What is athletic amenorrhea?

Amenorrhea is the medical term for missed menstrual periods. Menstruation helps your body get ready for the possibility of pregnancy each month. Each month, an ovary releases an egg. The egg travels through a tube called the fallopian tube into the uterus. Hormones make the lining of the uterus thicker to get ready for a baby in case the egg is fertilized by sperm. If a man’s sperm does not fertilize the egg, the uterus sheds the lining it prepared for a baby. When the uterus sheds its lining, blood flows out of your vagina. This is called menstrual flow, or your period.

Athletic amenorrhea is when you don’t have menstrual periods because you have been exercising very intensely and are very lean. Some women athletes stop having periods. Others don’t get their first period until years after the age at which most girls start menstruating. Some may not have a period until they are in their 20s.

What is the cause?

The female hormones estrogen and progesterone are important for overall body health. These hormones regulate your periods. Athletes have reduced hormone levels from a combination of:

• A lot of exercise, such as highly competitive athletes who train hard every day
• Not eating a healthy diet. Athletic amenorrhea is often seen in sports such as gymnastics, ballet, and long-distance running. With the pressure to be thin, some athletes may not eat enough.

What are the symptoms?

You do not have periods for 3 months or more.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you, including a pelvic exam. Tests may include:

• A pregnancy test
• Blood tests

You may have other tests or scans to check for other possible causes of your symptoms.

How is it treated?

To treat athletic amenorrhea, you may need to:

• Exercise less.
• Eat enough food to take in enough calories for your workouts.
• Make sure you have enough calcium in your diet.
• Take birth control pills or another form of estrogen and progesterone to restore your hormone balance and start having periods.

If you are sexually active you can get pregnant even if you have missed periods. Use birth control if you do not want to get pregnant.

How can I help prevent athletic amenorrhea?

A well-balanced diet with enough calories helps prevent athletic amenorrhea. Try not to exercise too much and eat too little.

If you think you have an eating disorder, talk with your healthcare provider.