Amenorrheic runners and ballet dancers have a high prevalence of osteopenia because lack of estrogen is a powerful influence on the loss of calcium from bone.

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Amenorrheic runners and ballet dancers have decreased estrogen levels due to excessive exercise and low body weight, which can result in bone loss and osteopenia. Estrogen plays a key role in maintaining bone density by reducing the activity of bone-resorbing cells called osteoclasts. Therefore, lack of estrogen can lead to increased bone resorption and decreased bone formation, resulting in osteopenia.

Amenorrheic Runners and Ballet Dancers Have a High Prevalence of Osteopenia