Menstrual dysfunction in norwegian elite athletes and non-athletic controls

Introduction

Female athletes are at risk for disturbed menstrual function [1]. Because menstrual dysfunction (MD) may have a profound negative effect on skeletal development [1], it is important to discover the prevalence of these endocrine abnormalities to facilitate treatment and preventive intervention. There is a lack of studies investigating the menarcheal age and prevalence of MD in high level athletes and controls. Thus, the aims of the present study were to examine the prevalence of late menarche and MD in all Norwegian female elite athletes and national representative controls.

Methods

A detailed questionnaire including questions regarding training and/or physical activity patterns, menstrual, dietary, and weight history, oral contraceptive use, and Eating Disorder Inventory (EDI) subtests was administered to all female elite athletes representing the national teams at the junior or senior level (aged 13-39 years, N=938), and a random sample of national representative controls in the same age group (N=900). After exclusion, a total of 669 athletes (88.3%) and 607 controls (70.2%) completed the questionnaire satisfactorily. For one part of the analysis, the athletes were divided into two groups (leanness and non leanness sports) and for another part of the analysis the athletes were divided into seven different sport groups (technical, endurance, aesthetic, weight class, ball game, power and anti gravitation sports).

Results

Age at menarche was later in athletes (13.4 ± 1.4 years) compared with controls (13.0 ± 1.3 years) (P<0.001), and differed among the seven sport groups. A higher percentage of athletes (7.3%) than controls (2.0%) reported a history of primary amenorrhea (P<0.001). A similar percentage of athletes (16.8%) and controls (15.2%) reported present menstrual dysfunction (PMD), while a higher percentage of athletes competing in leanness sports reported PMD (24.8%) compared with athletes competing in non-leanness sports (13.1%) (P<0.01) and controls (P<0.05).

Discussion/Conclusion

(i) Age at menarche occurred later in elite athletes than in controls, (ii) the prevalence of primary amenorrhea was higher in elite athletes than in controls; however, a similar percentage of athletes and controls reported PMD, (iii) a higher percentage of athletes competing in sports emphasizing thinness and/or a specific weight reported PMD compared with athletes competing in sports focusing less on such factors and controls.

References

[1]. Otis C.L. et al. (1997). Med. Sci. Sports Exerc. 29:i-ix.
Supported by The Norwegian Olympic Committee and Confederation of Sport, and The Norwegian Foundation for Health and Rehabilitation.