The symptoms of primary and secondary amenorrhea differ. In primary amenorrhea, a young woman who has had the normal body changes associated with puberty has not begun to menstruate by age 16. In secondary amenorrhea, the normal menstrual periods of a woman who is not pregnant become irregular and abnormal or stop altogether for 3 to 12 months.
Risk for amenorrhea increases with intense exercise and poor nutrition. Other risk factors for secondary ammenorrhea include obesity, use of certain hormones, and thyroid disease. Young women who participate in highly competitive sports are at risk for amenorrhea. That is because these athletes often have a low body fat content (less than 15% to 17%) that, combined with the psychic stress associated with exercise, can cause menstrual periods to stop. Young women who participate in sports that encourage excessive thinness, such as gymnastics, are also at increased risk for developing anorexia. Women not engaged in competitive athletics may decide to start exercising vigorously to lose weight and get in shape, and consequently develop secondary amenorrhea. While physical fitness is important, exercising and dieting to the point where menstruation stops puts you at increased risk for osteoporosis.
In general, the socially desirable body size for women is quite thin. A weight for height that is lower than 90% of "normal" (the rule of thumb is to allow 100 lbs for the first 5 feet and 5 lbs for each inch above 5 feet) indicates that the low body weight might be associated with the menstrual disorder Figure 02.
Figure 02. BMI calculator
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