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Julie C. Arends, Min-Yuen C. Cheung, Michelle T. Barrack, and Aurelia Nattiv

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.

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. Fink * 3 1996 6 6 1 1 14 14 23 23 10.1123/ijsn.6.1.14 Treatment of Athletic Amenorrhea with a Diet and Training Intervention Program Christine A. Dueck * Kathleen S. Matt * Melinda M. Manore * James S. Skinner * 3 1996 6 6 1 1 24 24 40 40 10.1123/ijsn.6.1.24 Effects of Diet and Diet

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Articles Athletic Women’s Experiences of Amenorrhea: Biomedical Technologies, Somatic Ethics and Embodied Subjectivities Holly Thorpe * 3 2016 33 1 1 13 10.1123/ssj.2015-0030 One Guy Named Mo: Race, Nation and the London 2012 Olympic Games Daniel Burdsey * 3 2016 33 1 14 25 10.1123/ssj.2015

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. Guzzo * MS, LAT, ATC Susan W. Yeargin * PhD, ATC Jeffery S. Carr * MS, ATC Timothy J. Demchak * PhD, LAT, ATC Jeffrey E. Edwards * PhD 11 2014 19 19 6 6 34 34 40 40 10.1123/ijatt.2014-0006 Population-Specific Concerns The Prevalence of and Attitudes Toward Oligomenorrhea and Amenorrhea in

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Athletes: Views of a Nutritionist on the Sports Medicine Team Dan Benardot * 6 1996 6 6 2 2 110 110 120 120 10.1123/ijsn.6.2.110 The Role of Medium-Chain Triglycerides in Exercise Jacqueline R. Berning * 6 1996 6 6 2 2 121 121 133 133 10.1123/ijsn.6.2.121 Nutritional Aspects of Amenorrhea in the Female

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Conferences The Female Athlete Triad: Disordered Eating, Amenorrhea, Osteoporosis Aurelia Nattiv M.D. Rosemary Agostini M.D. Kimberly K. Yeager M.D., M.P.H. Barbara Drinkwater Ph.D., FACSM 4 1993 2 2 1 1 90 90 93 93 10.1123/wspaj.2.1.90 National Girls and Women in Sport Symposium Sue E. Feldkamp 4

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.1123/att.4.5.26 Continuing Education Assessment Sports Vision/The Eye Neil Curtis EdD, ATC 9 1999 4 4 5 5 32 32 33 33 10.1123/att.4.5.32 Nutrition Notes The Female Athlete Triad: Amenorrhea and Osteoporosis Debra M. Vinci DrPH, RD 9 1999 4 4 5 5 34 34 35 35 10.1123/att.4.5.34 Web Site Reviews Web Site

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Nicole C.A. Strock, Kristen J. Koltun, Emily A. Southmayd, Nancy I. Williams, and Mary Jane De Souza

severity from luteal phase defects to amenorrhea consistent with the magnitude of energy deficiency, such that those with the most severe menstrual disturbances are also the most energy deficient ( De Souza et al., 2007b ). Owing to the long-term health outcomes associated with energy deficiency ( De Souza

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Johanna K. Ihalainen, Oona Kettunen, Kerry McGawley, Guro Strøm Solli, Anthony C. Hackney, Antti A. Mero, and Heikki Kyröläinen

logs, as was information relating to the menstrual cycle, which was subsequently used to assess self-reported amenorrhea. 13 All results from running competitions (800–10,000 m) during the investigated period were collected for ATH (n < 13). ATH PB, SB1 (season prior to T1), and SB2 (season prior to T

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Bryan Holtzman, Adam S. Tenforde, Allyson L. Parziale, and Kathryn E. Ackerman

screening tools to ascertain risk in athletes. One limitation of Triad CRA is that once some risk factors have been acquired, they cannot be resolved, even if they have not presented for several years. For example, an exercising woman with a prior eating disorder (ED) and prolonged amenorrhea may be