title: Stress fracture and premenstrual syndrome in Japanese adolescent athletes: a cross-sectional study.
abstract: To investigate the relationship between the occurrence of stress fracture and premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) in Japanese adolescent athletes.
  
  
  
  Cross-sectional study.
  
  
  
  Osaka, Japan.
  
  
  
  A school-based survey on menstruation and school life was conducted using a sample of 1818 Japanese female students who belonged to two public high schools in Japan. Among them, we recruited 394 athletes who had regular menstrual cycles (25-38 days) and completed a questionnaire about their premenstrual symptoms and their competitive career.
  
  
  
  Premenstrual symptoms and the occurrence of stress fracture.
  
  
  
  The prevalences of moderate-to-severe PMS and PMDD were 8.9% and 1.3%, respectively, which were the same as in collegiate athletes in a previous study. Premenstrual symptoms disturbed 'Work efficiency or productivity, home responsibilities', 'Relationships with coworkers or family' and 'Athletic performance in training or competition' more severely than menstrual pain (p=0.031, p=0.004 and p<0.001, respectively). 66 athletes (16.8%) reported having experienced a stress fracture. The severity of 'Overeating or food cravings', 'Physical symptoms' and 'Performance in training or competition' in athletes with previous stress fractures were much higher than in those without a history of stress fractures (p=0.015, p=0.008 and p=0.006, respectively). In terms of premenstrual symptoms, 'Physical symptoms' was associated with an increased risk of stress fractures in athletes (OR 1.66, 95% CI 1.06 to 2.62).
  
  
  
  The results from this study indicated that premenstrual symptoms may affect athletic performance and has the risk of stress fractures in adolescent athletes.
authors: Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan.
authors: Takashi
authors: 0000-0003-2428-1946
authors: T
authors: Takeda
authors: Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan.
authors: Yoko
authors: Y
authors: Imoto
authors: Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan.
authors: Hiroyo
authors: H
authors: Nagasawa
authors: Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan.
authors: Atsuko
authors: A
authors: Takeshita
authors: Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan.
authors: Masami
authors: M
authors: Shiina
mesh_terms: D000293:Adolescent; D056352:Athletes; D054874:Athletic Performance / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D015775:Fractures, Stress / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D065446:Premenstrual Dysphoric Disorder / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D014495:Universities
keywords: MENTAL HEALTH; SPORTS MEDICINE