If you have stopped having regular menstrual periods, you are experiencing amenorrhea. This is a health problem among many active women who under-eat (either by choice or unknowingly). It's the body's signal that you have too little energy to support normal bodily functions. Amenorrhea is linked with medical concerns including a much higher risk for stress fractures.

HOW TO RESOLVE AMENORRHEA:
• Throw away the scale.
Stop striving for a specific weight! If you are leaner than others in your family, don’t force your body into a weight that is too thin for your genetics. Amenorrhea is your body’s way to adapt to a calorie deficit and conserve calories.

• Practice this simple rule for eating!
Eat when you are hungry and stop when you are content. Don’t stop eating just because you think you should. You should not feel hungry all the time and constantly think about food. Enjoy even-sized meals at least every four hours, so you are well-fueled during the active part of your day. NOTE: It takes about 20 mins for your gut to message to your brain that you are full, so eat slowly.

• Eat adequate protein.
Include protein-rich foods at each meal and snack. Animal sources of protein offer the most readily available iron. If you are vegetarian, be sure to eat generous portions of beans, tofu, hummus, and other plant proteins. Dairy or soy milk and yogurt are excellent protein-rich choices.

• Maintain a calcium-rich diet.
Amenorrhea can lead to weakened bones and stress fractures. You should consume a calcium-rich diet daily to help maintain bone density. Enjoy a serving of milk, yogurt or cheese at each meal, plus generous amounts of other calcium-rich foods such as tofu, broccoli, dark green leafy vegetables and calcium-enriched orange juice.

• Include a source of fat at each meal and snack.
Fat is an essential part of a sports diet and should be a part of every sports meal. “Good fats” include peanut butter, nuts, salmon, cheese and olive oil. These fat sources help absorb certain vitamins, reduce inflammation and provide fuel for endurance exercise.

IS THERE LONG TERM BONE DAMAGE?
Teens who resume menses can restore some, if not most, of the bone density lost during their months of amenorrhea, if acting quickly to resume menses. Consider asking a dietitian to create a personalized fueling program so you can eat balanced meals, have energy to perform well and maintain a desired weight.

If you struggle with making the nutrition and exercise changes that would enhance resumption of menses, it’s important to seek assistance from a medical professional. Although you may think you are a healthy athlete, amenorrhea suggests your should ask for help from a health professional.