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GREMION, G., R. RIZZOLI, D. SLOSMAN, G. THEINTZ, and J-P. BONJOUR. Oligo-amenorrheic long-distance runners may lose more bone in spine than in femur. Med. Sci. Sports Exerc., Vol. 33, No. 1, 2001, pp. 15–21. Strenuous training can be associated with amenorrhea leading to amenorrhea-related accelerated bone loss. Insufficient calorie energy, calcium, and/or protein intakes can also be frequently encountered in women with intense training, possibly contributing to bone loss. Long-distance runners with or without regular menses (age range 19-37 yr) were prospectively studied. Changes in areal bone mineral density (BMD) were measured at 1-yr interval. Among 10 eumenorrheic, 11 oligo-amenorrheic, and 9 oral contraceptive users, there was no difference in energy, calcium, or protein intakes. Baseline BMD values were significantly lower in the oligo-amenorrheic group than in the two others at the level of lumbar spine (anteroposterior view: 0.941 ± 0.039 in oligo-amenorrheic vs 1.077 ± 0.029 or 1.051 ± 0.017 g·cm-2, P < 0.005, in the eumenorrheic and contraceptive user groups, respectively) but not in weight-bearing bone such as proximal and midshaft femur. Over a 1-yr interval, during which the three groups did not differ in terms of running distances and dietary intakes, oligo-amenorrheic women displayed a significant decrease in lumbar spine BMD in lateral view (−0.049 ± 0.012 in oligo-amenorrheic vs -0.001 ± 0.013 and 0.014 ± 0.012 g·cm-2, P < 0.005, in the eumenorrheic and contraceptive user groups, respectively). We did not detect any significant change in femoral neck, trochanter, or midshaft BMD. Oligo-amenorrhea in long-distance runners, with adequate dietary intakes, was associated with a decrease in BMD affecting more the lumbar spine than the proximal and midshaft femur during a 1-yr follow-up.