Effects on Health and Performance

Female athletes who experience menstrual dysfunction, particularly amenor-rhea, often show little concern for the disruption in their cycles; some even express relief at the ''break.'' Similarly, some coaches simply dismiss menstrual dysfunction, believing it is a natural result of hard training [18]. Nonetheless, despite these attitudes, it should be emphasized that menstrual dysfunction is not a normal response to training; rather, it is a clear indication that health is being compromised. The health consequences of menstrual dysfunction are well documented and include infertility and other reproductive problems, decreased immune function, an increase in cardiovascular risk factors, and, perhaps most importantly, decreased BMD and increased risk for premature osteoporosis [2,52].

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