Exercise can significantly improve your quality of life. In addition to helping ward off osteoporosis, regular activity can increase your cardiovascular fitness, strengthen your immune system and alleviate depression. However, female athletes who don't balance vigorous exercise with sufficient rest and a nutritious diet risk developing amenorrhea--lack of menstruation. Amenorrhea--far from being a sign of superior physical conditioning--is actually a serious disorder that can have dangerous consequences. If you experience missed or delayed periods, visit your doctor promptly for diagnosis and treatment.
Features
With primary amenorrhea, vigorous exercise at a young age causes the menarche, or first period, to be delayed. Ballet dancers--who often begin training heavily by age 9--are particularly susceptible; SportsDoctor.com notes that 24 to 40 percent of ballerinas have delayed menarche. Young women who haven't menstruated by age 16 should see a doctor. Secondary amenorrhea is the absence of three periods in a row after a woman has undergone two or more normal menses. Amenorrhea is diagnosed by physical examination and blood tests; before identifying overtraining as the cause, your doctor must first rule out conditions such as ovarian cysts, thyroid problems and pregnancy. Aside from cessation of periods, other symptoms of amenorrhea include slow pulse, low blood pressure and sensitivity to cold. According to an article in the 1999 issue of "Clinical Endocrinology and Metabolism," amenorrhea affects 5 to 25 percent of all female athletes, depending on the intensity of the sport.
Causes
Specific amounts of calories, protein and fat are needed to maintain menstruation; chronic dieting--along with excessive exercise--contributes to amenorrhea. According to an article published in the 1999 issue of "Clinical Endocrinology and Metabolism," patients with exercise-induced amenorrhea are almost always thin, with body weights at or under the "ideal" weight, low body fat and a low BMI, or body mass index. Eating a vegetarian diet and getting insufficient amounts of iron also make amenorrhea more likely to occur. The metabolic stressors of undereating and over-exercising cause the hypothalamus gland to malfunction, affecting the release of LS and FSH, pituitary hormones that trigger ovulation.
Consequences
Amenorrhea is linked with several harmful conditions. Many sports doctors classify amenorhea--along with osteoporosis and eating disorders such as anorexia and bulimia--as one part of an unhealthy syndrome known as female athlete triad, indicated by weight loss, fatigue and impaired concentration. Female runners with amenorrhea often have higher injury rates--with more frequent fractures of the femur, tibia, metatarsal and fibula bones--and lower bone density than normal, a paradox in light of the fact that weight-bearing exercise normally results in improved bone density. Delayed menarche may lead to irreversible bone mass deficiency; in severe cases, it can cause scoliosis, a sideways curvature of the spine.
Treatment
To treat amenorrhea, SportsDoctor.com advises decreasing training by 5 to 15 percent, while increasing caloric intake by 5 to 20 percent, with the goal of gaining 2 to 10 pounds. If menses don't return in six to 12 months, SportsDoctor.com advises seeking hormone replacement. Your doctor can help determine whether you need calcium and vitamin D supplements to correct any dietary deficiencies. Even with proper treatment, amenorrhea may take over six months to reverse.
