Amenorréia e osteoporose em adolescentes atletas
Palavras-chave:
puberdade, amenorréia, osteoporose, exercício, atletas, adolescente, dietaResumo
A participação feminina no esporte foi crescendo ao longo dos anos. Trabalhos científicos têm mostrado os benefícios trazidos por esta prática para a saúde da mulher, mas quando se trata de esporte competitivo podem surgir problemas. A complicação mais comum descrita pela literatura é a “tríade da atleta”, a qual envolve três processos: o distúrbio alimentar, a amenorréia e a osteoporose. A amenorréia atinge, nos Estados Unidos, até 66% das atletas de competição, e algumas de suas possíveis causas são: perda de peso, excesso de treino, quantidade insuficiente de gordura corporal, perda de estoques específicos de gordura corporal e dieta inadequada. Como conseqüência da amenorréia, a esportista pode desenvolver osteoporose precoce. Não se sabe ao certo a porcentagem de atletas com osteopenia, mas há indícios de que a falta de estrógeno, a dieta inadequada e o consumo insuficiente de cálcio serem fatores que as predispõem a desenvolver a doença.
Downloads
Referências
AMERICAN ACADEMY OF PEDIATRICS. Amenorrhea in adolescent athletes. Pediatrics. 1989; 84(2). [online]. Available from: http://www.aap.org/policy/02626.html>. [2000 Nov 3].
BALE, P., DOUST, J., DAWSON, D. Gymnasts, distance runners, anorexics body composition and menstrual status. Journal of Sports Medicine Physical Fitness, v.1, n.36, p.49-53, 1996.
BECK, B.B., SCHOEMAKER, M.R. Understanding key risk factors and therapeutic options. The Physician and Sports Medicine. 2000; 28 (2). [online]. Available from: http://www.physician and sports medicine.com/issues/2000/02_00/beck. htm>. [ 2001 agosto 28].
BENNEL, K.L., BRUKNER, P.D. Epidemiology and site specificity of stress fractures. Clinical Sports Medicine, v.16, n.2, p.179-196, 1997.
BENSON, J.E., EISENMAN, P.A., HEINRICH, K.K. The relation of caloric and fiber and metabolic rate to athletic amenorrhea In: KIES, C.V., DRISKELL, J.A. Sports nutrition: mineral and electrolytes. New York: CRC Press; 1995. p.305-315.
BEZNOS, G.W. Distúrbios menstruais. In: COATES, V., FRANÇOSO, L.A., BEZNOS,G.W. Medicina do adolescente. São Paulo : Sarvier, 1993. p.207-210.
BROSO, R., SUBRIZI, R. Gynecologic problems in female atheles. Minerva Gynecology, v.48, n.3, p.99-106, 1996.
BULLEN, B.A., SKRINAR, G.S., MERING, B.A., TURNBULL, B.A., McARTHUR, A.W. Induction of menstrual disorders by strenuous exercise in untrained women. New England Journal Medicine, v.312, p.1349-1353, 1984.
BURKE, L. Sports amenorrhea, osteopenia, stress fratures and calcium. In: BURKE, L. DEAKIN, V. Clinical sports nutrition. Sidney : McGraw-Hill, 1994. p.200-226.
CALABRESE, L.H., KIRKENDALL, D.T., FLOYD, M. Menstrual abnormalities, nutritional patterns and body composition in female classical ballet dancers. Physician Sports Medicine, v.11, p.86-90, 1983.
CALLAHAN, L.R. The evolution of the female athlete: progress and problems. Pediatrics Annals, v.29, n.3, p.149-153, 2000.
CARLBERG, K.A., BUCKMAN, M.T., PEAKE G.T. Exercise and the menstrual cycle. In: APPENZELLER, O., ATKINSON, R. Sports medicine: fitness, training, injuries. 2.ed. Baltimore : Urban & Schwarzenberg, 1983a. p.131-143.
