Exercise is generally not associated with poor bone health, cardiovascular dysfunction, or abnormal metabolic hormonal profile. Female athletes, however, are subjected to these health consequences when nutritional habits are poor and exercise is excessive.
Female athlete triad is a syndrome consisting of disordered eating, menstrual dysfunction, and the loss of bone mass. Exercise-associated menstrual dysfunction is just one of the major symptoms of the female athlete triad, but it is more common than you may think. Research suggest exercise-associated menstrual dysfunction can range from 0% to 60%, and can occur across a scale from mild disruptions in menses to no menses for 90 days, referred to as amenorrhea.2
To restore menses and combat bone loss, oral contraceptives are often prescribed – but they may result in undesirable side effects such as weight gain or mood disorders.3 Thus, non-pharmacological treatments, specifically dietary interventions, are more desirable.
Cialdella-Kam et al. hypothesized that an increase in energy intake – about 360 additional calories in the form of a CHO and protein shake – for 6-months would improve energy balance, bone health, and restore reproductive function in females with exercise-associated menstrual dysfunction.1 Eight endurance trained women with amenorrhea were recruited for the study and due to ethical reasons, there was no control group. At the end of 6-months, a shake consisting of 54 g of CHO and 20 g of protein proved to be beneficial. According to the authors, this is the first study to demonstrate that when females with exercise-associated menstrual dysfunction consumed an extra 360 calories per day for 6-months, menses and ovulation (except one) are restored. As expected, women with longer exercise-associated menstrual dysfunction took more time to resume menses.
The saying “food is the best medicine,” hold true. Consult with a registered dietitian to ensure your workouts are optimally fueled with the best medicine for health and sports performance – food!
Gavin Van De Walle is an ISSA Certified Fitness Trainer, a NANBF Natural Competitive bodybuilder, a nutrition columnist for “The Collegian,” and a dietetic student at South Dakota State University. Once Gavin becomes an RD, he will aim to achieve the distinguished Certified Specialist in Sports Dietetics (CSSD) credential.
1. Cialdella-Kam, L. et al., Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health. Nutrients 2014, 6, 3018-3039; doi: 10.3390/nu6083018.
2. Gibbs, J.C.; Williams, N.I.; de Souza, M.J. Prevalence of individual and combined components of the female athlete triad. Med. Sci. Sports Exerc. 2013, 45, 985-996.
3. American Society of Health-System Pharmacists, Inc. Estrogen and Progestin (Oral Contraceptives). Available online: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601050.html (accessed on August 6, 2014).