Conversely, AA lost femoral neck BMD over the winter and this was not recovered over the summer, although the increase in width of the femoral neck may have partly compensated BMD loss to maintain strength in bending. The final prospective analysis was conducted in a separate sample of female athletes who were diagnosed with a stress fracture injury. The aim of this analysis was to determine the magnitude and time scale of bone loss following a stress fracture injury and subsequent regain following retaining. A group of 4 stress fracture cases and 3 controls were followed for a period of 6-8 months following a stress fracture injury. BMD and BMC (lumbar spine, femoral neck, and trochanter) and estimations of geometric properties CSA, Z and buckling ratio) were assessed using DXA. The mean difference of bone loss and bone regain was determined by BMD, BMC and geometric parameters from baseline to 6-8 weeks and 6-8 weeks to 6-8 months respectively. No significant bone loss was found in either cases or controls from baseline to 6-8 weeks at any of the bone parameters. A significant difference at the femoral neck was found in the injured leg of the stress fracture cases from 6-8weeks to 6-8months (mean (SE) 1.042(0.102) to 1.070(0.102) g/cm2, p=0.004) with no significant change in the contra-lateral case leg 1.036 (0.102) to 1.054(0.109) g/cm2). No significant bone regain was found in the control subjects (health or injured legs ). Thus athletes do not seem to lose significant BMD during the recovery phase of training when partial weight bearing is required. Subsequent bone regain above the initial baseline value does seem to occur in the injured leg within 8 months following the stress fracture once training is resumed. In conclusion the work within this thesis has not only reinforced previous stress fracture findings, showing that a history of stress fracture is increased in athletes with a history of amenorrhoea, but has identified novel results indicating a lower incidence of stress fracture in female endurance athletes than previously reported. Exercise cognitions have been identified as risk factors for stress fracture history independent of menstrual dysfunction. Furthermore and potentially the most novel finding of this research is the importance for the examination of bone geometric properties in amenorrhoeic athletes. Findings suggest that possible structural adaptations counteract the effects of low BMD and annual losses of BMD during seasonal training in amenorrhoeic endurance athletes. In light of these findings this thesis highlights scope for further longitudinal research in the area of structural adaptation to bone in amenorrhoeic athletes. Keywords: Stress fracture, bone mineral density, bone geometry, endurance athletes, menstrual dysfunction, eating and exercise cognitions.

No description available.

Objective: This study investigated the behaviors and characteristics of the adult female endurance runner and potential components of the female athlete triad (FAT). The FAT consists of three components that are interrelated: low energy availability, menstrual dysfunction, and low bone mineral density. Low energy availability may occur with or without disordered eating. Reproduction becomes non-essential leading to irregular menstrual cycles. A reduction in estrogen levels may contribute to low bone mineral density which may lead to stress fractures. Research investigating the FAT has primarily focused on adolescent and young adult females. Adult females training for endurance events may also be at risk for the FAT. Method: A survey was constructed and distributed to females in a local half-marathon and marathon training group in Central Florida. The data was collected at one point in time and no additional follow-up was required. The survey aimed to identify specific behaviors and characteristics related to components of the FAT and determine the potential prevalence in a small sample of female endurance athletes aged 18 and older. Results: 72 females with a mean age of 40.92(± 9.61) years completed the survey. Subjects had an average height of 163.60(±6.41) cm, weighed an average of 62.24(±10.05) kg and had 10 years of running experience. Conclusion: Adult female endurance runners demonstrate behaviors and characteristics that may be indicative of the FAT. Participants demonstrated signs of inadvertent or intentional low energy availability. These characteristics can be due to either body dissatisfaction or wanting to increase performance.

Title: Menstrual Disorders in Ballet Dancers and Orienteering Runners Objectives: The aim of this thesis is to determine prevalence of selected menstrual disorders in ballet dancers and orienteering runners. The data were analyzed and compared to available literature. Methods: The theoretical part of this thesis is a summary of available literature. The data for the research were collected by anonymous non-standardized questionnaire and processed by descriptive analysis, which was proceeded in Microsoft Excel 2010, Statistika and NCSS free version. Qualitative data were evaluated by qualitative analysis. Results: A total of 103 women participated in the research, 57 women from general population (control group), 24 ballet dancers and 22 orienteering runners. The significant higher age at menarché was found in ballet dancers group (Chi square, p = 0,038; p < 0,05) as well in group of orienteering runners (Chi square, p = 0,032; p < 0,05) compared to cotrol group. There was proved a significant deviation of prevalence of secondary amenorrhea in ballet dancers group compared to orienteering runners (Chi square, p = 0,024; p < 0,05). There was no significant difference in prevalence of dysmenorrhea among groups. We found a mild positive correlation between hours of training per week and intensity of...

