ABSTRACT
Train less and eat more! But this is not popular with athletes or coaches. There needs to be a greater awareness of long-term risks, followed by a supportive approach involving the athlete and their entourage. In some instances oestrogen supplementation can be appropriate (oral contraceptive pill, or HRT of post-menopausal type). However, these treatments have side effects. In practice the effects of oestrogen supplementation have been disappointing, although some increased mineralisation has been shown. An obvious strategy is leptin supplementation. This has been shown to work in women with amenorrhea associated with strenuous exercise (Welt et al. 2004). Presumably only cost is limiting further trials (leptin costs around £100 per mg and approximately 10mg/day was used in the published trial).
