Study highlights overlooked health risks of high-volume training for young female athletes
September 16, 2025
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Training for elite adolescent ballet dancers is often grueling and complicated: dancers must build enough power to leap high in the air, must be strong and flexible enough to achieve extreme ranges of motion, and must maintain a lean physique expected by the sport.
Researchers led by Loyola University Chicago’s Parkinson School of Health Sciences and Public Health sought to gain a better understanding of how intense, sport-specific training affects young athletes. Female adolescent athletes, in particular, are an understudied group—especially when it comes to how training interacts with biomarkers and indicators of menstrual health.
In a study recently published by the Journal of Strength and Conditioning Research, researchers found notable differences between how male and female athletes are impacted, with findings that carry important health implications.
Key findings
The study, which evaluated dancers’ biomarkers with regular blood tests over the course of a semester, revealed clear differences in how male and female athletes respond to training stress:
- Iron levels dropped in both groups after high-intensity training, but only males recovered. Females showed prolonged low iron and ferritin levels, suggesting an increased risk of anemia.
- Menstrual irregularities were also observed, without clinically elevated cortisol levels. This differs from adult cases of functional hypothalamic amenorrhea, suggesting a divergent etiology. Notably, every athlete who reported irregular cycles had never discussed it with a healthcare provider.
“The abnormalities we discovered have potential to disrupt the athletes’ short- and long-term health,” said Parkinson Assistant Professor David Sanders, who led the study. “It’s crucial that athletes and their care team—such as their pediatricians and athletic trainers—have open and honest discussions to identify performance related deficiencies and opportunities for improvement. Together, this will help optimize the training stimulus for health and performance.”
Recommendations for support
- Vitamin D deficiency was found in all athletes, likely due to indoor training. Supplementation or increased vitamin D consumption is advised.
- Female athletes showed greater biological stress responses than males, underscoring the need for tailored monitoring.
- Performance and nutrition assessment can help identify deficiencies and guide safer, more effective training programs.
Read more stories from the Parkinson School of Health Sciences and Public Health.
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Assistant Professor
