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Diving and menstruation
Thu, 2012-06-28 11:02
Ok so I would say, here's one for the girls'. However I've yet to find another girl whos even heard of this.
I wouldn't quite call it a problem, but I'm really confused about the fact that diving seems to really affect my period.
When I dive once or twice in a month my period is so light and passes in a day or two, when I dive regularly i just don't get my period at all..
So working as a Divemaster lately is beginning to worry me. I don't know if it's doing any damage or not.
Everyone keeps telling me that diving shouldn't effect my period at all or vise versa.. But I think it's just a bit too many times to be coincidence. Plus, when I stop diving for a few weeks it comes back as normal, like nothing ever happened.
Does any body know what this could be.. Or at least have heard of it before?
Thu, 2012-08-02 13:37#1
My name is Maida Taylor and I am a gynecologist in the USA and a frequent consultant to DAN USA on women's health issues and diving. Another diving doc referred your query to me and asked that I respond.
No periods or infrequent periods (amenorrhea or oligomenorrhea) are well studied and recognized problems in women who engage in intense athletic activity. Most commonly, this problem is seen in so called glamour sports where appearance and body habitus affect how an athlete is judged. The rates are highest in ballerinas, gymnasts, and runners. There is a high correlation with weight, diet and intensity of training. Thin women are more likely to have problems. Some women are more resistant to the stress of athletic activity -- having a more stable reproductive hormonal axis. So one woman at 40 kg can be running 40 miles a week and have regular periods, while another woman of same weight running 20 miles may stop having her cycles entirely.
We can see effects in susceptible women with as little as 10 miles of running a week (or two miles a day) In terms of swimming that would be only 2.5 of swimming a week (yikes). Diving every day for hours, though not a stressful aerobic sport, does impose a huge thermal stress with a massive calorie debt, and can mess up your cycling.
I don't know your gynecological history -- age of onset of periods, body mass index, prior cycle regularity, any pregnancies etc. They all play into the risk of athletic amenorrhea. Food habits are also a factor...eating disorders make the risk much higher, but even being a vegan or very low fat diets can contribute to the problem.
But rest assured that as long as your cycles come back when you reduce your athletic endeavors, it is an indication that your hormonal regulatory mechanisms are recovering well. This is not dangerous. If you are very thin, there may be some risk of poor bone mineralization. Be sure you get enough calcium and vitamin D. See the article below, taken from an on line textbook of medicine. The link is also there.
Maida Taylor MD MPH FACOG
The growing lvement of women in sports and athletics, while enhancing general physical fitness, has led to an awareness of certain disorders of menstrual cyclicity as evidenced by delay of menarche, oligomenorrhea, amenorrhea, and abnormalities of luteal phase function.75 Exercise-induced amenorrhea has been attributed to a complex interplay of physical, hormonal, nutritional, psychological, and environmental factors that include the stress of competition, decreased protein consumption, and altered lean/fat ratio. Pure physiologic interpretation is complicated by the frequent accompaniments of weight loss and emotional stress that occur often in persons undergoing physical training and athletic competition. As noted in stress-related amenorrhea, cortisol levels have been demonstrated to be increased in amenorrheic athletes.76 This increase is greater than that in eumenorrheic athletes, which is greater than in nonathletic women.76 This suggests that a person's response to the CRH-cortisol axis is one of the underlying etiologies of exercise-associated amenorrhea. A persistent depression of circulating levels of estrogen, progesterone, LH, and FSH is characteristic of exercise-induced amenorrhea. Vigorous exercise, particularly if compounded by weight loss, can disturb menstrual cyclicity in initially normal untrained women.75 Cross-sectional studies report that 6% to 18% of women who are recreational runners and up to 50% of competitive runners training about 80 miles/week may be amenorrheic. LH pulse frequency can also be decreased, as evidenced in a group of eumenorrheic runners compared with sedentary women.77 It has been shown that amenorrheic athletes resume menstrual function during states of inactivity, despite minimal weight change.78
The direct association of endogenous opioids and exercise-related amenorrhea has been reviewed in several studies, with variable results.79 Many of the studies showed an increase in endorphin at the time of stress. Measurement of peripheral endorphin, however, is not valid, because the control levels and effect on the hypothalamus are pertinent. One study on amenorrheic athletes revealed that naloxone, an opioid receptor antagonist, did not enhance gonadotropin release in amenorrheic athletes.80 The relation between endogenous opioids and exercise remains to be clarified and could lead to a more accurate evaluation of the athlete with amenorrhea.
Physical exertion plays a major role in bone mass and bone remodeling. Surprisingly, bone loss rather than an increase in bone density can result from vigorous exercise in amenorrheic athletes as compared with eumenorrheic athletes.81,82 Thus, although physical activity has a beneficial effect on maintaining bone mineral, this effect can be overridden by other factors associated with long-term or prolonged strenuous activities in these amenorrheic athletes. Warren and co-workers identified a compromise in the exercise-induced increase in bone mass in a stressed bone of amenorrheic dancers.83 The risk of developing osteoporosis and the incidence of stress fractures are further emphasized by the association of scoliosis, stress fractures, and amenorrhea in ballet dancers.84