title: Is menstrual delay a serious problem for elite rhythmic gymnasts?
abstract: OBJECTIVE
  The aim of this study was to identify the influence of training workloads and dietary habits on the menstrual status of elite rhythmic gymnasts. In many sports disciplines, it has long been assumed that menstrual disorders among elite female athletes are related to intense physical effort and insufficient energy intake. Potential consequences of this condition include reduced fertility and decreased bone density.
  
  
  METHODS
  Eighty-one female gymnasts (age 15.9±3.1) completed two self-administered questionnaires: the Menstrual History Questionnaire (MHQ), and the Semiquantitative Food Frequency Questionnaire (FFQ). Eighty female athletes (age 16.3±3.7), who participated in basketball, volleyball, tae kwon do and fitness activity served as a control group. Physical characteristics, menstrual cycles, training workloads and dietary habits were compared and the relationship between physical training and menstrual cycle characteristics was assessed for the two groups.
  
  
  RESULTS
  Fifty percent of the gymnasts declared themselves amenorrheic. Age was significantly and positively correlated (P<0.01) with menarche and menstrual irregularities, and negatively correlated with amenorrhea. The percentage of variance for age at menarche, explained by training hours/week and body mass, was 43%, (P<0.01).
  
  
  CONCLUSIONS
  The present study, which examined and compared different age groups of gymnasts, showed that young rhythmic gymnasts who trained intensively, had a delayed onset of menarche of more than two years, thus favouring secondary amenorrhea. Nonetheless, almost all athletes, even though with significant delay, reached cycle regularity, thus minimizing the effect of menstrual disorders on fertility and bone density.
authors.affiliation: University of Molise, Campobasso, Italy. alessandra.dicagno@unimol.it
authors.forename: A
authors.initials: A
authors.lastname: Di Cagno
authors.forename: M
authors.initials: M
authors.lastname: Marchetti
authors.forename: C
authors.initials: C
authors.lastname: Battaglia
authors.forename: A
authors.initials: A
authors.lastname: Giombini
authors.forename: G
authors.initials: G
authors.lastname: Calcagno
authors.forename: G
authors.initials: G
authors.lastname: Fiorilli
authors.forename: M
authors.initials: M
authors.lastname: Piazza
authors.forename: F
authors.initials: F
authors.lastname: Pigozzi
authors.forename: P
authors.initials: P
authors.lastname: Borrione
mesh_terms: D000293:Adolescent; D000568:Amenorrhea / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006173:Gymnastics / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008572:Menarche / Q000502:physiology*; D008597:Menstrual Cycle / Q000502:physiology*; D005082:Physical Exertion / Q000502:physiology*; D011795:Surveys and Questionnaires