Amenorrhoea in adolescent female athletes

Female athletes often experience amenorrhoea at various times during training, but this should not be considered normal. Low energy availability is a common cause of menstrual dysfunction, and amenorrhoea can serve as a warning sign of some of the health and performance consequences associated with inadequate energy, including poor bone accrual and low bone mineral density. Adolescence is an important time for bone accrual, growth, and development, making delayed menarche and secondary amenorrhoea particularly concerning in young athletes. The development of disordered eating and eating disorder behaviours also peaks during adolescence. Thus, screening for low energy availability, establishing the various causes of amenorrhoea, and treating amenorrhoea and low energy availability with an interdisciplinary team is most effective.