Elite. Winning. but Deteriorating Pt. III
“Although science has proven that training could promote osteoblast differentiation (bone buildup), inhibit osteoclast activity (bone breakdown), and improve bone remodeling through the regulation of multiple signaling pathways, estrogen can disrupt the positive effects of training to promote stronger bones (Tong, Chen; 2019). “Estrogen protects bones by inactivating osteoclast activity, preventing osteoporosis in both estrogen-deficient and postmenopausal women” (Delgado, Lopez-Ojeda; 2020). The role of estrogen on bones is imperative due estrogen regulates the absorption of calcium. Thus, even if there is adequate calcium intake, the positive role of calcium on bones will have minimal effectiveness, without the presence of both fat and estrogen.
Putting the pieces together, if there is low energy availability, the cascade of what is known as the female athlete triad occurs. The triad is characterized by:
Lack of or inconsistent menstrual cycle
Due to the lack of enough calories to be available for the menstrual and reproductive system, estrogen is not released. Bones become weaker, due to the repetitive and long duration of stress and load of athletic training. Vitamins and minerals are not effective, as receptors and transporters are not available. As bones become weaker, stress fractures become an increased risk, as well as the onset of osteoporosis. “It is possible that a female athlete may have regular menstrual cycles, yet have a low bone mineral density, and be at risk for suboptimal bone health and stress fractures” (Karp, Smith; 2012). “The role of estrogen cannot be understated; it has implications for the female athlete, affecting muscle, tendon, ligament, and bone.”(Chidi-Ogbolu, Baar; 2019).
As female athletes, the desire to increase lean body mass and simultaneously improve performance are admirable. These can be achieved with optimal nutrition to support training, as well as a progressive and evidenced based training program. However, when the desire to “look” a certain way, and aesthetic overrule the priority of performance and physiology, the health and function of a female athlete is at risk. Along with reproductive system function suppression and bone fragility, the psychological and psychosocial implications cause the Female Athlete Triad to be a challenge. Female athletes should be encouraged that it is health is the primary focus, followed by performance. Aesthetics mean nothing in terms of a highly functional, strong, and fit body. A strong, fit, health body can help to increase a healthy mind, and a healthy social life. It all starts with the decision to value PERFORMANCE over AESTHETICS.
Effects of Estrogen on Musculoskeletal Performance and Injury Risk
Delgado BJ, Lopez-Ojeda W. Estrogen. [Updated 2020 Aug 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/
Russo C. R. (2009). The effects of exercise on bone. Basic concepts and implications for the prevention of fractures. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 6(3), 223–228.
Xiaoyang Tong, Xi Chen, Shihua Zhang, Mei Huang, Xiaoyan Shen, Jiake Xu, Jun Zou, "The Effect of Exercise on the Prevention of Osteoporosis and Bone Angiogenesis", BioMed Research International, vol. 2019, Article ID 8171897, 8 pages, 2019. https://doi.org/10.1155/2019/8171897
Karp, Jason; Smith, Carolyn, Running for Women:Your complete guide for a lifetime of running. 2012. Human Kinetics. ISBN:978-1-4504-04679