RT Journal Article
SR Electronic
T1 Oestrogen replacement improves bone mineral density in oligo-amenorrhoeic athletes: a randomised clinical trial
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 229
OP 236
DO 10.1136/bjsports-2018-099723
VO 53
IS 4
A1 Ackerman, Kathryn E
A1 Singhal, Vibha
A1 Baskaran, Charumathi
A1 Slattery, Meghan
A1 Campoverde Reyes, Karen Joanie
A1 Toth, Alexander
A1 Eddy, Kamryn T
A1 Bouxsein, Mary L
A1 Lee, Hang
A1 Klibanski, Anne
A1 Misra, Madhusmita
YR 2019
UL http://bjsm.bmj.com/content/53/4/229.abstract
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