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Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence.
Acta Obstet Gynecol Scand. 2009; 88(5):543-9.AO

Abstract

OBJECTIVE

To evaluate the long-term effects on bone mineral density (BMD) in women diagnosed with menstrual disorders in their adolescence.

DESIGN

Prospective follow-up study six years after the initial investigation.

SETTING

A youth clinic that is part of the school health system in Stockholm.

POPULATION

Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence.

METHODS

Subjects underwent gynecological examination, evaluation of eating behavior and physical activity. Whole body Dual Energy X-ray Absorptiometry was used for measurement of BMD.

MAIN OUTCOME MEASURES

BMD.

RESULTS

The overall frequency of osteopenia/osteoporosis was 52%, and three girls had osteoporosis. Women with previous secondary amenorrhea had significantly lower BMD in the pelvis and lumbar spine than those with previous oligomenorrhea. The strongest predictor of low BMD was a restrictive eating disorder in adolescence and the most important counteraction was high physical activity at follow-up and a body mass index (BMI) > or = 22. Persistent menstrual dysfunction at follow-up was associated with polycystic ovary syndrome and lower frequency of osteopenia.

CONCLUSIONS

This clinical follow-up study has demonstrated a high frequency of osteopenia in women diagnosed with menstrual disorders in adolescence. Previous anorectic behavior was the strongest negative predictor of BMD. It is important to pay attention to an underlying eating disorder in young women with menstrual dysfunction in order to promote bone health.

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    Authors+Show Affiliations

    Wiksten-Almströmer M
    Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden. marianne.wiksten@utbildning.stockholm.se
    Hirschberg AL
    No affiliation info available
    Hagenfeldt K
    No affiliation info available

    MeSH

    Absorptiometry, PhotonAdolescentAgingAmenorrheaAnorexia NervosaBody Mass IndexBone DensityBone Diseases, MetabolicExerciseFeeding and Eating DisordersFemaleFollow-Up StudiesHumansMenstruation DisturbancesOligomenorrheaOsteoporosisPolycystic Ovary SyndromePrognosisProspective StudiesRisk FactorsStatistics, NonparametricYoung Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19353333

    Citation

    Wiksten-Almströmer, Marianne, et al. "Reduced Bone Mineral Density in Adult Women Diagnosed With Menstrual Disorders During Adolescence." Acta Obstetricia Et Gynecologica Scandinavica, vol. 88, no. 5, 2009, pp. 543-9.
    Wiksten-Almströmer M, Hirschberg AL, Hagenfeldt K. Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence. Acta Obstet Gynecol Scand. 2009;88(5):543-9.
    Wiksten-Almströmer, M., Hirschberg, A. L., & Hagenfeldt, K. (2009). Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence. Acta Obstetricia Et Gynecologica Scandinavica, 88(5), 543-9. https://doi.org/10.1080/00016340902846080
    Wiksten-Almströmer M, Hirschberg AL, Hagenfeldt K. Reduced Bone Mineral Density in Adult Women Diagnosed With Menstrual Disorders During Adolescence. Acta Obstet Gynecol Scand. 2009;88(5):543-9. PubMed PMID: 19353333.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence. AU - Wiksten-Almströmer,Marianne, AU - Hirschberg,Angelica Lindën, AU - Hagenfeldt,Kerstin, PY - 2009/4/9/entrez PY - 2009/4/9/pubmed PY - 2009/5/21/medline SP - 543 EP - 9 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 88 IS - 5 N2 - OBJECTIVE: To evaluate the long-term effects on bone mineral density (BMD) in women diagnosed with menstrual disorders in their adolescence. DESIGN: Prospective follow-up study six years after the initial investigation. SETTING: A youth clinic that is part of the school health system in Stockholm. POPULATION: Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence. METHODS: Subjects underwent gynecological examination, evaluation of eating behavior and physical activity. Whole body Dual Energy X-ray Absorptiometry was used for measurement of BMD. MAIN OUTCOME MEASURES: BMD. RESULTS: The overall frequency of osteopenia/osteoporosis was 52%, and three girls had osteoporosis. Women with previous secondary amenorrhea had significantly lower BMD in the pelvis and lumbar spine than those with previous oligomenorrhea. The strongest predictor of low BMD was a restrictive eating disorder in adolescence and the most important counteraction was high physical activity at follow-up and a body mass index (BMI) > or = 22. Persistent menstrual dysfunction at follow-up was associated with polycystic ovary syndrome and lower frequency of osteopenia. CONCLUSIONS: This clinical follow-up study has demonstrated a high frequency of osteopenia in women diagnosed with menstrual disorders in adolescence. Previous anorectic behavior was the strongest negative predictor of BMD. It is important to pay attention to an underlying eating disorder in young women with menstrual dysfunction in order to promote bone health. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/19353333/Reduced_bone_mineral_density_in_adult_women_diagnosed_with_menstrual_disorders_during_adolescence_ L2 - https://doi.org/10.1080/00016340902846080 DB - PRIME DP - Unbound Medicine ER -