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Aurelia Nattiv, Rosemary Agostini, Kimberly K. Yeager, and Barbara Drinkwater

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Sharon H. Thompson, Presley Smith, and Rita DiGioacchino

A serious commitment to sport and exercise may predispose female athletes to the development of eating disorders. The energy restriction and accompanying menstrual disorders that are often associated with eating disorders may increase female athletes’ injury risks. The purpose of this study was to assess NCAA Division I, II, and III female collegiate cross country athletes’ weekly exercise time, rates of injury, menstrual dysfunction, and subclinical eating disorder risks. A paper-pencil survey was completed by athletes (mean age = 19.64 years) from NCAA Division I (n = 82), Division II (n = 103) and Division III (n = 115) colleges across the United States. Division I athletes spent significantly more weekly exercise time (M = 687.97 minutes) than Division II (M = 512.38 minutes, p = .0007) or Division III (M = 501.32 minutes, p = .0003) athletes. When examining rates of menstrual dysfunction, 23 percent reported amenorrhea or oligomenorrhea. Over 60 percent (64.3%) of the athletes reported a performance-related injury, with the knee being the most commonly injured site. 24 percent (23.7%) of the athletes reported having stress fractures. Scores for subclinical eating disorders for Division I athletes were significantly higher (M = 87.11) than Division III athletes (M = 82.94, p = .0042). Division I female athletes may be at an increased risk of developing subclinical eating disorders compared to those competing in Division II or III. Because early identification of those with subclinical eating disorders prevents the progression to eating disorders, further study is warranted.

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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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Claire-Marie Roberts and Jacky Forsyth

, bone health, immunity, protein synthesis, and cardiovascular health ( De Souza, Koltun, Southmayd, & Aurigemma, 2018 ). The first symptom of RED-S or the Female Athlete Triad is often amenorrhea—the absence of a normal menstrual period. It was disappointing to learn that some athletes had been advised

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downregulation of the hypothalamic-pituitary axis. In female athletes of reproductive age this manifests itself as amenorrhea. Together with low estrogen and other key hormones such as insulin-like growth factor-1 (IGF-1), bone health can be impaired, as described in the female athlete triad. Beyond effects on

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participated in the survey. Excluding those not of a reproductive age, 3.5% had amenorrhea, 6.0% oligomenorrhea, 42.1% eumenorrhea, 1.1% polymenorrhea and 48.4% were using hormonal contraception. 80.5% of women reported experiencing menstrual cycle-related symptoms every cycle, and 68.7% have had to alter

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Nancy I. Williams, Clara V. Etter, and Jay L. Lieberman

An understanding of the health consequences of abnormal menstrual function is an important consideration for all exercising women. Menstrual disturbances in exercising women are quite common and range in severity from mild to severe and are often associated with bone loss, low energy availability, stress fractures, eating disorders, and poor performance. The key factor that causes menstrual disturbances is low energy availability created by an imbalance of energy intake and energy expenditure that leads to an energy deficit and compensatory metabolic adaptations to maintain energy balance. Practical guidelines for preventing and treating amenorrhea in exercising women include evidence-based dietary practices designed to achieve optimal energy availability. Other factors such as gynecological age, genetics, and one’s susceptibility to psychological stress can modify an individual’s susceptibility to menstrual disturbances caused by low energy availability. Future research should explore the magnitude of these effects in an effort to move toward more individualized prevention and treatment approaches.

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Travis Anderson, Sandra J. Shultz, Nancy I. Williams, Ellen Casey, Zachary Kincaid, Jay L. Lieberman, and Laurie Wideman

or due to menstrual disturbances such as amenorrhea and oligomenorrhea) or if the chosen sampling days limited detectable concentrations. It is also not known if the threshold would be similar for non-collegiate female athletes, since it is unclear if the magnitude of change in relaxin varies based

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Jaqueline P. Batista, Igor M. Mariano, Tállita C.F. Souza, Juliene G. Costa, Jéssica S. Giolo, Nádia C. Cheik, Foued S. Espindola, Sarah Everman, and Guilherme M. Puga

normotensive according to the Brazilian Hypertension Society guidelines ( Brazilian Society of Cardiology, 2016 ) (systolic blood pressure [SBP] at rest 111 ± 11 mmHg and diastolic pressure at rest 71 ± 8 mmHg), at least 6.4 ± 5.4 years after menopause, as characterized by amenorrhea of at least 12 months

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Christina A. Geithner, Claire E. Molenaar, Tommy Henriksson, Anncristine Fjellman-Wiklund, and Kajsa Gilenstam

oligo/amenorrhea in top Polish athletes . American Journal of Human Biology, 10 ( 4 ), 511 – 517 . PubMed ID: 28561474 10.1002/(SICI)1520-6300(1998)10:4<511::AID-AJHB11>3.0.CO;2-B Smith , K.L. , & Weir , P.L. ( 2013 ). An examination of the relative age effect in developmental girls’ hockey