A survey of menstrual function in athletes

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Questionnaires were given to 254 female athletes and 426 nonathletic control subjects, and interviews were conducted with 95 athletes. Menstrual characteristics in the two groups were strikingly different, with oligo/amenorrhea reported by 12.1% of the athletes and 2.6% of the control subjects, and regular menstruation reported by 42.9% of the athletes and 64.3% of the control subjects. About half the athletes interviewed were able to cite specific changes in their menstruation that were associated with specific changes in their athletic training. Low body weight was the factor most commonly associated with oligo/amenorrhea in athletes, but among the control subjects menstrual characteristics did not appear to be influenced by body weight. Lighter oligo/amenorrheic athletes reported more severe menstrual disturbances than heavier oligo/amenorrheic athletes. Distance runners reported fewer menstrual periods per year than other athletes, and weekly training distance appeared to influence menstrual characteristics among the runners. Other factors which appeared to be associated with athletic oligo/amenorrhea included a vegetarian diet and a high altitude environment. We conclude that menstrual disturbances are often associated with athletic training, and that several factors, particularly low body weight, can increase susceptibility to exercise-related oligo/amenorrhea.

Supported by NIH grants 2R01-HD05794-08 and 5M01-ER00997-05