PT  - JOURNAL ARTICLE
AU  - Kathryn E Ackerman
AU  - Vibha Singhal
AU  - Charumathi Baskaran
AU  - Meghan Slattery
AU  - Karen Joanie Campoverde Reyes
AU  - Alexander Toth
AU  - Kamryn T Eddy
AU  - Mary L Bouxsein
AU  - Hang Lee
AU  - Anne Klibanski
AU  - Madhusmita Misra
TI  - Oestrogen replacement improves bone mineral density in oligo-amenorrhoeic athletes: a randomised clinical trial
AID  - 10.1136/bjsports-2018-099723
DP  - 2019 Feb 01
TA  - British Journal of Sports Medicine
PG  - 229--236
VI  - 53
IP  - 4
4099  - http://bjsm.bmj.com/content/53/4/229.short
4100  - http://bjsm.bmj.com/content/53/4/229.full
SO  - Br J Sports Med2019 Feb 01; 53
AB  - Objective Normal-weight oligo-amenorrhoeic athletes (OAA) are at risk for low bone mineral density (BMD). Data are lacking regarding the impact of oestrogen administration on bone outcomes in OAA. Our objective was to determine the effects of transdermal versus oral oestrogen administration on bone in OAA engaged in weight-bearing activity.Methods 121 patients with OAA aged 14–25 years were randomised to receive: (1) a 17β-estradiol transdermal patch continuously with cyclic oral micronised progesterone (PATCH), (2) a combined ethinyl estradiol and desogestrel pill (PILL) or (3) no oestrogen/progesterone (NONE). All participants received calcium and vitamin D supplementation. Areal BMD was assessed at the lumbar spine, femoral neck, total hip and total body less head using dual-energy X-ray absorptiometry at baseline, 6 and 12 months. Intention-to-treat (ITT) and completers analyses were performed.Results Randomised groups did not differ for age, body mass index or BMD Z-scores at baseline. For ITT analysis, spine and femoral neck BMD Z-scores significantly increased in the PATCH versus PILL (p=0.011 and p=0.021, respectively) and NONE (p=0.021 and p=0.033, respectively) groups, and hip BMD Z-scores significantly increased in the PATCH versus PILL group (p=0.018). Similar findings were noted in completers analysis.Conclusion Transdermal estradiol over 12 months improves BMD in young OAA, particularly compared with an ethinyl estradiol-containing contraceptive pill/oral contraceptives.Trial registration number NCT00946192; Pre-results