SynthesisBMJ open sport & exercise medicine2021
Effect of oral and transdermal oestrogen therapy on bone mineral density in functional hypothalamic amenorrhoea: a systematic review and meta-analysis.
Synthesis in BMJ open sport & exercise medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Pharmacological interventions to improve bone density in functional hypothalamic amenorrhea: a systematic review and network meta-analysis of randomized clinical trials.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- Medication for bone loss in female patients with anorexia nervosa: a systematic review and management algorithm.Eating and weight disorders : EWD · 2025Pooled it
- Impact of estroprogestin therapies on bone health from adolescence to postmenopause.Journal of endocrinological investigation · 2026Review
- Bone mineral density in women with functional hypothalamic amenorrhea compared to eumenorrheic controls and recently menopausal women.Frontiers in endocrinology · 2026Article
- Pharmacological vs. Non-Pharmacological Treatment in the Management of Relative Energy Deficiency in Sport (REDs): A Systematic Review and Meta-Analysis.Sports (Basel, Switzerland) · 2025Review
- Weight loss induced bone loss: mechanism of action and clinical implications.Bone research · 2025Review
- Advances in Diagnosis and Management of Childhood OsteoporosisJournal of clinical research in pediatric endocrinology · 2022Review
- Bone Perspectives in Functional Hypothalamic Amenorrhoea: An Update and Future Avenues.Frontiers in endocrinology · 2022Review
- EFFECT OF ORAL CONTRACEPTIVES ON BONE MINERAL DENSITY.Acta endocrinologica (Bucharest, Romania : 2005)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFemale athletes might develop reduced bone mineral density (BMD) and amenorrhoea due to low energy intake.
objectiveTo systematically review the literature of randomised controlled trials (RCTs) assessing the effect of oestrogen oral contraceptives (OCP), conjugated oestrogens (CE) and transdermal estradiol (TE) on BMD in premenopausal women with functional hypothalamic amenorrhoea (FHA) due to weight loss, vigorous exercise and/or stress.
methodsA comprehensive literature search in PubMed, MEDLINE, Cochrane Library, Ovid and CINAHL from inception to 1 October 2020. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted data. When possible, the data were pooled in a random-effects meta-analysis. MAIN OUTCOMES: Difference in BMD (g/cm
resultsNine RCTs comprising 770 participants met the inclusion criteria; five studies applied OCP, two CE and two TE. Four RCTs (two OCP, two TE) found an increased BMD in premenopausal women with FHA, and five (three OCP, two CE) found a decreased BMD compared with controls. A meta-analysis showed no difference in BMD between the treatment and control groups, (standardised mean difference (SMD) 0.30, 95% CI -0.12 to 0.73). A secondary analysis for change scores from baseline to first assessment point, showed a similar overall result (SMD 0.17, 95% CI -0.16 to 0.51). No serious adverse events were reported.
conclusionThe literature suggests that TE might increase lumbar BMD in premenopausal women with FHA, but pooled results revealed no effect of the intervention. The findings do not support oestrogen therapy to improve BMD in these patient groups.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.