Influence of sex hormones status and type of training on regional bone mineral density in exercising females

ABSTRACT

The primary objective of this study was to examine the influence of hormonal ovarian profile and training characteristics on spine, pelvis, and total body bone mineral density (BMD) in a group of well-trained females. Forty-two eumenorrheic females, twenty-eight monophasic oral contraceptive (OC) users and thirteen postmenopausal females participated in this study. Body composition was measured by total body dual-energy X-ray absorptiometry (DXA) to determine BMD of the areas of interest. Endurance-trained premenopausal females showed lower spine BMD compared to resistance-trained premenopausal females (1.03 ± 0.1 vs. 1.09 ± 0.09 g/cm²; p = 0.025). Postmenopausal females reported lower BMD level in comparison to eumenorrheic females in pelvis (1.079 ± 0.082 vs 1.19 ± 0.115 g/cm²; p = 0.005), spine (0.969 ± 0.097 vs 1.069 ± 0.109 g/cm²; p = 0.012) and total (1.122 ± 0.08 vs 1.193 ± 0.077 g/cm²; p = 0.018) and OC users whose duration of OC use was less than 5 years (OC < 5) in pelvis (1.235 ± 0.068 g/cm²; p < 0.001) and spine (1.062 ± 0.069 g/cm²; p = 0.018). In addition, lower BMD values were found in OC users who had been using OC for more than 5 years (OC ≥ 5) than eumenorrheic females in pelvis (1.078 ± 0.086 g/cm²; p = 0.029) and spine (0.966 ± 0.08 g/cm²; p = 0.05). Likewise, OC ≥ 5 showed lower values than and OC < 5 in pelvis (p = 0.004) and spine (p = 0.047). We observed a lower spine BMD value in premenopausal endurance-trained females compared to premenopausal resistance-trained females. Moreover, this research observed that prolonged use of OCs may reduce bone mass acquisition in the spine and pelvis, even in well-trained females. Finally, postmenopausal showed lower BMD despite being exercising women.

Trial registration: ClinicalTrials.gov identifier: NCT04458662.

Highlights

• Ovarian hormonal profile should be considered when assessing BMD in female athletes.

• The duration of oral contraceptive use influences spine and pelvis regional BMD in exercising females.

• Postmenopausal women show lower BMD when compared to premenopausal females despite being exercising females.

KEYWORDS:

• Eumenorrheic
• oral contraceptive
• postmenopause
• oestradiol
• mechanical load
• exercise

Acknowledgments

The authors thank the subjects who volunteered for this study, as well as the students who offered to volunteer in data collection. Finally, we would like to thank the other members of the IronFEMME study group for their contributions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The IronFEMME Study took place with the financial support of the Ministerio de Economía y Competitividad, Convocatoria de ayudas I+D 2016, Plan Estatal de Investigación Científica y Técnica y de Innovación 2013–2016 [Contract DEP2016-75387-P].