Menstrual dysfunction in athletes

Preparticipation physical examination: selected issues for the female athlete

OBJECTIVE

The purpose of this article was to examine the preparticipation examination (PPE) with regard to the female athlete. Ever-increasing participation of women in competitive sport has created a requirement for more gender-specific sport medicine knowledge. In particular, physicians and other health care professionals should be aware of the triad of disordered eating, amenorrhea (and other menstrual dysfunction), and osteoporosis (or altered bone mineral density) collectively described as the female athlete triad. Suggested additions to the standard PPE may help identify athletes at risk. DATA SOURCES/METHODS: A literature search was carried out using MEDLINE for years 1966 to 2003, with keywords female athlete triad, PPE, female athlete, eating disorders, amenorrhea, and osteoporosis. Further studies were identified through reference lists.

RESULTS

Better recognition and prevention of these problems is essential. At present, there is little evidence-based information available to guide the practicing clinician in this area. It remains to be determined which methods are the most sensitive and specific for detecting the triad disorders, as well as the most economical and time-efficient.

CONCLUSIONS

The PPE offers an excellent opportunity to screen for these entities, as well to initiate early treatment. It is recommended that a standardized form (or part of the form) be developed for the female athlete.

Development of a medical nutrition therapy protocol for female collegiate athletes

Nutrition intervention can improve athletic performance and reduce the risk of nutrition related problems in women athletes. The current healthcare environment demands that dietitians document the outcomes of the medical nutrition therapy (MNT) they provide. This requires the development and validation of MNT protocols so that outcomes can be documented and compared in similar populations across multiple settings. The purpose of this project was to develop a sports nutrition management MNT protocol for collegiate women athletes. A registered dietitian currently working with collegiate women athletes collaborated with four dietitians from the community to develop an MNT protocol. Further testing and validation using this MNT protocol will help dietitians document the outcomes of their interventions in this population.

Ethnic and age trends for body composition in women residing in the U.S. Southwest: II. Total fat

This study assessed body density (BD) in an ethnically diverse sample of women (African American, Caucasian, Mexican American and Native American) (N = 139) who were between 20 and 30 or 40 and 50 yr of age and of normal weight for their height. BD was assessed using three methods: hydrostatically determined density (UWW), total body potassium (TBK) and the Jackson et al. (1980) sum of seven SF with gluteal circumference (SF). Ethnic differences in BD were detected by TBK and UWW. BD from SF did not detect ethnic differences, and the SEE was unacceptable. Based on multiple regression, the prediction equation was: BD = 1.1197794 - 0.000224382 (X3) + 0.006999 (e2) - 0.000320177 (X2) - 0.001892 (e1) + 0.001750 (e3) - 0.000537005 (x1) (where x1 = gluteal C, x2 = age in years, x3 = sum of 7 SF and e1, e2, and e3 describe ethnicity). This formula had a reduced SEE, a higher correlation with hydrostatically determined BD, and was sensitive to ethnic differences detected with other measures of BD. A 24-mmol decrease in potassium was found when comparing the older Caucasian women with the younger Caucasian women, while the difference for the African, Mexican, and Native American groups was 200-300 mmol.