Extreme physical training in adolescent females is often associated with disordered eating and amenorrhea which leads to low bone mass. As a group, women who exercise and maintain normal menstrual cycles have the greatest bone mass. Eumenorrheic women who do not exercise have less bone mass, and amenorrheic women who exercise have the least. Female athletes who participate in gymnastics, diving, figure skating, dance, track, and synchronized swimming appear to be at the most risk. Treatment for osteoporosis consists of exercise, most commonly in the form of a walking program, modification of the environment to reduce the risk of falls, and medications.
Calcium supplements are beneficial only when a patient s dietary intake is inadequate.
Excess intake of calcium affords no benefit and can be harmful. Vitamin D deficiency occurs most commonly in strict vegetarians and in northern locations during the winter. A single high dose injection of Vitamin D in early winter has shown signs of being beneficial for these people. Estrogen administration to postmenopausal women has clearly been shown to prevent bone loss and protect against fragility fractures. Calcitonin administered by injection and, more recently, intranasally is an alternative to estrogen therapy.