Bakgrund: Återhämtning och nutrition är viktiga aspekter för att minimera risken för skador hos idrottare. Ett för lågt energiintag kan leda till flera negativa fysiologiska effekter då kroppens energibehov inte tillgodoses. Hos kvinnor är menstruationsdysfunktion (MD) ett vanligt symptom på långvarig låg energitillgänglighet och hög förekomst har främst rapporterats hos kvinnliga idrottare inom viktkänsliga idrotter såsom uthållighetsidrott. Syfte: Syftet med denna studie var därför att beskriva skadebilden hos svenska och danska kvinnliga landslagsidrottare på seniornivå samt undersöka eventuella samband mellan förekomst av skador och menstruation. Metod: Alla danska och svenska kvinnliga landslagsidrottare blev kontaktade per mejl och tillfrågade om deltagande via online-enkät där frågor om skador det senaste året och menstruation ingick. Deltagare blev klassificerade att ha MD om de uppgav att de aldrig haft menstruation, ingen menstruation de senaste tre månaderna, menstruationscykler med längre intervall än 35 dagar eller &lt;9 menstruationscykler de senaste 12 månaderna. Alla deltagare blev klassificerade som antingen icke-viktkänsliga (t.ex. bollsport) eller viktkänslig idrottare (t.ex. uthålligsidrott). Resultat: Totalt svarade 634 (25%) idrottare på enkäten. Den rapporterade skadeprevalensen under de senaste 12 månaderna för samtliga inkluderade deltagare var 57%. 30% av deltagarna blev klassificerade att ha MD med en högre förekomst i viktkänsliga idrotter (39% vs 24%; P = &lt;0,001). Deltagare med MD rapporterade fler skador under de senaste 12 månaderna (P = 0,004) och hade en högre risk för skada (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) samt högre risk för att ha varit långvarigt skadad (&gt;22 dagar) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) jämfört med deltagare med regelbunden menstruation. Deltagare från viktkänsliga idrotter hade en högre risk för skada (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) och högre risk för att ha varit långvarigt skadad (OR = 2,11; 95% CI = 1,38–3,24; P = &lt;0,001) jämfört med deltagare från icke-viktkänsliga idrotter. Konklusion: Resultaten indikerar att kvinnliga landslagsidrottare med självrapporterad MD har en ökad skaderisk, speciellt inom viktkänsliga idrotter som uthållighetsidrott. Menstruationsdysfunktion bör därför tas i beaktning då det har negativ inverkan på idrottares hälsa och prestation. Vidare finns det ett stort behov av mer kunskap för att implementera effektiva kön- och idrottsspecifika preventionsåtgärder. / Background: Recovery and nutrition are important aspects in order to minimize injury risk in athletes. Multiple negative physiological impairments have been recognized in athletes due to low energy intake. One common symptom of prolonged low energy availability in females is menstrual dysfunction (MD) and high prevalence has been reported mostly in female athletes in weight-sensitive sports like endurance sports. Aim: The aim of the present study was to describe injuries among Swedish and Danish female national team athletes and to investigate potential connections between injury prevalence and menstruation. Method: All Swedish and Danish national team athletes were invited via e-mail to complete an anonymous online survey, which held questions about injuries the past year and menstruation. Participants were classified with MD if they stated that they never had menstruation, no menstruation the last three months, menstruation cycles with longer intervals than 35 days or &lt;9 menstruation cycles the last 12 months. The participants were also divided in groups of non-weight sensitive athletes (e.g. ball game) or weight sensitive athletes (e.g. endurance sport). Results: A total of 634 (25%) athletes completed the survey. Among all participants an injury prevalence of 57% was observed and 30% were classified with MD. Higher prevalence of MD was reported in weight-sensitive sports (39% vs. 24%; P = &lt;0,001). Athletes with MD sustained more injuries (P = 0,004), reported higher risk of injury (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) and to be long-term injured (&gt;22 days) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) compared to athletes with regular menstruation. In athletes from weight-sensitive sports a higher risk of injury was observed (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) and also to be long-term injured (OR = 2,11; 95% CI = 1,38–3,24; P = &lt;0,001) compared to athletes from non weight-sensitive sports. Conclusion: The result indicates that female national team athletes with self-reported MD have increased injury risk, especially in weight-sensitive sports like endurance sports. Menstrual dysfunction has a negative impact on both health and performance, and therefore athletes and coaches need to pay attention to menstrual function. More research is needed to implement effective sex and sport-specific preventive measures.

