Working out and dieting can get you in shape, but overdoing it may put you at high risk for several serious problems that could affect your health, ability to remain active and chance of injuries. Read on to learn how to stay fit without causing fractures or, worse, osteoporosis... 

Are you exercising too much? Eating too little? Have your menstrual periods stopped or become irregular? 

If so, you could be putting yourself at risk for developing osteoporosis, a disease in which bone density is decreased, leaving bones vulnerable to fracture (breaking).

Why is missing my period such a big deal?
Some athletes see amenorrhea (the absence of menstrual periods) as a sign of successful training.

Others see it as a great answer to a monthly inconvenience. And some young women accept it blindly, not stopping to think of the consequences. 

But missing your periods is often a sign of decreased estrogen levels. And lower estrogen levels can lead to osteoporosis, a disease in which your bones become brittle and more likely to break.

Usually, this doesn’t happen until women are much older. But some young women, especially those who exercise so much their periods stop, develop brittle bones and may start to have fractures at a very early age. Some 20-year-old female athletes have been said to have the bones of an 80-year-old woman.

Even if bones don’t break when you’re young, low estrogen levels during the peak years of bone-building – the preteen and teen years – can affect bone density for the rest of your life. And studies show that bone growth lost during these years may never be regained.

Broken bones don’t just hurt – they can cause lasting physical malformations.

Have you noticed that some older women and men have stooped postures? This is not a normal sign of aging. Fractures from osteoporosis have left their spines permanently altered.

Overtraining can cause other problems besides missed periods. If you don’t take in enough calcium and vitamin D (among other nutrients), bone loss may result. This may lead to decreased athletic performance, decreased ability to exercise or train at desired levels of intensity or duration, and increased risk of injury.

Who’s at risk for these problems? 
Girls and women who engage in rigorous exercise regimens or who try to lose weight by restricting their eating are at risk for these health problems. They may include serious athletes, “gym rats” (who spend considerable time and energy working out), and girls and women who believe “you can never be too thin.”

How can I tell if someone I know, train with, or coach may be at risk for bone loss, fracture, and other health problems? 
Here are some signs to look for:


  • Missed or irregular menstrual periods
  • Extreme or “unhealthy-looking” thinness
  • Extreme or rapid weight loss
  • Behaviors that reflect frequent dieting, such as eating very little, not eating in front of others, trips to the bathroom following meals, preoccupation with thinness or weight, focus on low-calorie and diet foods, possible increase in the consumption of water and other no- and low-calorie foods and beverages, possible increase in gum chewing, limiting diet to one food group, or eliminating a food group
  • Frequent intense bouts of exercise (e.g., taking an aerobics class, then running 5 miles, then swimming for an hour, followed by weight-lifting)
  • An “I can’t miss a day of exercise/practice” attitude
  • An overly anxious preoccupation with an injury


  • Exercising despite illness, inclement weather, injury and other conditions that might lead someone else to take the day off
  • An unusual amount of self-criticism or self-dissatisfaction
  • Indications of significant psychological or physical stress, including depression, anxiety or nervousness, inability to concentrate, low levels of self-esteem, feeling cold all the time, problems sleeping, fatigue, injuries, and constantly talking about weight

What changes can I make to improve my bone health? 
If you recognize some of these signs in yourself, the best thing you can do is make your diet more healthful.

That includes consuming enough calories to support your activity level.

If you’ve missed periods, it’s best to check with a doctor to make sure it’s not a sign of some other problem, and get your doctor’s help as you work toward a more healthy balance of food and exercise.

Also, a doctor can help you take steps to protect your bones from further damage.



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