DYING TO DANCE
New York Dance Scene
By Sondra Forsyth

October 15, 1997

Please Note: Our workload and the large number of reader questions on this topic make it impossible for us to reply to your questions. PLEASE see your doctor if you have any symptoms of amenorrhea or if dance is pushing you to consider anorexia!

Dear Dancers,

The sudden death last June 30 of 22-year-old Boston Ballet dancer Heidi Guenther focused national attention on the fact that everything is not always beautiful at the ballet. Apparently, given the fact that Heidi was whippet-thin and the discovery that she had been carrying a stash of over-the-counter laxatives in her bag, she had gone to dangerous lengths to maintain what she felt was the weight that would get her the roles and eventually the promotions she wanted.

Heidi's tragic death, along with a cry for help from a 12-year-old who visits this site, prompted me to devote this month's column to some consciousness-raising about the dangers of over-zealous dieting. The worst case scenario, obviously, could be death at an early age. Michele Vivas, a nutritionist who was on the staff of the School of American Ballet, told me that seriously underweight people begin to use up the muscles of the heart. Heidi died of a heart attack. Nina Berger, the head of public relations for the Boston Ballet, issued a statement saying that a doctor in San Francisco, where Heidi was visiting her parents when she died, had ruled out anorexia. Draw your own conclusions.

Short of dying, however, young women who don't eat

enough almost always suffer from a disorder called amenorrhea. In plain English, they stop getting their periods. (Sorry, fellas. This is a girls-only topic. Just be glad you don't have to deal with it, just as you don't have to wear pointe shoes!) Ironically, the 12-year-old who wrote to us had heard about amenorrhea and wanted to lose weight precisely so that she wouldn't have to bother with menstruating anymore. She says that she matured early, and her parents are afraid to let her use tampons. At her ballet school, she is only allowed to wear pink tights and a leotard.

Who among us can't relate to that predicament! The solution? For starters, you (and your parents) will be relieved to know that tampons, particularly the slender ones designed for teens, are absolutely painless and very easy to insert. What's more, the hymen (a thin membrane which usually ruptures for the first time when you become sexually active) will not be broken by a tampon, so your "virginity" will be uncompromised. However, if you or your parents are still uncomfortable with the idea of tampons -- or if tampons do not provide enough protection on "heavy" days -- try the slim pads. They won't show, even when you do a develope a la seconde. I promise! Of course, there is always the slight chance that any protection will fail you and you'll stain. You will not be the first person this has happened to, and even if you think you're going to die of embarrassment, the truth is that everybody including the strictest teacher will sympathize. Menstruation is a messy but miraculous female bodily function, something to regard with awe and pride instead of shame. So if you ever do get a stain, maintain your poise and excuse yourself to change into that extra pair of tights you always keep in your dance bag for just such a moment. (One of my absolutely favorite students got her period for the very first time in the middle of an ABT summer audition with Baryshnikov. She went to the dressing room, took care of the problem, and gamely returned to finish the class. She is still alive and well and dancing in New York City!)

But, you are probably wondering, what could be so terrible about having your periods stop? Plenty! For one thing, girls and women who do not have regular cycles can suffer stress fractures and a loss of bone mass, according to Michelle Warren, M.D., a gynecologist whom I interviewed a couple of years ago for a women's magazine. Dr. Warren is at St. Luke's-Roosevelt Hospital in New York City, and chief researcher in an ongoing project on causes and cures of amenorrhea. "All underweight women, whether they are simply rigorous dieters or have a clinical eating disorder -- anorexia and/or bulimia -- are definitely high-risk," says Dr. Warren.

Why would amenorrhea have anything to do with a stress fracture? "If the condition goes untreated, a woman is likely to develop early-onset osteoporosis -- a gradual reduction in the amount of bone-tissue mass," Dr. Warren explains. Her study of female ballet dancers between the ages of thirteen and eighteen revealed that a full 30 percent had gone without their periods for five months or longer. X-rays revealed an unusually high incidence of stress fractures -- a symptom of osteoporosis. This debilitating condition usually doesn't afflict women until they go through menopause -- the natural ending of menstruation which happens around the age of 50. The reason for bone loss in young women with amenorrhea (just as in menopausal ones) is a diminished supply of circulating estrogen -- the hormone that, among other things, promotes bone density. Osteoporosis is progressive and, in later stages, may result in bones so fragile that the simple effort of standing erect can cause splintered hips or exquisitely painful "crush fractures" of the vertebrae.

Osteoporosis is not the only problem associated with amenorrhea, however. A loss of fertility -- the ability to conceive a baby -- often results. "In most cases, when a woman starves herself, the system shuts down and she stops ovulating," Dr. Warren says. "That's because her reproductive system has gotten the message she's too undernourished to support a pregnancy." Usually, if a woman gains weight, she will start ovulating again. But why take chances?

Three or more missed periods in a row should be taken seriously. In addition to gaining some weight, you should be sure to get an adequate intake of calcium, the bone-building mineral. Skim milk and low-fat cheeses, as well as dark green vegetables such as broccoli and spinach, are rich sources. A supplement isn't a bad idea either. Dr. Warren suggests taking one thousand milligrams of calcium a day in two five-hundred-milligram tablets.

However, the good news is that regular weight-bearing exercise is essential in promoting peak bone density. In other words, dancing is good for you -- as long as you don't starve yourself!

OK, the lecture is over! (Sorry! I care about you guys and I just had to give you all that information.) Now, relax and check out my new postcard on The 92nd St. Y as well as another update on resumes and a bulletin about Master Teacher David Howard.

Have a Hauntingly Happy Halloween!

Sondra