Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence.
OBJECTIVE
To evaluate the long-term effects on bone mineral density (BMD) in women diagnosed with menstrual disorders in their adolescence.


METHODS
Prospective follow-up study six years after the initial investigation.


METHODS
A youth clinic that is part of the school health system in Stockholm.


METHODS
Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence.


METHODS
Subjects underwent gynecological examination, evaluation of eating behavior and physical activity. Whole body Dual Energy X-ray Absorptiometry was used for measurement of BMD.


METHODS
BMD.


RESULTS
The overall frequency of osteopenia/osteoporosis was 52%, and three girls had osteoporosis. Women with previous secondary amenorrhea had significantly lower BMD in the pelvis and lumbar spine than those with previous oligomenorrhea. The strongest predictor of low BMD was a restrictive eating disorder in adolescence and the most important counteraction was high physical activity at follow-up and a body mass index (BMI) > or = 22. Persistent menstrual dysfunction at follow-up was associated with polycystic ovary syndrome and lower frequency of osteopenia.


CONCLUSIONS
This clinical follow-up study has demonstrated a high frequency of osteopenia in women diagnosed with menstrual disorders in adolescence. Previous anorectic behavior was the strongest negative predictor of BMD. It is important to pay attention to an underlying eating disorder in young women with menstrual dysfunction in order to promote bone health.
Wiksten-Almströmer
Marianne
M
Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden. marianne.wiksten@utbildning.stockholm.se
Hirschberg
Angelica Lindën
AL
Hagenfeldt
Kerstin
K
D015502:Absorptiometry, Photon; D000293:Adolescent; D000375:Aging; D000568:Amenorrhea / Q000503:physiopathology; D000856:Anorexia Nervosa / Q000150:complications* / Q000503:physiopathology; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000209:etiology; D015444:Exercise / Q000502:physiology; D001068:Feeding and Eating Disorders / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008599:Menstruation Disturbances / Q000503:physiopathology*; D009839:Oligomenorrhea / Q000503:physiopathology; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult