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Chapter 7
Health Concerns for Female Athletes
Everyone needs regular exercise to stay healthy. Women often have questions about
exercise related to the menstrual cycle and reproduction. By knowing the answers and
learning how to avoid the pitfalls, women can benefit from a full exercise program.
For both men and women, regular exercise offers weight loss, reduced levels of harmful
cholesterol, fewer sick days and an improved self-concept. Those who exercise have less
low backache, headache, anxiety, depression and fatigue. Weight-bearing exercises build
and maintain strong bones in both sexes. The points to note about exercise concern the
physical differences between men and women:
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Menstrual symptoms, including a group called molimina (appetite changes,
breast tenderness, fluid retention and mood changes) are eased.
Stronger bones developed with weight-bearing exercise may help prevent
osteoporosis that often occurs after menopause.
Women tend to have smaller hearts and less lung capacity. Their muscles are
smaller and they have more body fat. Despite this, women can still achieve a
lower heart rate and blood pressure, loss of body fat and increased strength by
doing aerobic exercise.
Hormonal Changes
Effect on Menstrual Cycle
For some women, especially those with little body fat, too much exercise can reduce the
levels of hormones (estrogen and progesterone) which control menstruation. The results
may range from normal periods with no egg produced, to infrequent and light periods
(oligomenorrhea), to no periods at all (amenorrhea). For girls near puberty, the onset of
periods may be delayed by intense training. Changes in the menstrual cycle can have an
effect on fertility, although this usually only occurs with excessive training.
Effect on Bones
Estrogen and progesterone help bone growth. If hormone levels are low for a long time,
such as during too much exercise, calcium will be lost form the bone. This loss is similar
to that which occurs after menopause. It may result in broken bones, especially the spine
and hips. More often, however, bone growth is improved with exercise.
Reversing the Effects
The reason for exercise-related hormone changes are complex and not well understood.
What is known is these changes can be reversed with small reductions in training or
small weight gains. Certainly women who have irregular periods, no matter what the
cause, should see a doctor. Women who have a history of irregular periods could have
their bone density measured to determine if there has been any associated bone loss.
Iron Levels
Active women must maintain proper iron levels in the body. Iron is found in hemoglobin,
which is in the red blood cells carrying oxygen from the lungs to the tissues. Iron is also
an important part of many body proteins and cell components.
Women who menstruate risk having low iron because of the regular loss of blood (and
therefore iron) which occurs each month. Very active women have an added risk because
their bodies absorb less iron. They also lose iron with sweat and have a breakdown of red
blood cells in some of the tissues.
Red meat provides the best source of iron. Any red meat and the dark meat of poultry
provide a form of iron called heme-iron.
This is more easily used than the iron found in vegetables and grains. It is most effective
when combined with vegetable proteins. For example, split-pea soup with ham, or
chicken soup with lentils are high-iron combinations. Vitamin C, plentiful in fruits, will
also increase iron absorption.
Some people who restrict meat from their diets are also counting calories. These people
may cut back on other food groups which supply iron. One way to increase iron,
especially if calories are being limited, is to choose breads, cereals and pasta with
'enriched' or 'fortified' on the label.
The single or combined effect of loss of iron through menstruation, exercise and diet
restrictions may cause iron deficiency. The symptoms of low iron include tiring easily
and poor performance. If iron stores become too low, anemia will result and the added
symptoms of this include paleness, greater fatigue and shortness of breath.
All women should eat a diet with enough iron (see table). It is also important that they
have hemoglobin levels checked on a regular basis by a doctor. For those at risk of low
iron, the body's iron stores should be measured.
Increasing Iron Intake
To be sure you are taking in enough in your food, try the following:
At each meal, eat foods that are high in vitamin C. Vitamin C helps the body use iron.
Drink orange juice with an iron enriched cereal, or combine pasta with broccoli,
tomatoes and green peppers.
Sources of Iron
Amount
Iron (mg)
3.5 oz.
3.5 oz
3.0 oz
3.0 oz
3.0 oz
3.0 oz
4.0
3.4
2.1
1.9
1.0
1.0
12
9
1/2 c
1/2 c
1/2 c
1/2 c
1/2 c
1/2 c
6.0
5.0
3.0
3.0
2.0
2.0
1.0
1.0
(contain heme iron)
Pork Chop
Lean ground beef
Lamb (leg)
Turkey (dark)
Chicken
Tuna
(contain non-heme iron)
Dried apricots
Dates
Baked Beans
Kidney Beans
Raisins
Spinach
Green Beans
Enriched Pasta
Risk of Injury
A question often asked about women in sports is whether they are at higher risk of injury
than men. This concern, without basis in fact, kept women from taking part in many
sports until recently. For example, women were not allowed to compete in the marathon
at the Olympics until 1984.
The body's response to exercise is the same for both sexes. Each sport puts demands on
the body and carries its own risk of injuries. Women are at no greater risk of these
injuries than men and should be allowed to take part in any sport.
If a training program is suited to the level of fitness, women are no more likely than men
to suffer injury. Any sports injury should be treated promptly by a doctor.
Exercise During Pregnancy
One concern to women in sport is exercise during pregnancy. For this special case,
pregnant women should discuss the exercise program with a doctor.
Conclusion
Exercise is a key to good health for everyone. Women should take part in regular
exercise and sport, not only for their health but also for the pure pleasure of
participation.