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We compared bone mineral density and turnover in women with exercise-associated menstrual disorders (AMD, n=10; 0–9 cycles·y−1), hormonal contraceptive users (AHC, n=16; 12 cycles·y−1), and regularly menstruating controls (AE, n=13; 10–13 cycles·y−1). Thirty-nine active women (≥ 5 h aerobic exercise/wk) participated in this cross-sectional study. BMD was lower in AMD vs. AHC and AE . Serum hormone and bone turnover markers did not differ between AMD and AE. Cortisol was elevated (P=0.0002), progesterone suppressed (P=0.05), and bone alkaline phosphatase significantly lower (P=0.03) in AHC vs. AE. Lifetime missed menstrual cycles and body weight were significant, independent predictors of lumbar spine BMD, regardless of current menstrual status (adj R2=42.8%). Exercise-associated menstrual disorders have a negative effect on BMD.
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