The effects of endurance training on body composition, menstrual cycles, and sex steroids were studied in 19 healthy, regularly menstruating women. Body composition and midfollicular plasma concentrations of estradiol (E2), estrone (E1), and testosterone (T) were examined at baseline and after each subject's weekly mileage had increased 30 miles (delta 30) and 50 miles (delta 50) above baseline. Total body weight did not change, but the subjects became leaner. Mean +/- standard error of the mean E2 decreased from 70.6 +/- 13.9 pg/ml at baseline to 33.6 +/- 4.8 pg/ml at delta 50 (P = 0.03). Mean E1 decreased progressively, but not significantly, while T did not change. Eighteen women developed menstrual changes (mainly oligomenorrhea), but not amenorrhea. Endurance running in women results in frequent menstrual dysfunction and is associated with a significant decrease in E2 concentrations.