Restoration of Menses With Nonpharmacologic Therapy in College Athletes With Menstrual Disturbances: A 5-year Retrospective Study

Int J Sport Nutr Exerc Metab. 2012 Apr;22(2):98-108. doi: 10.1123/ijsnem.22.2.98.

Abstract

Background: Functional hypothalamic amenorrhea is common among female athletes and may be difficult to treat. Restoration of menses (ROM) is crucial to prevent deleterious effects to skeletal and reproductive health.

Objectives: To determine the natural history of menstrual disturbances in female college athletes managed with nonpharmacologic therapies including increased dietary intake and/or decreased exercise expenditure and to identify factors associated with ROM.

Study design: A 5-yr retrospective study of college athletes at a major Division I university.

Methods: 373 female athletes' charts were reviewed. For athletes with menstrual disturbances, morphometric variables were noted. Months to ROM were recorded for each athlete.

Results: Fifty-one female athletes (19.7%) had menstrual disturbances (14.7% oligomenorrheic, 5.0% amenorrheic). In all, 17.6% of oligo-/amenorrheic athletes experienced ROM with nonpharmacologic therapy. Mean time to ROM among all athletes with menstrual disturbances was 15.6 ± 2.6 mo. Total absolute (5.3 ± 1.1 kg vs. 1.3 ± 1.1 kg, p < .05) and percentage (9.3% ± 1.9% vs. 2.3% ± 1.9%, p < .05) weight gain and increase in body-mass index (BMI; 1.9 ± 0.4 kg/m2 vs. 0.5 ± 0.4 kg/m2, p < .05) emerged as the primary differentiating characteristics between athletes with ROM and those without ROM. Percent weight gain was identified as a significant positive predictor of ROM, OR (95% CI) = 1.25 (1.01, 1.56), p < .05.

Conclusions: Nonpharmacologic intervention in college athletes with menstrual disturbances can restore regular menstrual cycles, although ROM may take more than 1 yr. Weight gain or an increase in BMI may be important predictors of ROM.

MeSH terms

  • Amenorrhea / physiopathology
  • Amenorrhea / therapy*
  • Athletes
  • Body Mass Index*
  • Diet*
  • Energy Metabolism / physiology*
  • Exercise / physiology*
  • Female
  • Humans
  • Hypothalamus
  • Menstruation*
  • Oligomenorrhea / diet therapy
  • Oligomenorrhea / physiopathology
  • Oligomenorrhea / therapy*
  • Retrospective Studies
  • Universities
  • Weight Gain / physiology*