EXERCISE-ASSOCIATED AMENORRHEA, LOW BONE-DENSITY, AND ESTROGEN REPLACEMENT THERAPY

Background: Women with exercise-associated amenorrhea have a higher fr equency of osteoporosis than eumenorrheic runners and sedentary women. The use of hormone replacement therapy was suggested many years ago t o increase bone density in exercising women with amenorrhea and low bo ne density. Objective: To determine if hormone replacement therapy inc reased bone density in women with exercise-associated amenorrhea. Meth ods: We performed a retrospective clinical study comparing the changes in bone density in 8 women runners who took hormone replacement thera py with 5 who refused medication but who were followed up as controls over 24 to 30 months. Results: Vertebral and femoral neck bone density significantly increased by 8.0%+/-1.2% (+/-SEM) and 4.1%+/-0.3% (+/-S EM), respectively, in 8 women runners with amenorrhea taking 24 to 30 months of estrogen replacement therapy with progestational support. Co ntrol women not taking replacement therapy had nonsignificant decrease s of less than 2.5% at each site. Conclusion: Hormone replacement ther apy appears to increase bone density in amenorrheic runners.