Journal CME, November 2021: Menstrual Irregularity, Hormonal Contraceptive Use, and Bone Stress Injuries in Collegiate Female Athletes in the United States-Menstrual Irregularity

Menstrual Irregularity - article.pdf

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The study investigates the relationship between menstrual irregularity (MI), hormonal contraceptive (HC) use, and bone stress injuries (BSIs) among 1,020 female collegiate athletes in the U.S. MI, a component of the Female Athlete Triad, is common in athletes and is often treated with HCs, which can mask the underlying causes of MI, including disordered eating and low energy availability.<br /><br />Key Findings:<br />1. <strong>HC Use:</strong> 65% of athletes reported current HC use, with oral contraceptive pills (OCPs) being the most common type. HC use was more prevalent in athletes with a history of MI (73% vs. 57%). Among HC users, birth control and symptom reduction were primary reasons cited for use.<br />2. <strong>MI Prevalence:</strong> 47% had a history of MI, and 32% of non-HC users reported current MI. Current HC use was linked to past MI; athletes with MI were more likely to use HCs to regulate menstrual cycles.<br />3. <strong>BSIs:</strong> 25% of athletes reported a history of stress fractures, with lean/aesthetic sports participants being at higher risk. Injectable HCs were associated with an increased risk of stress fractures, while OCP use was linked to a reduced risk.<br />4. <strong>Demographics:</strong> Most participants were Caucasian (91%) and from the Northeast (58%).<br /><br />Conclusions:<br />The study highlights the need for better education among athletes and physicians regarding the use of HCs, which can obscure the symptoms of MI and potentially exacerbate components of the Female Athlete Triad. Further research is warranted to explore the impacts of different HC formulations on sports-related injuries and overall health in female athletes.

Keywords

menstrual irregularity

hormonal contraceptive

bone stress injuries

female collegiate athletes

Female Athlete Triad

oral contraceptive pills

stress fractures

disordered eating

low energy availability

sports-related injuries