Amenorrheic Athletes

Many female  athletes experience menstrual irregularities at one time or another, particuraly those involved in endurance events or competitive sports such as gymnastics or ice skating. Any active woman, whether she is a full-time fitness instructor or a dedicated fitness enthusiast, may experience a few missed periods now and then. In general, temporary menstrual irregularities are not cause for concern.

Problems arise, however, when menstrual irregularities are no longer temporary. Amenorrhea, which is defined as the absence of at least three consecutive periods in a woman who has previously had regular periods, may leave individuals at risk for skeletal injury. In the short term, there is a greater risk of incurring stress fractures. In the long term, osteoporosis may develop.


Research has shown that weight training and weight-bearing exercise can, in fact, increase bone mass. John P. DiForiori, M.D., assistant clinical professor, UCLA School of Medicine, writes in the Postgraduate Medicine Journal,  “Despite these protective effects, a dramatic loss of bone mineral densisty may occur in female athletes with amenorrhea.”

He goes on to explain that loss of bone mineral density in young athletic women can have significant consequences. It is important to establish and maintain strong bones early in life to prevent osteoporosis later on.


The bone loss that occurs as a result of amenorrhea is generally a symptom of a deeper problem. Diet and exercise play a primary role in the functioning of a woman’s reproductive system. Amenorrhea may occur for many reasons: rapid weight loss, poor nutritional balance, disordered eating, or diminished body fat as a result of exercise.

Just as there are different causes, there are also different treatments for amenorrhea. For some women, shaping up the diet or increasing body fat may be the answer. Others may require hormonal therapy to begin menstruating on a regular basis. As for exercise, every woman’s body is different. The level of exerrcise that might be considered excessive to one woman may be fine for another. These are no hard and fast rules. Women who are amenorrheic shoudl discuss their condtion with their physician to determine appropriate treatiment. While amenorrhea itself can be treated easily with the use of hormonal therapy, the cause is not always so. Negative self image or extreme pressure to maintain an aesthetic ideal, whether it be for competition or a job requirement, are two contributory facctors that need to be addressed for treatment to be considered complete.

Daryl Conant, M.Ed.