Food Versus Pharmacy: Assessment of Nutritional and Pharmacological Strategies to Improve Bone Health in Energy-Deficient Exercising Women

Emily A. Southmayd, Adelaide C. Hellmers, Mary Jane De Souza

Research output: Contribution to journalReview article

5 Scopus citations


Purpose of Review: The review aims to summarize our current knowledge surrounding treatment strategies aimed at recovery of bone mass in energy-deficient women suffering from the Female Athlete Triad. Recent Findings: The independent and interactive contributions of energy status versus estrogen status on bone density, geometry, and strength have recently been reported, highlighting the importance of addressing both energy and estrogen in treatment strategies for bone health. This is supported by reports that have identified energy-related features (low body weight and BMI) and estrogen-related features (late age of menarche, oligo/amenorrhea) to be significant risk factors for low bone mineral density and bone stress injury in female athletes and exercising women. Summary: Nutritional therapy is the recommended first line of treatment to recover bone mass in energy-deficient female athletes and exercising women. If nutritional therapy fails after 12 months or if fractures or significant worsening in BMD occurs, pharmacological therapy may be considered in the form of transdermal estradiol with cyclic oral progestin (not COC).

Original languageEnglish (US)
Pages (from-to)459-472
Number of pages14
JournalCurrent Osteoporosis Reports
Issue number5
StatePublished - Oct 1 2017


All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

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