Sex-Related Considerations for Exercise.pdf

Sex-Related Considerations for Exercise female participation in exercise, physical activity, and sport has increased dramatically in past several decades due to: o knowledge of health benefits of exercise and physical activity o passage of Title IX legislation in 1972 (↓ societal prejudices and obst...

Sex-Related Considerations for Exercise female participation in exercise, physical activity, and sport has increased dramatically in past several decades due to: o knowledge of health benefits of exercise and physical activity o passage of Title IX legislation in 1972 (↓ societal prejudices and obstacles to females participating in sports) females generally respond to training and exercise in the same way males do; female specific issues include: o reproductive function (menstrual cycle, pregnancy) o orthopedic injury ▪ example - ACL injury: females are at a 2-9 times greater risk of ACL injury than their male counterparts in the same cutting/jumping/landing activities/sports categories of risk factors: anatomic, environmental, hormonal, and biomechanical possible risk factors: anatomy (e.g., Q angle, femoral notch), hormones, flexibility/laxity, neuromuscular factors, core stability, sociocultural effects, etc. multi-factorial syndromes associated with sports o female athlete triad (concept originated in 1980s) ▪ traditional definition: disordered eating, amenorrhea, osteoporosis ▪ current ACSM description involves 3 interrelated spectrums: o (1) optimal energy availability to low energy availability (with or without eating disorders) ▪ low energy availability: unintentional vs. intentional o (2) eumenorrhea to amenorrhea ▪ normal menstrual cycle is the result of a precise synchronization of hormonal events in the hypothalamus, anterior pituitary gland, and ovaries ▪ a proposed mechanism of the menstrual disturbances associated with vigorous exercise and/or low energy intake is an imbalance in the hypothalamic-pituitarygonadal axis ▪ low energy availability can lead to amenorrhea has been observed since the 1950s that intense training was associated with menstrual cycle changes ▪ oligomenorrhea: irregular or inconsistent menstrual cycles ▪ amenorrhea: complete cessation of menstrual cycle prevalence in the general population: 2-5% prevalence in women engaged in vigorous exercise training: 5-46% elite runners: 40% professional ballet dancers: 66% ▪ cessation of menstrual cycle is associated with low bone mineral density o (3) optimal bone health to osteoporosis ▪ osteoporosis: BMD ≥2.5 standard deviations below average bone mass for a young sex- and race-matched reference population and/or the presence of a fragility fracture ▪ osteopenia: BMD ≥1 but