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Menstrual Disorders in the Athlete, Sports Medicine

Kayla Daniel, MD and Anastasia Fischer, MD, FAAFP, FACSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Menstrual dysfunction: a lack of regular menstrual periods (every 22 to 35 days) 1 to 2 yr after menarche 1:

    • Primary amenorrhea is the lack of spontaneous uterine bleeding:

      • By the age ...

DIAGNOSIS

HISTORY

  • Menstrual history:

    • Age of menarche, family history of menarche

    • Last menstrual period

    • Frequency and duration of menses

    • Longest time between menses

    • Changes in menstrual cycle with exercise

    • Pr...

TREATMENT

GENERAL MEASURES

Functional hypothalamic amenorrhea: 
  • Primary goal of treatment (+/− female athlete triad) is weight restoration or normalization of body weight through nutritional rehabilitat...

REFERENCES

1
Klein DA, Poth MA. Amenorrhea: an approach to diagnosis and management. Am Fam Physician.  2013;87(11):781–788.
2
Nattiv A, Loucks AB, Manore MM, et al. American College of Sports Medic...

CLINICAL PEARLS

  • There is a correlation between BMD decline and number of missed menstrual cycles; loss of BMD is not fully reversible.

  • Relative risk for stress fracture is 2 to 4 times greater in ameno...

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