A Crucial Period

Continued...

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.

MAKING THE DIAGNOSIS

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
Nutrition
Exercise
Common Medical Problems
Dental Health
Emergency!
Infectious Disease
Sexual Health
Emotional Well-Being
Eating Disorders
Alcohol & Other Drugs
Environmental Health
Prevention