Amenorrhea refers to the absence of menstruation in women. Amenorrhea is diagnosed in women who miss at least three consecutive menstrual periods and girls who have not had their first menstrual period by 16 years of age. The causes of amenorrhea include pregnancy, which is the most common, and problems with hormone levels or the reproductive organs. Excessive exercise or training can also cause amenorrhea.
Amenorrhea
A girl who has not had menstruation by the age of 16 has primary amenorrhea. Secondary amenorrhea refers to a woman who has had normal menstruation that has stopped at a later time. The symptoms of amenorrhea, which may vary based on the cause of the condition, include hair loss, headache, nipple discharge, acne and excess facial hair. A woman is at increased risk of amenorrhea if she has a family history of the condition, an eating disorder or engages in excessive athletic training. Amenorrhea can lead to infertility and osteoporosis, or weakening of the bones. Amenorrhea can also cause metabolic changes, including decreased estrogen levels, according to the American Academy of Pediatrics.
Female Athletic Triad
The female athletic triad, as described by American Academy of Orthopaedic Surgeons, includes three interrelated conditions that occur when a female athlete engages in extreme exercise and dieting. Disordered eating can result from eating disorders or excessive exercise that prevents the body from getting the nutrition it needs. Menstrual dysfunction caused by hormonal changes can result from a combination of poor nutrition, inadequate calories, high energy output, low body fat and emotional and physical stress. Premature osteoporosis occurs when the lack of menstrual periods disrupts the processes the body uses to build bones.
Activities
Female athletes who participate in sports that value thin bodies, such as gymnastics and figure skating, are more likely to develop the conditions to lead to amenorrhea. Females who engage in performance sports such as rowing or distance running are also more likely to develop amenorrhea. According to the American Academy of Pediatrics, female athletes participating in gymnastics and ballet are at elevated risk for primary and secondary amenorrhea.
Treatment
Treatment for amenorrhea usually requires a team approach. The patient's doctor, athletic trainer, mental health professional and nutritionist work together to determine the treatment plan, which might include helping the patient find balance in her approach to exercise. Additional tests, such as bone density tests, can help doctors determine the extent of damage caused by the amenorrhea and the treatment required.
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