Reproductive health of professional female dancers

Ples je oblik scenske umjetnosti u kojoj plesač svoje tijelo koristi kao instrument. Plesač kao umjetnik mora zadovoljiti i estetske i fizičke zahtjeve svoje profesije te zbog toga ovu profesionalnu skupinu moramo gledati kao umjetnike, ali i kao sportaše. Ples kao profesija sa gledišta medicine rada i sporta nosi sa sobom određene rizike koji se pravodobnom prevencijom i edukacijom mogu umanjiti. Zbog činjenice da se u većem broju plesnih stilova preferira niski indeks tjelesne mase i niski postotak tjelesne masti plesači su u većem riziku za razvoj poremećaja prehrane koji dovodi do sindroma relativnog deficita energije u sportu (prijašnji naziv atletski trijas) koji obuhvaća poremećaje brojnih fizioloških funkcija u organizmu uključujući poremećaje metabolizma, imunološkog, reproduktivnog i kardiovaskularnog sustava, poremećaja gustoće kosti, sinteze proteina i oštećenje psihičkog zdravlja. Dugotrajni deficit energije i/ili visoki psihički ili fizički stres dovodi do raznih poremećaja u menstruacijskom ciklusu od kojih je najčešća funkcionalna hipotalamička amenoreja. Dugotrajna oligomenoreja ili amenoreja smanjuju razinu estrogena u organizmu što dovodi do smanjene gustoće kostiju i većeg rizika od stres fraktura. Zbog navedenih rizičnih čimbenika vezanih uz samu profesiju i kratkoće radnog vijeka profesionalni plesači, a posebice plesačice često nisu u mogućnosti u potpunosti ostvariti svoj reproduktivni potencijal. Kako bi zaštitili profesionalnu skupinu plesača od razvoja i posljedica sindroma relativnog deficita energije te očuvali njihovo reproduktivno zdravlje potrebno je razviti odgovarajuće strategije primarne, sekundarne i tercijarne prevencije.Dance is a performance art form in which a dancer uses her/his body as an instrument. The dancer as an artist must meet the aesthetic and physical requirements of her/his profession, and therefore we must look at this professional group as artists and as athletes. Occupational and sports medicine has to be aware that dance as a profession carries certain risks that can be mitigated by timely prevention and education. Due to the fact that a large number of dance styles prefer a low body mass index and a low percentage of body fat as an advantage in performance, dancers are at greater risk of developing eating disorders leading to a Relative Energy Deficiency Syndrome in Sports (RED-S) (previously called athlete triad) that includes disorders of many physiological functions including metabolic disorders, immune, reproductive and cardiovascular system disorders, bone density and protein synthesis disorders and mental health impairment. Long-term energy deficit and/or high mental or physical stress lead to various menstrual cycle disorders, most commonly the functional hypothalamic amenorrhea. Long-term oligomenorrhea or amenorrhea reduce the level of estrogen in the body, leading to reduced bone density and greater risk of stress fractures. Because of the above-mentioned risk factors related to the profession itself and the shortness of working life, professional dancers, especially female dancers, are often unable to fully achieve their reproductive potential. In order to protect professional dancers from the development and consequences of the Relative Energy Deficiency Syndrome and to protect their reproductive health, it is necessary to develop appropriate primary, secondary and tertiary prevention strategies