DEAR DR. DONOHUE: My daughter is devoted to gymnastics. She’s been training since she was 5. She is now 13 and slightly small for her age. She has not yet had a menstrual period. She practices 20 hours a week. Do you think this is too much, and could it be the reason she hasn’t had a period? – M.S.

ANSWER:
First let me say something about gymnastics. It’s a wonderful sport. Male gymnasts are pictures of perfectly proportioned athletes. Female gymnasts are equally well-conditioned. They tend to be more slender and shorter. Shorter, slender athletes can more easily propel their bodies through the twists, vaults, spins and jumps required of them.

Female gymnasts are in danger of overdoing exercise and underdoing nutrition to stay on the thin side. The result can be the female athletic triad of unbalanced eating (too few calories to meet the demands of strenuous exercise), delayed onset or loss of menstruation and osteoporosis. The average age for menstruation in the United States is about 12½ years. Your daughter is still within the norms, but you should supervise her food intake. A rough estimate for calculating the daily calorie requirement of a young girl performing demanding exercise is the product of her current body weight times 20. If she is thin, take the average weight of a girl her age and multiply that by 20. She must take in around 1,200 mg of calcium to prevent osteoporosis.

If your daughter is happy with her demanding program, if she doesn’t have injury after injury and if she is able to complete her schoolwork, then her schedule is not harming her.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.


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