The major menstrual-related event that requires energy is making the reproductive hormones such as estrogen & progesterone which allow for healthy reproductive function. Depending upon the duration & severity of the energy insufficiency, various hormonal disturbances may occur & result in irregular periods (oligomenorrhea) or stop altogether (amenorrhea).

A female athlete should consult a physician in the event of:

• delay of menarche (first period) beyond the age of 15 years
• several missed periods (though missing an occasional period is absolutely normal, especially up to the age of 19-20 years)