Optimising Bone Health in Female Athletes: A Narrative Review

Abstract

Bone health is crucial for female athletes to optimize performance, prevent injuries, and ensure long-term well-being. Factors like hormonal changes, nutritional deficiencies, and overtraining can compromise skeletal integrity, increasing risks of stress fractures, osteoporosis, and Relative Energy Deficiency in Sport (RED-S). This review highlights strategies to maintain bone health, focusing on adolescence and early adulthood as critical periods for achieving peak bone mass through weight-bearing and high-impact exercises. The Female Athlete Triad—low energy availability, menstrual dysfunction, and reduced bone mineral density—is a significant risk factor often linked to disordered eating. Nutritional strategies, including sufficient intake of calcium, vitamin D, and balanced diets, are essential for bone health. Exercise interventions like resistance training and plyometrics enhance bone density, while structured training programs with adequate rest reduce cumulative stress on bones. Monitoring menstrual cycles and timely hormonal interventions address menstrual irregularities affecting bone health. Tools like DEXA scans allow early detection of bone density issues, especially in postmenopausal women. Preventive measures, including education and multidisciplinary approaches, help manage conditions like RED-S and promote awareness. Emerging technologies, such as biomarkers and genetic testing, enable personalized care and monitoring. A holistic approach involving collaboration among sports physicians, dietitians, and psychologists ensures optimal bone health, reducing injury risks and supporting athletes’ overall well-being across all life stages.