ABSTRACT
The last 100 years has seen increasing participation in elite sports by women. A number of sports injuries appear to be more common in women (e.g. anterior cruciate ligament problems). There are also issues related to exercise during pregnancy. However, a rather unexpected problem has dominated this area – an inhibitory effect of intense training on reproductive function and a parallel reduction in bone mineral density. These two changes are associated with under-eating, hence the triad:
Osteopenia – menstrual disturbances – disordered eating
Incidence The clearest indication is irregularity or cessation of menstrual periods – oligomenorrhea or amenorrhea (Table 1). Early indications may be luteal phase shortening. Incidence of menstrual disorders is higher in athletes and dancers than in the general population. It is clearly associated with low body weight, particularly low body fat levels. For example, it is more common in lightweight rowers than heavyweights and is a particular problem in dance and gymnastics where slim body shape is important. Menstrual problems are also seen in weight-sensitive sports such as endurance running, but are not so common in swimming or power events.
