Menstrual patterns in ultramarathon runners.

The menstrual status of 70 female ultramarathon runners who were neither pregnant, menopausal or on contraceptive medication was examined and compared with: (i) their menstrual status before they began running; and (ii) that of a sedentary comparison group. Compared with their pre-running menstrual status, the overall incidence of chronic menstrual dysfunction (oligo- or amenorrhoea) was unchanged (9%) and was only slightly higher than that of the comparison group (7%). Those likely to develop chronic menstrual dysfunction tended to be younger, had started running at a young age, trained over a long distance each week, had low body weight, had experienced previous menstrual irregularity and tended to be the better performers. In addition, there was frequently a past history of anorexia nervosa. Short-term menstrual irregularity (any temporary deviation from normal menstrual patterns) was experienced by 41% of the runners during periods of intensive training and competition. Menstrual patterns normalised once these stresses were removed. It is concluded that the menstrual dysfunction found in ultramarathon runners is of two kinds: (i) a short-term irregularity induced by the physical and emotional stresses of competitive ultramarathon running; and (ii) chronic menstrual dysfunction which is probably a reflection of a particular life-style, personality type, body build, and, possibly most importantly, nutritional status.