EDITORIAL
Midnight Basketball for Girls?
The health benefits of exercise for people of all ages
have been well described. These have included re-
duced risk for cardiovascular disease, the leading
killer of both sexes, through prevention of obesity
and increased levels of HDL-Cholesterol. During
adolescence, sports participation has played an im-
portant role in the experience of boys, most of whom
have benefited socially and physically.
With removal of many historic barriers to girls’
participation in competitive sports in the late l970’s,
this generation of women has entered the playing
field in record numbers. Health professionals have
looked on with great interest, observing sex and
gender differences in teenagers’ experience with ex-
ercise and sports. Many reports have since appeared
in the medical literature which describe negative
outcomes such as “athletic amenorrhea”, sports in-
juries (higher in girls in certain sports) and, most
recently, growing abuse of anabolic steroids to en-
hance muscle strength, as well as associated prob-
lems of anorexia nervosa.
Among the positive effects of girls’ participation
in sports, are reports of decreased menstrual cramps
and obesity, possible enhancement of bone density
and the potential for team socialization with its
putative long-term advantages in the Board Room. In
this issue of the Journal of Adolescent Health we learn
of another. According to a study by Sabo et al. (1)
adolescent female athletes have a lower pregnancy
rate than non-athletes. This intriguing finding raises
a number of questions about the possible mecha-
nisms of action of such an effect. How might athletics
be responsible, directly or indirectly, for reducing
pregnancy in adolescents?
There are a number of possible explanations, some
biologic, others psychosocial. Among these are the
possibility that anovulation resulting from weight
loss and/or stress of competitive sports has pre-
vented pregnancy despite sexual intercourse. It
could also reflect differences in the male athletes
with whom these girls associate or that the social
experience of peer group interaction has delayed
onset of sexual activity. Alternatively, the enhanced
self-esteem resulting from the sports experience has
decreased girls vulnerability to premature sexual
experiences.
A randomized trial in which young girls are
assigned to become athletes or remain sedentary and
then followed prospectively would allow for exami-
nation of a few of these hypotheses, but is obviously
not possible (or even necessarily desirable). A retro-
spective examination of the risk factors and athletic
experiences of a larger number of subjects (those
who have and have not become pregnant as adoles-
cents) from a broader cross-section of worlds’ popu-
lation might provide some answers. Until this ques-
tion is answered empirically, clinicians and
researchers, as well as educators, might profitably
focus on new approaches to reversing or preventing
those factors known to be associated with early
adolescent pregnancies. Yes, perhaps even night
basketball for girls!
Iris F. Litt, M.D.
Editor-in-Chief
References
1. Sabo DF, Miller KE, Farrell MP, et al. High school athletic
participation, sexual behavior and adolescent pregnancy. A
regional study. J Adolesc Health l999;25:207–216
JOURNAL OF ADOLESCENT HEALTH 1999;25:173
© Society for Adolescent Medicine, 1999
Published by Elsevier Science Inc., 655 Avenue of the Americas, New York, NY 10010
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PII S1054-139X(99)00072-5