineral density (BMD) and content (BMC) were measured yearly by dual x-ray absorptiometry. Stress fractures were confirmed by x-ray, magnetic resonance imaging, or bone scan.
Randomization to OC was unrelated to changes in BMD or BMC in oligo/amenorrheic (N=50) or eumenorrheic runners (N=100). However, treatment-received analyses (which considered actual OC use) showed that oligo/amenorrheic runners who used OC gained about 1% per year in spine BMD (P<0.005) and whole-body BMC (P<0.005), amounts similar to those for runners who regained periods spontaneously and significantly greater than those for runners who remained oligo/amenorrheic (P<0.05). Dietary calcium intake and weight gain independently predicted bone mass gains in oligo/amenorrheic runners. Randomization to OC was not significantly related to stress fracture incidence, but the direction of the effect was protective in both menstrual groups (hazard ratio [95% CI]: 0.57 [0.18, 1.83]), and the effect became stronger in treatment-received analyses. The trial's statistical power was reduced by higher-than-anticipated noncompliance.
OC may reduce the risk for stress fractures in female runners, but our data are inconclusive. Oligo/amenorrheic athletes with low bone mass should be advised to increase dietary calcium and take steps to resume normal menses, including weight gain; they may benefit from OC, but the evidence is inconclusive.</description><identifier>ISSN: 0195-9131</identifier><identifier>EISSN: 1530-0315</identifier><identifier>DOI: 10.1249/mss.0b013e318074e532</identifier><identifier>PMID: 17805075</identifier><identifier>CODEN: MSPEDA</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Amenorrhea - complications ; Amenorrhea - drug therapy ; Biological and medical sciences ; Bone Density - drug effects ; Contraceptives, Oral, Hormonal - adverse effects ; Contraceptives, Oral, Hormonal - therapeutic use ; Energy Intake - physiology ; Female ; Fractures, Stress - epidemiology ; Fractures, Stress - etiology ; Fractures, Stress - prevention & control ; Fundamental and applied biological sciences. Psychology ; Humans ; Oligomenorrhea - complications ; Oligomenorrhea - drug therapy ; Risk Assessment ; Running - injuries ; Running - physiology ; United States - epidemiology ; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports</subject><ispartof>Medicine and science in sports and exercise, 2007-09, Vol.39 (9), p.1464-1473</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-9581fb88542d6cd404a1ffc328a0c6391a2e69879697dba810b7158866e664143</citedby><cites>FETCH-LOGICAL-c412t-9581fb88542d6cd404a1ffc328a0c6391a2e69879697dba810b7158866e664143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19055413$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17805075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>COBB, Kristin L</creatorcontrib><creatorcontrib>BACHRACH, Laura K</creatorcontrib><creatorcontrib>SOWERS, Maryfran</creatorcontrib><creatorcontrib>NIEVES, Jeri</creatorcontrib><creatorcontrib>GREENDALE, Gail A</creatorcontrib><creatorcontrib>KENT, Kyla K</creatorcontrib><creatorcontrib>BROWN, Byron W</creatorcontrib><creatorcontrib>PETTIT, Kate</creatorcontrib><creatorcontrib>HARPER, Diane M</creatorcontrib><creatorcontrib>KELSEY, Jennifer L</creatorcontrib><title>The effect of oral contraceptives on bone mass and stress fractures in female runners</title><title>Medicine and science in sports and exercise</title><addtitle>Med Sci Sports Exerc</addtitle><description>To determine the effect of oral contraceptives (OC) on bone mass and stress fracture incidence in young female distance runners.
One hundred fifty competitive female runners ages 18-26 yr were randomly assigned to OC (30 microg of ethinyl estradiol and 0.3 mg of norgestrel) or control (no intervention) for 2 yr. Bone mineral density (BMD) and content (BMC) were measured yearly by dual x-ray absorptiometry. Stress fractures were confirmed by x-ray, magnetic resonance imaging, or bone scan.
