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Sports & Menses
Today, more and more adolescent girls
and young women are taking part in many different sports. As a
result, they are healthier, in better shape, and more active.
Being active improves cardiovascular (heart) fitness, bone
strength, and overall health.
Most girls who play a sport have
regular menstrual periods. Girls who are very active may even skip
a few periods. However, some girls who train really hard may skip
many menstrual periods, or they may get their period at a late
age, especially if they have lost weight or have developed an
eating disorder. Girls may begin to skip periods if they are not
getting enough nutrition, or if there is too much stress on their
body from sports. This stress lowers estrogen levels, which may
cause skipped periods. Low estrogen levels and a lack of menstrual
periods can lead to osteoporosis (weakened bones) and stress
fractures (small cracks) in your bones.
What is the Female Athlete Triad?
Recently, doctors, athletes, and
coaches have used the term "Female Athlete Triad" (triad means
three) to refer to athletic girls who have the following:
1.
Disordered eating:
Disordered eating means that your body is not getting healthy
nutrition. You may be focusing too much of your time on eating,
diets, and keeping thin. Healthy nutrition is needed to have
regular periods and normal estrogen levels. If you lose weight,
you are especially likely to skip periods. There are two common
eating disorders related to the Female Athlete Triad. They are:
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Anorexia nervosa: This
eating disorder happens when not enough calories and nutrition are
taken in to maintain a healthy weight.
-
Bulimia:
The practice of binge eating (eating too much uncontrollably in
one sitting) and then purging (vomiting, exercising intensely) to
get rid of the food just eaten.
When a girl or
young woman with anorexia nervosa or bulimia does too much
exercise, she is putting an extreme strain on her body. Even
eating regular amounts of food may not be enough for a very active
person to maintain a normal weight.
2.
Amenorrhea: This is
defined as the absence of menstrual periods for longer than 6
months. This lack of menstrual periods can happen when there is
weight loss, disordered eating, or intense training or exercise. A
certain percentage of body fat is healthy for the body, and girls
will stop their periods if their weight drops to an unhealthy
level. Having your period only every 2 to 3 months or very light
periods is a sign that you may be pushing your body too hard.
A healthy weight is especially important for you to have normal
levels of the female hormone, estrogen. Normal levels of estrogen
are important for your body to absorb calcium (a mineral your body
needs to build strong bones). Not enough estrogen can cause your
bones to lose thickness and strength.
3.
Osteoporosis: This is when
your bones are weaker than they should be. Although physical
activity helps to build a healthy skeleton and strong bones, too
much exercise can cause problems if you are not having regular
periods and normal estrogen levels. Everyone, teen girls
especially, need the right balance of exercise, body weight,
calcium intake in your diet, vitamin D, and estrogen levels to
have healthy bones.
What health problems can the Female
Athlete Triad cause in the future?
Each of the three conditions
(disordered eating, amenorrhea, and osteoporosis) is a serious
problem that needs medical care and can cause problems in the
future.
Even if you only have one or two of
the conditions, it is important to talk about them with your
health care provider. For example, athletes can be eating a
healthy diet and yet still skip menstrual periods and be at risk
of osteoporosis.
Disordered eating can cause heart
problems such as an irregular heartbeat, muscle weakness or
fatigue, fainting, and loss of concentration with schoolwork and
athletics.
Amenorrhea is a sign that your body
is not functioning properly. The biggest concern is that the low
estrogen levels may result in osteoporosis.
Preventing osteoporosis is very
important for teens. The teen years are the most important time in
a girl's life for developing normal, strong bones. Girls should
add HALF of the bone mass that they will have for their lifetime
during their teen years. Very little bone mass is added after you
are 20 years old, and so the teen years are VERY important for
getting the right amount of bone for your LIFETIME. Even during
your teen years, weak bones and intense exercise together can make
it easier for you to get stress fractures. A stress fracture is a
very small crack that can occur in bones when you do the same
activity over and over for too long. For example, a runner may get
a stress fracture in her lower leg or foot, and a gymnast may get
a stress fracture in her spine. If you continue to do the activity
in spite of the pain, the bone may break.
How will I know if I have
osteoporosis?
If you are skipping periods and your
health care provider is worried about osteoporosis, he/she may
suggest that you have a test that tells whether your bones have
lost thickness or strength. One of these tests is called a DEXA,
or Dual Energy X-Ray Absorptiometry, scan. It is a painless test
that uses low radiation waves to take a picture of your bones.
This tells your doctor whether you have more or less bone than
other girls your age.
Who is at risk for the Female Athlete
Triad?
Any athlete who does a great amount
of physical activity is at risk for any of the three conditions of
the Female Athlete Triad. Athletes who are very competitive or
focus a large part of their lives on their sport are considered to
be at a higher risk. Certain activities that involve a lot of
endurance (long distance running, for example) may put you at more
risk for the Triad. There is also a higher risk among those girls
involved in activities that demand a thin physical appearance,
like gymnastics or dancing. Being aware of these demands or
pressures on your body is a good first step to keeping yourself
healthy. It is important to remember to balance yourself. Too much
of a good thing, such as exercise, can become dangerous and
harmful to your body. The right balance will keep you healthy.
What should I do if I'm a female
athlete?
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Give your body enough energy to fuel performance.
During sports seasons, make sure you eat a healthy diet with
enough calories to make up for all of your training. Try not to
lose weight if you are already a normal weight. Check with your
health care provider and discuss healthy weights for you. Through
eating a healthy diet and taking vitamins, make sure you get 1300
mg of calcium and 400 international
units of vitamin D every day to keep your bones strong.
Over-the-counter multi-vitamin tablets contain 400 international
units, or IU, of vitamin D.
-
Keep a menstrual calendar.
If you are skipping menstrual periods, see your health care
provider. It may be a sign that your body is under too much
stress.
-
Don't ignore injuries.
If you develop the same pain in your leg or foot every time you
run, the same pain in your back whenever you do gymnastics, or the
same pain in any part of your body whenever you do the same
activity, you may have a stress fracture. Be sure to get it
checked out.
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Talk to your health care provider.
If you are bingeing, purging, not letting yourself eat, or worried
about your weight a lot of the time, get help from coaches,
trainers, and health care providers. While some problems, such as
anorexia and bulimia, may be hard to talk about with someone, the
earlier they are treated, the better.
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