Hormonal changes may raise bone injury risks for Winter Olympians as athletes age
Athletes at the Milano Cortina 2026 Olympic Winter Games span a wide age range, from teenagers to competitors in their 50s. Research suggests hormonal changes may affect bone health and stress-fracture risk more directly than athletic performance.
Athletes of all ages are competing in the Milano Cortina 2026 Olympic Winter Games, from 15-year-old skier Abby Winterberger to 54-year-old curler Rich Ruohonen. Research suggests that hormonal changes may not have a direct influence on athletic performance, but hormonal status can influence factors that may lead to a bone injury, such as a stress fracture, which can affect performance by limiting the ability to train and compete.
At age 52, Austrian snowboarder Claudia Riegler made history at this year’s Games as the oldest female Winter Olympian. She is among many athletes who are proving age is just a number, especially as more Olympians in their 30s, 40s, and 50s are competing now than in previous decades.
How hormones affect male athletes is very different from how hormones affect female athletes, and puberty is a pivotal point. For men, the predominant sex hormone is testosterone, which is why men typically have more muscle mass than women. For women, the predominant sex hormone is estrogen.
Both estrogen and testosterone have very potent effects on bone metabolism. When those levels go down, the skeleton can start to lose bone, which makes the bone susceptible to an injury like a stress fracture. In that respect, a fluctuation in hormone levels can cause a change in bone metabolism that puts an athlete at risk.
Adolescence is the time period when people accrue the majority of their bone mass for their lifetime. If bone health is not optimized in that adolescent period, there can be increased risk of poor bone health in adulthood. When people reach their mid-20s or so, that window of opportunity to continue to increase bone mass closes, and from then on, it is about trying to preserve bone density.
Early research has found that when ovarian function is suppressed in women — effectively reducing their estrogen levels and temporarily making them post-menopausal — women lose both bone mass and lean mass. Further studies indicate that the size of women’s muscles may shrink due to a lack of estrogen, though further studies among larger cohorts are needed to confirm this.
It is typical for females to gain weight and potentially experience a temporary decline in their sports performance during puberty as they adjust to their changing body. Estrogen is important for bone health, and discussions about hormonal changes can be central for athletes dealing with bone stress injuries, nutrition concerns, and menstrual disturbances.