Evaluation and management of menstrual dysfunction in athletes.

The prevalence of menstrual dysfunction is greater among athletes than in the general population. Many factors undergo change during the course of an athletic training program and any or all of these may contribute to disturbances in menstrual cyclicity. All athletes with oligomenorrhea, amenorrhea, or menarcheal delay require thorough evaluation to rule out serious pathological conditions, since the diagnosis of exercise-associated menstrual dysfunction can be made only by excluding other etiologic factors. Most athletes who have these problems should be treated to prevent undesirable sequelae.