Missed Period in Female Athlete

Patient

Q: I am a 17 year old long distance runner and I have stopped getting my period because I'm just getting back into training. There is a history of osteoporosis in my family and I'm worried about bone density. I am not losing any weight now but I had an eating disorder a year ago; I'm a healthy 130 lbs and 5'6, eating somewhere around 2500 cals/day. I'm only training 4 or 5 days a week. Is there anything I can do to get my period back? I know a lot of girls that run much more than me and don't have this problem. I really don't want to stop running but I will if my health is at risk. Thankyou

Doctor

A:   Hello, I understand your concern about missed periods probably caused by your intense training. Certainly the first cause to rule out is pregnancy, if you don’t think this could be the case then we might think of excess exercise, it is commonly presented in long distance runners such as yourself, however there are also another possibilities as well that need to be considered such as weight loss but since you have not lost weight recently and your body mass index according to your height and weight is in the limit, we might need to study other possibilities.
First we need to confirm that you have amenorrhea which is the loss of three consecutive periods or just one missed period to start a workup in order to rule out the cause. I will suggest you to consult your Gynecologist, he or she will rule out other endocrine possibilities to make sure no regulatory systems are compromised and to give you the right treatment.
I don’t think you have to worry now for Osteoporosis. Certainly an increase in proteins and carbohydrates might need to be added to your diet, this could be the only reason but like I said before, we need to take a more detailed history, examination and probably blood tests. I wish you the best.

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