The difficult (menstrual) cycle of athletes forced to lean –

What the female athletes suffer from menstrual irregularitiesali certainly not a novelty, but a recent and extensive survey conducted in Finland by the Faculty of Sport and Health Sciences of the University of Jyvskyl, has reported the attention on the problem with a precise series of data. Two age groups were investigated: from 14 to 16 years and from 18 to 20. In the first group it was seen that 8% of the athletes, against 0% of the non-athletes, suffer from primary amenorrhea (ie the non-arrival of menstruation within 15 years of age in girls with normal growth and secondary sexual characteristics). In young adults, it is seen that in those who do sport in a demanding and continuous way menstrual disordersat the, understood as primary and secondary amenorrhea (i.e. cycle every 35 or more days, interruptions of the cycle for 3 or more consecutive months), affect 39% of girls, against 6% of non-athletes.

What can be the causes of the problem?
In the Finnish study – replies Gianfranco Beltrami, specialist in sports medicine and national vice president of the Italian Sports Medical Federation – it is rightly emphasized that the reduction of caloric intake to keep weight down, a very important element in some sports activities, is the most accused. . The organism that has preserved its “primitive” way of functioning when confronted with what it interprets as an unwanted reduction in food is concerned with directing energy resources towards vital functions, certainly not reproductive ones. Rather, come if the body “thought”: here there is no food for one, let alone for two.

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It seems contradictory, but the research shows that the most dissatisfied with their appearance are not the athletes, who also undergo continuous calorie restrictions, but the “others”, how do you explain it?
In the Finnish study we read that only 20% of athletes are not happy with their body compared to 40% of non-athletes. But the fact that those who practice sports at a certain level keep the kilos under control not so much for reasons of aesthetics, but of performance. Keep the weight low in the artistic gymnastics, but also in skating as in dance, or in the marathon, it means being able to achieve better results. Not always and not all coaches realize the risks these girls run. Risks that go far beyond menstrual irregularities: eating disorders can occur that can accompany them throughout their life, beyond their career as athletes. Eil reduced caloric intake at a young age can reduce bone mass with consequences that you risk having to pay later in the years.

Does the stress faced by girls who compete in competitions play a role?
Without a doubt, and also in a more complex way than one might think. Not only the stress of the night before the races to affect. The body interprets exaggerated physical activity as a warning sign – need for escape, response to threats – and once again directs available energy resources towards vital functions. We are not talking about a generic, predictable, justified competition anxiety, but about a real modification of the hormonal structure.

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What is your advice as a sports doctor? How can we intervene in cases like these?
We must act on two fronts: sports and food. The workouts must be calibrated on a case-by-case basis and adequate recovery times must always be ensured. In the Finnish study, athletes are defined as girls who do at least four sessions a week, but often seven days of demanding training are reached out of seven. Too much. As for the diet, the Mediterranean one is very well balanced according to the needs of the individual. In women, to avoid menstrual disorders, with all the consequences that can arise even after some time, the fat mass should never drop below 17%, while men can also remain around 8-11%. Finally, remember that abdominal fat protects the internal organs and, in the female sex, also the ovaries: if it is reduced too much, the body thinks of yet another alarm signal and interrupts the menstrual cycle.

March 5, 2021 (change March 5, 2021 | 18:23)

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