CARLBERG, K.A., BUCKMAN, M.T., PEAKE, G.T., RIEDESEL, M.L., Body composition of oligo/amenorrheic athetes. Medicine Science Sports Exercise, v.15, n.3, p.215-217, 1983b.
COHEN, J.L., CHUNG, S.K., MAY, P.B. Exercise, body weight, and amenorrhea in professional ballet dancers. Physician Sports Medicine, v.10, p.92-100, 1982.
DEUSTER, P.A., KYLE, S.B., MOSER, P.B., VIGERSKY, R.A., SINGH, A.,SCHOOMAKER, E.B. Nutritional intakes and status of highly trained amenorrheic and eumenorrheic women runners. Fertil Steril, v.46, n.4, p.636-643, 1986.
DRINKWATER, B.L., NILSON, K., CHESTNUT, C.H., BREMNER, W.J. SHAINHOLTZ, S., SOUTHWORTH, M.B. Bone mineral content of amenorrheic and eumenorrheic athletes. New England Journal of Medicine, v.311, n.5, p.277-281, 1984.
DUNKER, K.L.L. Avaliação nutricional e comportamento alimentar de adolescentes com sintomas de anorexia nervosa. São Paulo, 1999. Dissertação (Mestrado) – Faculdade de Saúde Pública, Universidade de São Paulo, 1999.
ERICSON, S.M., SEVIER, T.L. Osteoporosis in active women: prevention, diagnosis, and treatment. The Physician and Sports Medicine. 1997; 25: 11. [online]. Available from: http://www.physician and sports medicine.com/issues/1997/11nov/erickson.htm>. [2001 agosto 28].
FRISCH, R.E., McARTHUR, J.W. Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenance or onset. Science, v.185, n.4155, p.949-951, 1974.
FRISCH, R.E., Wyshak, G., VINCENT, L. Delayed menarche and amenorrhea in ballet dancers. New England Journal of Medicine, v.303, n.1, p.17-19, 1980.
FRISCH, R.E., GOTZ-WELBERGEN, A.V., McARTHUR, J.W., ALBRIGHT, T., WITSCHI, J., BULLEN, B., BIRNHOLZ, J., REED, R.B., HERMANN, H. Delayed menarche and amenorrhea of college athletes in relation to age on onset training. Journal of American Medicine Association, Chicago, v.246, n.4, p.1559-1563, 1981.
FRUTH, S.J., WORRELL, T.W. Factors associated with menstrual irregularities and decreased bone mineral density in female athletes. Journal of Orthopedics Sports Physician Therapeutic, v.22, n.1, p.26-38, 1995.
HALE, R.W. Factors important to women engaged in vigorous physical activity. In: STRAUSS, R.H. Sports medicine. Philadelphia : WB Sauderes, 1984. p.258-263.
HILL, J.O., SPARLING, P.B., SHIELDS, T.W., HELLER, P.A. Effects of exercise and food restriction on body composition and metabolic rate in obese women. American Journal of Clinical Nutrition, Bethesda, v.46, n.4, p.622-630, 1987.
HIRSCHBERG, A.L., HAGENFELDT, K. Athletic amenorrhea and its consequences. Hard physical training at an early age can cause serious bone damage. Lakartidningen, v.95, n.50, p.5765-5770, 1998.
INSTITUTE OF MEDICINE (US). Dietary references intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington DC: National Academy Press, 1998. 432p.
KAISERAUER, S., SNYDER, A.C., SLEEPER, M., ZIERATH, J. Nutritional, physiological and menstrual status of distance runners. Medicine Science Sports Exercise, v.23, p.15, 1991.
KREBS, N.F. Bioavailability of dietary supplements and impact of physiological state: infants, children and adolescents. Journal of Nutrition, v.131, n.4, p.1351S-1354S, 2001. Supplement.
LAUDER, T.D. The female athlete triad: prevalence in military women. Military Medicine, v.164, n.9, p.630-635, 1999.
LLOYD, T., BUCHANAN, J.R., BITZER, S. Interrelationships of diet, athletic activity, menstrual status, and bone density in collegiate women. American Journal of Clinical Nutrition, Bethesda, v.46, n.4, p.681-684, 1987.
