Week 6 - RED-S + the female athlete Flashcards
Skeletal differences in the female athlete
Shorter, smaller peak bone mass, wider pelvis (greater Q angle), wider carrying angle of elbows, shorter limbs so less lever
Body composition differences in the female athlete
Increased % body fat, lower lean body mass
Physiological differences in female athlete
Lower blood volume, Hb, iron stores, smaller heart, lower aerobic capacity, less muscle fibres
What factors contribute to increased injury risk in females
Sport specific.
Q angle - ACL and MCL, patellofemoral tracking problems, ITB problems
Joint laxity - rotator cuff injuries, ankle injuries, overuse injures of lumbar spine
Positive effects of exercise for women
Mensutral function, bone mineral density, cardiac RF, physical + psychological wellbeing
What is REDs?
Relative Energy Deficiency. Complex endocrine assortment.
Used to be female athlete triad - eating disorders, osteoporosis and menstrual disturbance
Risks of disordered eating therefor growth disruption, menarche, amenorrhoea
Discuss menstrual problems from disordered eating
Reduced fat leads to reduction in leptin, leads to upset of hypothalamic control of menstruation. Can lead to luteal suppression/anoviulatory cycles/oligomenorrhoea/amenorrhoea
Luteal suppression can lead to sub-fertility, unopposed oestrogen can increase risk of cancer, detected by day 21 progesterone
RF - sports with low body weights, adolescent, social isolation, win at all costs mentality etc
Discuss effects on bone
Amenorrhoea leads to increased bone resorption so decrease in bone mineral density (associated with up to 4% loss per year). Associated with decrease in peak bone mass as peak achieved at 30.
Reduced BMD, increased risk stress fractures, risk osteoporosis.
Osteoporosis is 2.5 STD below mean
Treatment of REDs
RESTORATION OF MENSES by reduction in training intensity or increase in body weight.
ORAL CONTRACEPTIVE PILL may improve BMD in amenorrhoeic athletes but not to peak bone mass (oestrogen helps bone resorption)
BMD improvements occur with restoration of menses but may still be irreversible bone loss. repeat assessments at 6-12 months.
Team approach
Prevention better than cure….
What’s REDs-CAT
An IOC clinical assessment tool for screening and management of RED-S (Mountjoy et al 2015). Also helps with RTP decisions, much like SCAT tool in rugby.
Psychological problems from REDS
Mountjoy et al 2015 - Depression, impaired judgement, irritability, decreased concentration
Discuss effect of menstrual changes due to strenuous exercise
Stage 1 - normal follicular, normal luteal phase
Stage 2 - prolonged follicular and a shortened luteal phase results in luteal phase defects which is associated with infertility and premenstrual tension
Stage 3 - euoestrongeic anovulatory oligomenorrhoea, possibility of endometrial hyperplasia if this phase persists
Stage 4 - hypo-oestrogenic - amenorrhoea leads to oesteoprosis and genital atrophy
