Context: Adolescent female athletes are at risk for menstrual dysfunction in the setting of exercise and low energy availability. Education regarding menstrual dysfunction and its associated consequences is important to promote athlete well-being.

Objectives: The primary aim was to determine the prevalence and characteristics of female athletes who believe that losing their period is a normal response to high training demands. The secondary aim was to explore the relationship between menstrual dysfunction and patient-reported quality of life measures.

Design: Cross-sectional study.

Setting: Pre-participation evaluations for a local high school district.

Participants: Female athletes,13–18 years old.

Independent Variables: Presence of menstrual dysfunction, and response (yes/no) to the question, “Do you think it is normal to lose your period during high levels of athletic training?”

Main Outcome Measures: Health history, family affluence, and patient-reported quality of life measures.

Results: Forty four percent (n=40) of 90 adolescent athletes answered that losing their period was a normal response to a high level of training, and this group had lower BMI, were less likely to report being worried about current weight, and had a higher family affluence level than those who answered losing their period was not a normal response to training. The overall prevalence of menstrual dysfunction was 28%. After adjusting for age and BMI, menstrual dysfunction was significantly associated with higher levels of anxiety, fatigue, and pain interference.

Conclusion: Nearly half of our sample of adolescent female athletes perceive losing their period as a normal response to high training demands. Females with menstrual dysfunction reported higher levels of anxiety, fatigue, and pain interference than those without. Understanding adolescent perceptions of menstrual dysfunction and the characteristics of those with menstrual dysfunction can guide future educational interventions aimed at athletes at risk for the female athlete triad.

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