Like many female dancers, you probably have a quintessential “period disaster” tale—maybe it’s the white booty shorts you had to wear at a competition or the time you were partnered with your class crush when you were retaining more water than a camel. Still, there’s a lot more to your menstrual cycle than a monthly date with discomfort or embarrassment. Reproductive health, specifically in your teen years, impacts your body throughout your entire life. Here’s the lowdown on your period.

Getting “Started”
Every woman’s body is different, but most girls get their first period (or menarche, as it’s officially called), between ages 10 and 15. Good indicators that menstruation will begin soon (usually within 3–6 months) include breast and pubic hair growth. Occasionally, a young woman will start puberty, but she won’t get her period. This is called primary amenorrhea, and it happens in athletic and/or thin girls who don’t have enough fat to produce sex hormones. If you suspect you might have this condition, see your doctor.

Missing Periods
You may think that skipping periods is a blessing, especially during peak performance seasons, but missed periods can actually have serious consequences, so don’t rejoice just yet. The condition in which a woman of reproductive age skips periods is called secondary amenorrhea.
Why is it a big deal? Oddly enough, it has to do with your bones. Peak bone mass is built between ages 15 and 25. After that, bone building stops, so it’s important to develop strong bones now to maintain bone health throughout the rest of your life. Low bone density leads to osteoporosis, a weakening of the bones, which in turn can lead to stress fractures. (Test your bone health and calcium knowledge with our quiz on p. 70!)

How does this relate to menstruation? When your period stops, estrogen levels fall. This hormone is necessary for optimum calcium absorption, a key mineral in bone building. Dr. Steven Chatfield, the executive director of the International Association for Dance Medicine and Science and an associate professor and coordinator of dance sciences at the University of Oregon, explains that while it’s uncommon for young dancers to develop osteoporosis, it is possible, especially if calcium intake is also restricted. Alternately, amenorrheic dancers who don’t seek treatment may develop osteoporosis at a much earlier age than they would have otherwise. That can also cause injuries that end dance careers.

So what causes secondary amenorrhea?

• Over-exercising

• Restricted caloric intake

• Stress

• Weight loss

• Other medical issues

The Female Athlete Triad
You’ve probably heard the term “Female Athlete Triad” tossed around in the news. It refers to a combination of disordered eating, amenorrhea and early-onset osteoporosis that can develop in athletes who train intensely. This is how it happens:

• Disordered eating occurs when you don’t consume enough calories or eat the right combinations and quantities of foods for your body to absorb needed nutrients. It can also mean full-blown eating disorders like anorexia nervosa or bulimia nervosa.
  

• Restricting caloric intake and dancing long hours—in other words, consuming less food than needed to fuel your physical activity level—can lower your body’s estrogen. This hormone is needed to regulate your cycle.

• The combination of low estrogen levels and poor diet leads to osteoporosis.
  

Besides the long-term consequences, such as slowed bone building, the Female Athlete Triad will interfere with your performance. Research shows that the incidence of injury is higher in amenorrheic dancers.

When To See the Doctor
If you’ve started menstruating but haven’t had a period in three months, talk to your parents and then go to the doctor. Since a woman’s monthly cycle can vary from 21 to 35 days, after three months, you may have skipped up to three periods. Your doctor will check for other problems that can cause irregular periods besides disordered eating and intense exercise, such as polycystic ovary syndrome or thyroid disorders.

It’s important to find a doctor who understands dancers and with whom you feel completely comfortable. If there isn’t anyone in your town who specializes in dance medicine, your best bet is someone who works with athletes. If you don’t have an eating disorder and your doctor says “eat more and work out less,” find another doctor.

To regulate your period, your doctor may prescribe the birth control pill—weigh the benefits and side effects of this option carefully. Your doctor may also refer you to a nutritionist to help you balance your caloric intake with your exercise load. Chatfield points out that it’s important to work with a nutritionist who’s licensed by the American Dietetic Association, since this field isn’t regulated and any person can claim to be a nutritionist.

A Pain in the Belly
Is this scenario familiar? You’re getting dressed for class just like any other day, but suddenly the idea of putting on tights seems completely overwhelming and you burst into tears. This isn’t normal, you think! They’re just tights!

It could be premenstrual syndrome, or PMS, which refers to a group of common physical and emotional symptoms that occur prior to menstruation—mood swings, diarrhea, cramping, bloating, breast tenderness and lower back pain. About 85 percent of women who menstruate have at least one PMS symptom during their cycle, according to The American College of Obstetricians and Gynecologists!

Keep track of your symptoms in a notebook. If they interfere with your day-to-day life, show your notes to your doctor. In severe cases, you may need prescription drugs. But if your symptoms are relatively mild to moderate, some lifestyle adjustments may help you feel better. If you have PMS, try these ideas:

• Go to class. You might be tempted to skip dance when your monthly cycle has you feeling blue—don’t do it! Research suggests that moderate exercise can alleviate mild bloating, cramps and mood swings. If dancing feels like too much, try a yoga class.

• Stay stocked. Over-the-counter pain relievers like ibuprofen may lessen cramps, breast tenderness and joint aches. For cramps, you can try heating pads like ThermaCare Heat Wraps. Most pharmacies or drugstores carry them.

• Eat right. Drink plenty of water, eat your fruits and veggies and lay off the caffeine!

• Pamper yourself. Set aside time to do something special for yourself. Watch “So You Think You Can Dance” on TiVo, take a walk in the park or get a massage.

While menstruating isn’t most women’s favorite time of the month, it doesn’t have to be the worst either. (It’s sort of a miracle, right?) Pay attention to your body, and don’t be shy about seeking medical advice. You’re worth it!