GLOSSARY

Ovulation Release of an oocyte from an ovarian follicle, an event not reliably confirmed by a predicted calendar date alone.

A natural menstrual cycle includes follicular development, ovulation and a luteal phase, with individual variation in timing and hormone concentrations. Calendar dates alone do not reliably verify ovulation or hormone exposure, and hormonal contraception changes the interpretation. Symptoms may influence food choice, comfort or training. Current evidence does not justify a universal phase-based nutrition prescription for all athletes. Track the individual's experience when useful, maintain adequate fueling and investigate persistent disturbances rather than attributing every performance fluctuation to a presumed cycle phase.

Nutrition for a female athlete starts with adequate energy and nutrients for the actual sport, health and life stage. Menstrual history, iron losses, contraception, pregnancy and menopause can add important context. Average sex differences do not define every person's needs, and evidence from one hormonal state cannot automatically be applied to another. Ask about symptoms and preferences without assuming that menstruation requires restriction. Preserve confidentiality and use relevant health information to support care rather than to judge selection, commitment or athletic potential.

Menstrual dysfunction is a clinical signal with several possible causes, including pregnancy, endocrine disorders, medication and inadequate energy availability. Functional hypothalamic amenorrhea is diagnosed after appropriate evaluation, not from training volume alone. Missing periods should not be normalized as an inevitable sign of serious training. Withdrawal bleeding on hormonal contraception does not establish recovery of spontaneous menstrual function. A qualified team should assess the history, energy supply, bone health and other causes while coordinating nutrition, medical care and training decisions.