Persistent osteopenia in ballet dancers with amenorrhea and delayed menarche despite hormone therapy: a longitudinal study.
OBJECTIVE
To investigate the role of estrogen deprivation and replacement in amenorrheic and nonamenorrheic dancers on hormone therapy and calcium.


METHODS
Clinical, placebo-controlled, randomized trial study.Healthy volunteers in an academic research environment.


METHODS
Fifty-five dancers (mean age: 22.0 +/- 4.6, age at menarche: 14.7 +/- 2.3 years), including 24 amenorrheics.


METHODS
Amenorrheics were randomized in a controlled trial to receive placebo or Premarin, 0.625 mg for 25 days monthly, with Provera, 10 mg, for 10 of these 25 days (hormone therapy) for 2 years. These women were compared to normally menstruating controls. The study participants also received 1250 mg of calcium per day.


METHODS
Bone mineral density (BMD) measured at the foot, wrist, and lumbar spine. Our overall results showed no difference in BMD between the treated or placebo groups, indicating that hormone therapy did not change or normalize BMD when compared to normals. Five patients (all on placebo) who resumed menses during the study showed an increase in BMD without normalization.


CONCLUSIONS
These findings suggest that mechanisms other than hypoestrogenism may be involved with the osteopenia associated with exercise-induced amenorrhea.
Warren
Michelle P
MP
Departments of Obstetrics and Gynecology, and Medicine and Orthopedics, St Luke's-Roosevelt Hospital Center and the Columbia College of Physicians and Surgeons, New York, New York 10032, USA. mpw1@columbia.edu
Brooks-Gunn
Jeanne
J
Fox
Richard P
RP
Holderness
Claire C
CC
Hyle
Emily P
EP
Hamilton
William G
WG
Hamilton
Linda
L
D000328:Adult; D000375:Aging; D000568:Amenorrhea / Q000150:complications / Q000209:etiology* / Q000503:physiopathology; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D003615:Dancing; D004334:Drug Administration Schedule; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008572:Menarche; D045167:Progesterone Congeners / Q000008:administration & dosage*
D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate