“…25,26 During a woman's reproductive years, strenuous exercise activity is associated with an increased likelihood of secondary amenorrhea, irregular or anovulatory menstrual cycles, and shortened luteal phases of the menstrual cycle. 27,28 These alterations in menstrual function have been associated with reduced levels of estradiol, progesterone, and follicle-stimulating hormone, particularly during adolescence. 27,29,30 Studies of recreational athletes suggest that ovarian function may be altered in women who engage in less strenuous activity through lower mean hormone levels, longer menstrual cycle lengths, 31,32 or the occurrence of anovulatory menstrual cycles, 33 but to our knowledge the data are not as conclusive as those for athletes.…”