University Park, Pa. --- A Penn State study of female athletes has linked psychological stress resulting from a poor body image, along with inadequate diet and excessive exercise, to transient menstrual disturbances that could render a woman temporarily infertile.
Dr. Nancy I. Williams, assistant professor of kinesiology and director of the study, says, "Most people are comfortable with telling women athletes who experience menstrual abnormalities simply to eat more and exercise less but our research is beginning to show that eating and exercise aren't the only factors. Our research indicates that there are also psychological and behavioral issues that need to be addressed in helping women athletes to prevent menstrual problems."
Williams will present the findings today (June 2) at the annual meeting of the American College of Sports Medicine in Seattle, Wash., in a paper, "Body Image, Disordered Eating, Exercise and Depression in Athletes and Non-Athletes: Association with Menstrual Status." Her co-authors are Dr. Kristine L. Clark, director of sports nutrition and instructor in nutrition; Dr. Shannon L. Mihalko, assistant professor of kinesiology; Angelique N. Matuch, graduate student; and Heather J. McConnell, graduate student.
Previous studies of menstrual irregularities in female athletes have focused either on eating or exercise. Few have simultaneously examined the interrelationships of eating and exercise with psychological or behavioral factors and most studies have not included a non-athlete group for comparison.
The Penn State study compared two groups of volunteers: 185 female varsity or club team athletes and 132 women who did not play team sports. About 30 percent of the athletes reported menstrual cycles shorter (less than 26 days) or longer (more than 32 days) than the normal range. Only 19 percent of the non-athletes reported abnormal cycle lengths.
Williams notes, "What was surprising was that when a representative subgroup of the athletes were studied more intensively in the laboratory, almost 60 percent of them were found to have abnormal levels of reproductive hormones, even though many had normal cycle lengths of 27 to 31 days. These alterations in hormone levels could impact their fertility." The observed abnormalities included the complete cessation of menstrual flow and ovulation; the absence of ovulation with continued flow; and reduction of progesterone production in the second half or luteal phase of the cycle which could prevent a fertilized egg from implanting.
Both groups of women were given a battery of surveys including depression, eating disorder, social physique anxiety and physical activity inventories. The women were also asked to keep track of their exercise and daily diet and to provide urine samples during a complete menstrual cycle so that their hormone status and ovulation could be tracked.
The results showed that athletes who experienced irregular menstrual periods also had a poorer body image and more excessive exercise schedules than the non-athletes.
"Anxiety over body image as a manifestation of psychological stress has been related previously to eating disorders in non-athletes but not in athletes," Williams says.
"The personal desire to do well in competition, to please the coach, and to look good playing before a crowd are all related to eating and exercise issues for female athletes," she adds.
The Penn State researcher in the College of Health and Human Development emphasized that the new findings do not contradict earlier work that shows that poor diet and excessive exercise are directly related to menstrual disorders in athletes. Rather, she says, "These preliminary findings indicate that psychological stress may exacerbate the effects of poor or inadequate diet and excessive exercise."
The Interdisciplinary Seed Grant Program of Penn State's College of Health and Human Development supported the study.
EDITORS: Dr. Williams is at 814-865-1346 or at niw1@psu.edu by e-mail.