Female Trouble

Some women, particularly elite female athletes, experience variations in their menstrual cycle that can be linked to their athletic activities.

There are three types of menstrual irregularities:

> Oligomenorrhea, which is defined as an irregular menstrual cycle in women who previously had a normal one

> Secondary amenorrhea, which is defined as the absence of menstruation in women who previously periodically menstruated (primary amenorrhea is defined as previously regular cycles that have ceased)

> Dysmenorrhea, which is defined as pain during menstruation

Highly athletic women, particularly those who have low body fat, are more prone to irregularities with their menstrual cycles (either oligomenorrhea or secondary amenorrhea) than their sedentary counterparts. That's because adipose tissue (fat) is the site of conversion of androgens (male hormones) to estrogens (female hormones). An alteration in body composition can change the estrogen levels in the body and therefore affect the menstrual cycle. It should be noted, however, that there are athletes with low body fat who do not suffer altered menstrual cycles, and some heavier athletes who do. The women most prone to menstrual irregularities are young athletes engaged in intense daily training who have both low body weight and a low percentage of body fat.

On the other hand, dysmenorrhea—abdominal pain with menstruation—is reported to occur less frequently and with less severity in athletes than in the rest of the population.

Amenorrhea or oligomenorrhea have no detrimental effects on athletic performance. However, whenever a change in the menstrual cycle occurs, a gynecologist should always be consulted. While "the absence of menstruation" might sound more like a cause to celebrate than to worry, the problem that faces women who have irregular or no menstrual cycles is the possible early onset of bone density loss, which normally begins at menopause.

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