The female athlete

Over the past 30 years, the number of women participating in organized spor ts has grown dramatically. Several forms of menstrual irregularities have b een described in the female athlete: primary and secondary amenorrhoea, oli gomenorrhoea, short luteal phases and anovulation. The incidence of menstru al irregularities is much higher in activities where a thin body is require d for better performance. The hormonal pattern seen in these athletes is a hypothalamic amenorrhoea profile. There appears to be a decrease in gonadot rophin-releasing hormone (GnRH) pulses from the hypothalamus, which in turn decreases the pulsatile secretion of luteinizing hormone (LH) and follicle -stimulating hormone (FSH) and shuts down stimulation of ovary. Recently, a nother type of amenorrhoea has been described in swimmers which is characte rized by mild hyperandrogenism. Athletes with low weight are at risk of dev eloping the female athletic triad, which includes amenorrhoea, osteoporosis and disordered eating. Athletes with this triad are susceptible to stress fractures. Other issues include the pregnant athlete. Intensive exercise du ring pregnancy can cause bradycardia. Safe limits of aerobic exercise in pr egnancy depend on previous exercise habits. Infertility, which may develop with exercise, is probably reversible with reduction of exercise or weight gain. High impact sports activities may produce urinary incontinence. Oestr ogen replacement therapy is often prescribed in amenorrhoeic athletes, but bone loss may not be completely reversible.