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Managing contraception in amenorrheic runners.


 The author responded to a physician's inquiry concerning the diagnosis and treatment of amenorrhea and oligomenorrhea among joggers and runners. Amenorrhea or oligoamenorrhea commonly occurs among women who jog or actively participate in other sports. These women experience a reduction in body weight and a considerable reduction in body fat which in turn affects hormone production. In diagnosing jogging related amenorrhea, other causes of amenorrhea must be ruled out first. The patient should be examined for other organic causes and given a pregnancy test before the symptoms can be attributed to jogging. The physician should also ascertain if the patient is under unusual stress or is taking some type of medication which could disrupt the cycle. Patients with jogging related amenorrhea who seek contraceptive advice, should be told that 1) they should not rely on their amenorrhea for pregnancy protection and 2) they should not use oral contraceptives. Patients who wish to become pregnant should be instructed to reduce their running and jogging. Normal cycles are generally reestablished 3-6 months after activity is reduced. In a recent study of 168 women, 34% of the women who were runners and 23% who were joggers experienced oliogomenorrhea. Those who ran or jogged more than 30 miles a week or more than 5 miles a day experienced a significant decrease in menstrual flow and frequency. Those who ran or jogged less than this experienced only minimal changes in their menstrual cycle.