MANTOANELLI, G., BITTENCOURT, V.B., PENTEADO, R.S., PEREIRA, I.M.T.B., ALVAREZ, M.C.A. Educação nutricional: uma resposta ao problema da obesidade em adolescente. Revista Brasileira de Crescimento e Desenvolvimento Humano, v.2, n.7, p.85-93, 1997.
McGEE, C. Secondary amenorrhea leading to osteosporosis incidence and prevention. Nurse Practitioner, v.22, n.5, p.38-65, 1997.
NGUYEN, T.V., JONES, G., SAMBROOK, P.N. Effects of estrogen exposure and reproductive factors on bone mineral density and osteoporotic fractures. Journal of Clinical Endocrinology Metabolism, v.80, n.9, p.2709-2714, 1995.
NATIONAL RESEARCH COUNCIL (USA). Recommended dietary allowances. Washington DC: National Academy Press, 1989. 283p.
O’MALLEY, M.J., HAMILTON, W.G., MUNYAK, J., DEFRANCO, M.J. Stress fractures at the base of the second metatarsal in ballet dancers. Foot Ankle International, v.17, n.2, p.89-94, 1996.
NATTIV, A., ARMSEY JR, T.D. Stress injury to bone in the female athlete. Clinics Sports Medicine, v.16, n.2, p.197-224, 1997.
PATRICK, L. Comparative absorption of calcium sources and calcium citrate malate for the prevention of osteoporosis. Alternative Medicine Review, v.4, n.2, p.74-85, 1999.
PETTERSSON, U., STALNACKE, B., ATHÉNIUS, G., HENRIKSSON-LARSÉN, K., LORENTZON, R. Low bone mass density at multiple skeletal sites, including the appendicula skeleton in amenorrheic runners. Calcified Tissue International, v.64, n.2, p.117-125, 1999.
PHINNEY, S.D., LaGRANGE, B., O’CONNEL, M. DANFORTH, E. Effects of aerobic exercise on energy expenditure and nitrogen balance during very low dieting. Metabolism, v.37, n.8, p.758-765, 1988.
RENCKEN, M.L., CHESNUT, C.H., DRINKWATER, B.L. Bone density at multiple skeletal sites in amenorrheic athletes. JAMA, Chicago, v.276, n.3, p.238-240, 1996.
SANBORN, C.F., HOREA, M., SIEMERS, B.J., DIERINGER, K.L. Disordered eating and female athlete triad. Clinical Sports Medicine, v.19, n.2, p.1999-1213, 2000.
TIMMERMAN, M.G. Medical problems of adolescent female athletes. Wisconsin Medical Journal, v.95, n.6, p.351-354, 1996.
TO, W.W., WONG, M.W., CHAN, K.M. Association between body composition and menstrual dysfunction in collegiate dance students. Journal Obstetric Gynecology Research, v.23, n.6, p.529-535, 1997.
WEST, R.V. The female athlete. The triad of disordered eating, amenohrrea and osteporosis. Sports Medicine, v.26, n.2, p.63-71, 1998.
WIGGINS, D.L., WIGGINS, M.E. The female athlete. Clinical Sports Medicine, v.16, n.4, p.593-612, 1997.
YOUNG, N., FORMICA, C., SZMUKLER, G., SEEMAN, E. Bone density at weight-bearing and nonweight- -bearing sites in ballet dancers: the effects of exercise, hypogonadism, and body weight. Journal Clinical Endocrinology Metabolism, Duluth, v.78, n.2, p. 449-454, 1994.
ZENI, A.L., STREET, C.C., DEMPSEY, R.L., STATON, M. Stress injury to the bone among women athletes. Physician Medicine Rehabilitation Clinics North American, v.11, n.4, p.929-947, 2000.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Graziela MANTOANELLI, Maria Sylvia de Souza VITALLE, Olga Maria Silverio AMANCIO
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
