Chicago Girl athletes should be watched closely to make sure that their training doesn't include poor eating habits that could result in damaging bone loss, the American Academy of Pediatrics says.
Doctors, coaches and parents also should be alert for missed or delayed menstrual periods, which may result from inadequate food intake, the academy said.
Treatment to solve such problems may involve taking a break from sports, the academy said in the September issue of the journal Pediatrics.
A lack of calories, weight and body fat may throw the reproductive system off-kilter, disrupting the production of sex hormones and resulting in low estrogen levels.
Because estrogen helps maintain bone density, such girls run the risk of stress fractures and are more prone to developing osteoporosis in adulthood.
Studies have shown that as many as 66 percent of women in some sports stop having menstrual periods for several months, another effect of low estrogen levels.
Though the prevalence is not known, anecdotal evidence suggests it affects many girls ranging from participants in school sports to those training for the Olympics, said Dr. Miriam Johnson, a sports medicine specialist and member of an academy committee that wrote the statement.
Treatment may include establishing healthy eating habits, quitting sports until gaining weight and hormone supplements in older teens and young women, the academy said.