More and more women are participating in sports today, and many of them are very intense, especially athletes who participate in competitions. It is estimated that more than 6 million women worldwide participate in competitive sports. They have a high incidence of menstrual disorders. There is also a high incidence of menstrual disorders among some recent dancers, especially barre dancers, which has attracted the attention of medical professionals. The prevalence of amenorrhea or menorrhagia in the general population is estimated to be about 5%. However, about 1/3 of long-distance runners who compete have menstrual disorders, at least for a short period of time. About 20% have prolonged amenorrhea or menorrhagia. Some report a higher incidence of amenorrhea in race runners. The occurrence of amenorrhea and hypomenorrhea is directly related to exercise clearance, altered tissue composition in the body, stress and dietary changes. Hormonal changes also play an important role. This menstrual disorder appears to be reversible and its recovery is closely related to preventive and therapeutic measures. The onset of menstrual disorders begins with ovulatory menstruation, progresses to luteal phase insufficiency (normal or prolonged follicular phase), then to anovulatory type with normal estrogen levels, and finally to anovulatory amenorrhea with low estrogen. Many factors can lead to menstrual disorders in athletes, and these continents may be synchronized and interact with each other. However, they can also act individually. The effect of some factors varies greatly between individuals. This may be due to significant energy expenditure and weight loss prior to menarche. A high percentage of athletes with amenorrhea have a history of irregular menstruation in their previous menstrual history. The diet of amenorrheic runners provides fewer calories from protein than that of normally menstruating runners and non-athletes. Although the total calories provided by food are similar, the protein component is deficient. It has also been reported that professional ballerinas consume less calories from food than the recommended requirement. Therefore, the calorie content of food may also be a factor affecting menstruation. 2. The changes in the stimulus of exercise amenorrhea Prolactin, adrenocorticotropic hormone, growth hormone and androgen increase in the blood during exercise, but they return to normal levels within 1-2 hours when training is stopped, so this hormonal change is temporary. In chronic amenorrhea, follicle stimulating hormone (FSH) and LH are low, and in severe cases, estrogen is also at a low level. In recent times, endogenous opioid effects have been proposed, such as endorphins that are significantly elevated in runners. It is now thought to regulate hypothalamic-pituitary kinetochore secretion and to inhibit the pulsatile release of the all important gonadotropic releasing hormone. This pulsatile secretion is essential to maintain proper secretion of FSH and LH. 3. Diagnosis All patients with amenorrhea, including athletes, should be carefully judged. Anorexia nervosa, hyperthyroidism, pregnancy, pituitary tumors, and other organic diseases must be excluded. Patients should have their blood prolactin FSHLH and thyroid function measured, and a pregnancy test should be taken. If the pregnancy test is negative, a luteal awakening should be given to perform a withdrawal bleeding test. A positive withdrawal bleeding test indicates that the serum estrogen level is above 4opg/ml, which is sufficient to maintain normal menstrual function. If the FSH level is low, it is indicative of thalamic amenorrhea. In thalamic amenorrhea, pterionic saddle photography or CT examination should be performed to exclude pituitary tumors. After careful exclusion. If there is no organic disease or other endocrine system and systemic diseases, and if there is a history of exercise training, then it can be determined as exercise amenorrhea. 4.Treatment The cause of amenorrhea must be determined before treatment, and treatment should vary from person to person. The treatment of sports amenorrhea and menorrhagia can be broadly divided into the following points: (1) Reduce the amount of exercise and reduce the training or mental stress. In long-distance runners, menstruation is expected to return when the amount of exercise is reduced. Of course, some athletes are reluctant to do this, especially when they are close to a race. However, patients should be made aware of the possible dangers of prolonged anovulation and low estrogen, such as osteoporosis and reduced epithelial resistance. (2) If the patient is unwilling to reduce training, or when regular menstruation cannot be restored despite the reduction in training, then pharmacological treatment should be considered. Pharmacological treatment includes cyclic treatment with estrogen and progestin (artificial cycle) or chlorzopheniramine 50mg daily for 5 days per month for 3 months to induce ovulation. If necessary, treatment with chorionic gonadotropin can also be added for 5 days 7 days after cessation of chlorzapheniramine. (3) Ovulation induction therapy is not suitable for athletes with low estrogen levels. Estrogen replacement therapy is preferable. Young women with secondary amenorrhea have the same bone loss as postmenopausal women in terms of bone mineral density. Therefore, combined estrogen should be supplemented from the first to the twenty-fifth day of the month. Adding progesterone 10mg daily on days 16 to 25 will prevent bone loss while causing menstruation. The occurrence of withdrawal bleeding at an unscheduled time may be a sign of recovery of endogenous ovarian function.