Bakgrund: Ett av sex par har någon gång upplevt problem relaterat till fertilitet under sina reproduktiva år och efter 30 års ålder är infertilitet vanligare hos kvinnor än hos män. Flera delar av menstruationscykeln består av energikrävande processer som exempelvis ägglossning och produktion av könshormoner. Näringsbrist och låg energitillgänglighet leder till brist på substrat till dessa energikrävande processer och i västvärlden orsakas låg energitillgänglighet vanligen av en ätstörning som anorexia nervosa, vilket kan leda till funktionell hypotalamisk amenorré (FHA) hos kvinnor. FHA resulterar i en minskad frisättning av könshormonerna östrogen och progesteron vilket kan leda till infertilitet. En av 20 kvinnor har erfarenhet av ätstörning under graviditeten men få studier har undersökt hur en historik med ätstörning påverkar fertilitet och graviditet. Syfte: Syftet med studien var att undersöka om FHA hos kvinnor med anoreci leder till nedsatt fertilitet och komplikationer vid en eventuell graviditet. Metod: En litteratursökning genomfördes på PubMed och Web of Science med sökorden amenorrhea, fertility, eating disorders, anorexia nervosa, reproduction (1999-2021). Resultat: Åtta studier inkluderades och resultatet visade att kvinnor med anorexi födde färre barn och hade större sannolikhet för att ha genomgått fertilitetsbehandling än friska kvinnor i kontrollgruppen. Vidare visade resultatet att kvinnor med anorexi oftare rapporterade komplicerade graviditeter med till exempel lägre fostertillväxt, prematur födsel och kejsarsnitt. Slutsats: Utifrån resultatet i den aktuella litteraturstudien kan konkluderas att kvinnor med FHA på grund av en ätstörning har lägre fertilitet än friska kvinnor. Kvinnor med ätstörning upplever i högre utsträckning mer komplicerade graviditeter och även fosterutvecklingen verkar påverkas negativt och därför kan tätare kontroller under och efter graviditet vara nödvändigt för dessa kvinnor. Resultatet kan vidare tolkas som att den negativa påverkan på reproduktionsförmågan kan vara reversibel när ätstörninssymptomen behandlats. / Background: One in six couples has sometime during their reproductive years experienced problems related to fertility and after the age of 30, infertility is more common in somen than in men. Several parts of the menstrual cycle require a lot of energy, such as ovulation and the production of sex hormones. Malnutrition and low energy availability is usually caused by an eating disorder such as anorexia nervosa, which can lead to functional hypothalamic amenorrhea (FHA) in women. FHA leads to a reduced release of the sex hormones estrogene and progesterone, which leads to infertility. One in 20 women have experience of an eating disorder during pregnancy, but few studies have examined how a history og eating disorder affects fertility and pregnancy. Aim: The aim of this study was to investigate whether FHA in women with anorexia nervosa leads to reduced fertility and complications in a potential pregnancy.  Method: A literature search was made on PubMed and Web of Science with the keyword´s amenorrhea, fertility, eating disorders, anorexia nervosa reproduction (1999-2021). Results: Eight studies were included, and the results showed that women with anorexia gave birth to fewer children and were more likely to have experienced fertility treatment than healthy women in the control group. Furthermore, the results showed that women with anorexia more often reported more complicated pregnancies with, e.g., lower fetal growth, premature birth, and cesarean section. Conclusion: Based on the results of the current literature study, it can be concluded that women with FHA due to an eating disorder have lower fertility than healthy women. Women with an eating disorder experience more complicated pregnancies and fetal development also seems to be negatively affected and therefore more frequent checks during and after pregnancy may be necessary fore these women. The results can further be interpreted as that the negative impact on reproductive health is reversible when symptoms of eating disorder are treated.