Suitability of Cyproterone Acetate in the Treatment of Osteoporosis Associated with Athletic Amenorrhea

Abstract

The effectiveness of the antiandrogenic agent cyproterone acetate (CA) in its contraceptive form (2 mg CA + 50 µg ethinyl estradiol) in the treatment of osteoporosis associated with athletic amenorrhea was studied in seven high-performance athletes. Four women with similar characteristics served as controls. Their mean age was 21.9 years±3.9. Training was started at a mean age of 14.0 years±2.0. The mean training intensity expressed as kilometers run per week was 35±15.

Mineral density was primarily affected by the hypoestrogenic status of these athletes (= 22 pg/ml±8.8 in the midluteal phase). All participants showed low serum progesterone ( = 2.85 ng/ml±2.10) and LH profiles ( = 5.6 mlU/ml±0.8) during the midluteal phase. Cyproterone acetate was administered for 8 months to treat the increased bone loss in seven women athletes. Vertebral density appeared to be increased with 9.5%±2.45% (mean±SD) while cortical base mineral content measured at the radius was not significantly changed. Our results demonstrate that cyproterone acetate administered in combination with estrogens provides a suitable therapeutic agent in the management of osteoporosis due to a hypoestrogenic status. This treatment could substitute other contraceptive agents. Moreover, women with the most severe estrogen deficiency showed a more pronounced reaction to this therapy.

Key words

amenorrhea - athletic menstrual irregularity - bone mineral density - cyproterone acetate - estrogens - osteoporosis - women