Sports Medicine
A Crucial Period
Good Pain, Bad Pain
On Your Knees
Secondary Injuries
Imaging Technology
What's Sciatica?
The Female Athlete
Putting Your Feet First
Itis Schmitis
Too Much, Too Soon
Under the Influence
What's Goin' On?
Think Inches, Not Pounds
Preventing Vaginitis
That Painful Pull
Athlete's Heart
Exercise & Arthritis
Chilled to the Bone
Measuring Body Fat
Exercise and Your Breasts
Choosing a Sports Doctor
Lean on Me (Shoulder)
Exercise & Anemia
Exercise Abuse
Pelvis Sighting
Hand Aid
It's All in the Wrist
Back in Action
Altitude Adjustment
Tennis Elbow, Anyone?
Exercising in the Heat
Agony of the Feet
Restless Legs
Night Time Cramps
Birth Control Concerns
No Periods, No Babies?
Post Partum Prescription
Weight Loss Mystery
Undesirable Cooldown
To Brew Or Not To Brew
Fitness After Baby
Biking and Back Pain
Swimmer's Shoulder
A Hidden Athlete
Avoiding Osteoporosis
Drug Testing
Maximum Heart Rate
Headway Against Headaches
Torn Rotator Cuff
Fat Figures
Bloody Urine
Sag Story
Lackluster Leg
Bothersome Bulge
Gaining in Years
Taking It On the Shin
Aching Ankles
Hoop Help
Tender Toes
Meals For Muscle
Growing Pains
Hot Tips
High Altitude PMS
Personal Bests
Air Pollution
Ankle Blues
Heartbreak Heel
Yeast Relief

A Crucial Period


Follow-up studies of the amenorrheic women in Drinkwater's original group demonstrated that with lifestyle changes (reducing exercise by 10 percent and gaining at least 4 pounds), some of the women resumed menstruation without any other treatment. That was the good news. In those who did so, bone mass slowly increased - more good news.

But further follow-up and research indicated that bone mass never returned to the levels of athletic women who menstruate regularly The clear message is that cessation of menstrual periods due to EAA leads to irreversible bone loss.


There are two categories of amenorrhea: primary and secondary Primary amenorrhea, also called delayed menarche, refers to the absence of menstrual periods by age 16. Exercise is only one possible factor that may delay the beginning of menstruation. Any woman who has not begun menstruation by age 16 should see a physician to evaluate the cause.

Secondary amenorrhea is defined as the absence of three consecutive men-strual periods after a woman has had two or more normal menses. Between 2 and 5 percent of all women have secondary amenorrhea at some time in their life. Amenorrhea may be caused by many different medical conditions, including ovarian cysts, thyroid problems and pituitary tumors. It may also result from overtraining.

Therefore, EAA is a diagnosis of exclusion, meaning that all the other causes of amenorrhea, including pregnancy, need to be ruled out first. Every woman with amenorrhea needs a thorough evaluation by a clinician well-versed in the field of "sports gynecology." A proper evaluation includes a complete medical and training history, a physical examination and blood tests. Your Weight history and dietary habits should also be reviewed because amenorrhea can be a symptom of an eating disorder such as anorexia.

The exact cause of EAA hasn't been determined, but researchers believe the problem originates in the master gland of the body - the hypothalamus. In an am-enorrheic woman, all hormonal signals from the hypothalamus to the pituitary and then to the ovaries are turned off, while the body's energy is directed elsewhere. Levels of the pituitary hormones (LH, FSH) and ovarian hormones (estrogen and progesterone) are very low. How is this evaluated?

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Table of Contents

Foreword: Billie Jean King

Comments by Barb Harris
Editor in Chief,
Shape Magazine

General Health
Common Medical Problems
Dental Health
Infectious Disease
Sexual Health
Emotional Well-Being
Eating Disorders
Alcohol & Other Drugs
Environmental Health

The information in this web site is for educational purposes only and is not providing medical or professional advice. It should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional medical care. If you have or suspect you might have any health problems, you should consult a physician.

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