Randomization to OC was unrelated to changes in BMD or BMC in oligo/amenorrheic (N=50) or eumenorrheic runners (N=100). However, treatment-received analyses (which considered actual OC use) showed that oligo/amenorrheic runners who used OC gained about 1% per year in spine BMD (P<0.005) and whole-body BMC (P<0.005), amounts similar to those for runners who regained periods spontaneously and significantly greater than those for runners who remained oligo/amenorrheic (P<0.05). Dietary calcium intake and weight gain independently predicted bone mass gains in oligo/amenorrheic runners. Randomization to OC was not significantly related to stress fracture incidence, but the direction of the effect was protective in both menstrual groups (hazard ratio [95% CI]: 0.57 [0.18, 1.83]), and the effect became stronger in treatment-received analyses. The trial's statistical power was reduced by higher-than-anticipated noncompliance.
OC may reduce the risk for stress fractures in female runners, but our data are inconclusive. Oligo/amenorrheic athletes with low bone mass should be advised to increase dietary calcium and take steps to resume normal menses, including weight gain; they may benefit from OC, but the evidence is inconclusive.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Amenorrhea - complications</subject><subject>Amenorrhea - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Bone Density - drug effects</subject><subject>Contraceptives, Oral, Hormonal - adverse effects</subject><subject>Contraceptives, Oral, Hormonal - therapeutic use</subject><subject>Energy Intake - physiology</subject><subject>Female</subject><subject>Fractures, Stress - epidemiology</subject><subject>Fractures, Stress - etiology</subject><subject>Fractures, Stress - prevention & control</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Oligomenorrhea - complications</subject><subject>Oligomenorrhea - drug therapy</subject><subject>Risk Assessment</subject><subject>Running - injuries</subject><subject>Running - physiology</subject><subject>United States - epidemiology</subject><subject>Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports</subject><issn>0195-9131</issn><issn>1530-0315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1L3kAUhQdp0VfrP5AyG7uL3pv5yMyyiFVBcKPrMJncwUgyeTs3KfTfm-ILQlfnLJ5zFo8QFwhXWGt_PTFfQQeoSKGDRpNR9ZHYoVFQgULzRewAvak8KjwRp8xvANAohcfiBBsHBhqzEy_PryQpJYqLnJOcSxhlnPNSQqT9MvwhlnOW3ZxJToFZhtxLXgptNW3Msm5VDlkmmsJIsqw5U-Fv4msKI9P5Ic_Ey6_b55v76vHp7uHm52MVNdZL5Y3D1DlndN3b2GvQAVOKqnYBolUeQ03Wu8Zb3_RdcAhdg8Y5a8lajVqdiR8fv_sy_16Jl3YaONI4hkzzym0NWlkH9QbqDzCWmblQavdlmEL52yK0_3S2m872f53b7Pvhf-0m6j9HB38bcHkAAscwbkpyHPiT82CMRqXeAdfefio</recordid><startdate>20070901</startdate><enddate>20070901</enddate><creator>COBB, Kristin L</creator><creator>BACHRACH, Laura K</creator><creator>SOWERS, Maryfran</creator><creator>NIEVES, Jeri</creator><creator>GREENDALE, Gail A</creator><creator>KENT, Kyla K</creator><creator>BROWN, Byron W</creator><creator>PETTIT, Kate</creator><creator>HARPER, Diane M</creator><creator>KELSEY, Jennifer L</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope></search><sort><creationdate>20070901</creationdate><title>The effect of oral contraceptives on bone mass and stress fractures in female runners</title><author>COBB, Kristin L ; BACHRACH, Laura K ; SOWERS, Maryfran ; NIEVES, Jeri ; GREENDALE, Gail A ; KENT, Kyla K ; BROWN, Byron W ; PETTIT, Kate ; HARPER, Diane M ; KELSEY, Jennifer L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-9581fb88542d6cd404a1ffc328a0c6391a2e69879697dba810b7158866e664143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Amenorrhea - complications</topic><topic>Amenorrhea - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Bone Density - drug effects</topic><topic>Contraceptives, Oral, Hormonal - adverse effects</topic><topic>Contraceptives, Oral, Hormonal - therapeutic use</topic><topic>Energy Intake - physiology</topic><topic>Female</topic><topic>Fractures, Stress - epidemiology</topic><topic>Fractures, Stress - etiology</topic><topic>Fractures, Stress - prevention & control</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Oligomenorrhea - complications</topic><topic>Oligomenorrhea - drug therapy</topic><topic>Risk Assessment</topic><topic>Running - injuries</topic><topic>Running - physiology</topic><topic>United