Can You Use Estrogens to Treat a Runner Who Has No Periods?

QUESTION: I'm a woman runner with a problem, but can't seem to get a straight
answer from anyone. Please help. Can you use estrogens to treat a marathon
runner who has no periods?
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ANSWER: The use of estrogens in women athletes whose periods have stopped is
a controversial subject. The reason periods stop with strenuous exercise is
not clearly understood, so we aren't sure how to treat the problem, or whether
it should be treated at all. At first, it was believed that these changes in
menstrual cycles were temporary, and that they had no long-term effects. Now
we know that women athletes may also suffer from changes in their bone
density, which can lead to fractures and other skeletal problems. There are
also concerns about the long-term effects of these changes on fertility.
There are more questions than there are answers in this area, and more
research will hopefully supply the answers we need to treat the problem.
At this time, there are many opinions among even the experts in the field
of hormonal therapy, so it is not surprising that many women are very confused
about it. Estrogens are known to increase the risk of endometrial (uterine)
cancer, and they can also cause bloating and depression in some women. The
one common approach to estrogen therapy for athletes is careful monitoring of
bone density. If periods are disturbed and the bone density is decreased,
serious thought should be given to modifying nutrition, exercise and possibly
estrogen therapy. Comprehensive counseling regarding all these factors is
necessary before a good plan can be established.
It's clear to me that most women will benefit from increasing their
calcium intake and limiting fat in their diets. Regular, moderate exercise in
a variety of forms should start at an early age, but exercise should not be
regarded as a cure for all health problems. We don't have all the facts on
estrogen yet, and each time it is prescribed, it should be with careful
thought to all the risk factors.