States - epidemiology</topic><topic>Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>COBB, Kristin L</creatorcontrib><creatorcontrib>BACHRACH, Laura K</creatorcontrib><creatorcontrib>SOWERS, Maryfran</creatorcontrib><creatorcontrib>NIEVES, Jeri</creatorcontrib><creatorcontrib>GREENDALE, Gail A</creatorcontrib><creatorcontrib>KENT, Kyla K</creatorcontrib><creatorcontrib>BROWN, Byron W</creatorcontrib><creatorcontrib>PETTIT, Kate</creatorcontrib><creatorcontrib>HARPER, Diane M</creatorcontrib><creatorcontrib>KELSEY, Jennifer L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><jtitle>Medicine and science in sports and exercise</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>COBB, Kristin L</au><au>BACHRACH, Laura K</au><au>SOWERS, Maryfran</au><au>NIEVES, Jeri</au><au>GREENDALE, Gail A</au><au>KENT, Kyla K</au><au>BROWN, Byron W</au><au>PETTIT, Kate</au><au>HARPER, Diane M</au><au>KELSEY, Jennifer L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of oral contraceptives on bone mass and stress fractures in female runners</atitle><jtitle>Medicine and science in sports and exercise</jtitle><addtitle>Med Sci Sports Exerc</addtitle><date>2007-09-01</date><risdate>2007</risdate><volume>39</volume><issue>9</issue><spage>1464</spage><epage>1473</epage><pages>1464-1473</pages><issn>0195-9131</issn><eissn>1530-0315</eissn><coden>MSPEDA</coden><abstract>To determine the effect of oral contraceptives (OC) on bone mass and stress fracture incidence in young female distance runners.
One hundred fifty competitive female runners ages 18-26 yr were randomly assigned to OC (30 microg of ethinyl estradiol and 0.3 mg of norgestrel) or control (no intervention) for 2 yr. Bone mineral density (BMD) and content (BMC) were measured yearly by dual x-ray absorptiometry. Stress fractures were confirmed by x-ray, magnetic resonance imaging, or bone scan.
Randomization to OC was unrelated to changes in BMD or BMC in oligo/amenorrheic (N=50) or eumenorrheic runners (N=100). However, treatment-received analyses (which considered actual OC use) showed that oligo/amenorrheic runners who used OC gained about 1% per year in spine BMD (P<0.005) and whole-body BMC (P<0.005), amounts similar to those for runners who regained periods spontaneously and significantly greater than those for runners who remained oligo/amenorrheic (P<0.05). Dietary calcium intake and weight gain independently predicted bone mass gains in oligo/amenorrheic runners. Randomization to OC was not significantly related to stress fracture incidence, but the direction of the effect was protective in both menstrual groups (hazard ratio [95% CI]: 0.57 [0.18, 1.83]), and the effect became stronger in treatment-received analyses. The trial's statistical power was reduced by higher-than-anticipated noncompliance.
OC may reduce the risk for stress fractures in female runners, but our data are inconclusive. Oligo/amenorrheic athletes with low bone mass should be advised to increase dietary calcium and take steps to resume normal menses, including weight gain; they may benefit from OC, but the evidence is inconclusive.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17805075</pmid><doi>10.1249/mss.0b013e318074e532</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0195-9131 |
| ispartof | Medicine and science in sports and exercise, 2007-09, Vol.39 (9), p.1464-1473 |
| issn | 0195-9131 1530-0315 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_20436802 |
| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Journals@Ovid Complete |
| subjects | Adolescent Adult Amenorrhea - complications Amenorrhea - drug therapy Biological and medical sciences Bone Density - drug effects Contraceptives, Oral, Hormonal - adverse effects Contraceptives, Oral, Hormonal - therapeutic use Energy Intake - physiology Female Fractures, Stress - epidemiology Fractures, Stress - etiology Fractures, Stress - prevention & control Fundamental and applied biological sciences. Psychology Humans Oligomenorrhea - complications Oligomenorrhea - drug therapy Risk Assessment Running - injuries Running - physiology United States - epidemiology Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports |
| title | The effect of oral contraceptives on bone mass and stress fractures in female runners |
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