Actually, blood tests are often very unhelpful when it comes to diagnosing an eating disorder. Our bodies have a narrow window in which they keep our blood lab values, and will digest parts of the body to keep the value in the normal range. For example, if your body isn’t getting enough calcium it will digest some bone; if you aren’t getting enough protein it will digest muscle, for various other nutrients it will digest some of the liver. So in anorexia, blood tests typically remain normal until the malnutrition is quite advanced. The average female, however, loses menses much sooner. Typically menses will be lost at 10 pounds below the lowest healthy weight for an individual body. (So if an athlete’s healthy weight range is 140-150, she will typically cease to menstruate at 130–but blood tests may remain normal.)
The issue is that this form is for the school district, not a doctor.
The student also has to go to a doctor, and the doctor has to fill out a (less extensive) form from NY State to okay the student for sports.
Wow, that’s sobering to hear in those words.
Yes, unfortunately in the past there was a big lack of knowledge about the dangers of under-nutrition in sports (specifically not getting enough calories for the given amount of exercise.) It used to be thought that delayed puberty in certain sports (gymnastics, distance running, dance etc) was “normal” or even a sign of “fitness.” Now it is known that this can cause problems such as long term bone density.
This combo of 1) Abnormal menstrual pattern 2) Not enough calories given the exercise and 3) Weak bones used to be called The Female Athlete Triad. Now there is increasing awareness that male athletes can suffer from under-nutrition as well (although less common) so the name has been changed to RED-S, relative energy deficiency in sport.
This is to screen for cardiac issues. For example long QT causes cardiac arrest and is a possible cause if someone dies young without other known contributing factors. It isn’t routinely screened for but if a student has a family history of either of these events it would suggest cardiac issues could be at play.
It is important because the athletic department, trainers, nurse etc….should be aware and all relevant personnel should be trained in using an AED. PA has a whole page of their athletic physical form dedicated to sudden cardiac death. My daughters had to complete online tutorials on the subject.
You need to be aware that some common mental health medications have severe interactions with some common antibiotics–as in the combo can prompt fatal heart arrhythmias. This is why other doctors as well as dentists need to know everything you take. Omitting this information on medical forms comes with risk.
ETA: Sounds like you and your daughters are aware of this possibility already, and so run any new meds past their dad who is a doctor. But most patients and families aren’t aware, and don’t even think that the combo of a common gentle antidepressant and a common antibiotic brand could be a problem.
For medications, generally, I’d say for someone who might be giving you something else to take (eg dentist) it’s important to inform them of all current drugs and supplements. For a coach or athletic trainer, seems less important for them to know about ssri or ocp prescriptions; on balance, given they don’t really work in a HIPAA heavy work environment, I’d worry about stigma and confidentiality.
Age of first menstrual cycle and regularity is on our high school physical form and has been for years. I always just assumed it was to alert the medical professional performing the physical of any potential overtraining or disordered eating issues.
The answers to these questions are not seen by a physician. These questions are on a form required by the school district, for the school district. This form is turned in to the school. There is a separate form for the student’s physician.
Why would anyone in the school district require this level of health information? If something goes wrong with my child, I want them to call me, and if necessary, 911. They should absolutely be trained in using an AED. However, how are they going to behave differently because my child has a relative who drowned? (And how is it going to help my child to disclose that he/she has herpes, or spent the night in the hospital?)
Thank you for this warning. Yes, serotonin syndrome is important to understand and consider. I was thinking more of been asked this question by doctors/dentists who are not going to prescribe anything, or people who are not MDs or dentists at all.
So here’s how it worked when I used to perform sports physicals at an urgent care in my state. The part that had the questionnaire I reviewed very carefully. I would not perform the physical until I could review the answers to those questions. The menstrual history answers could prompt further questioning from me which may involve not clearing the patient until further follow up was provided by their personal health care provider. Missed periods that could not be explained by taking BCP, having an IUD, etc. could indicate more than just nutritional issues. It could indicate thyroid problems, pituitary gland problems, PCOS, pregnancy, or reproductive structural issues. Fainting, dizziness, palpitations, etc. could indicate cardiac problems.
The completed forms were then given back to the athlete like any other school-required physical forms. I believe only the section that had the clearance part signed was what was required to be given to the school. If the student/parent handed in all of the parts of the paperwork that was their decision.
I honestly don’t remember what was asked or on the forms for my high school/college athlete. I do not think any forms went to the coaches, and her hs coaches weren’t even teachers so there would have been nowhere to store all the files. I think maybe the coaches had contact info for families, and maybe insurance info for the players (one did get hurt at a game).
I do know that when we moved to Florida there was about an inch of forms for each kid. Some of them had stupid questions and we just didn’t answer them (is ‘mother’ your 1) natural mother 2) step mother, 3) foster mother 4) guardian? None of those were correct so we just skipped it) and no one EVER contacted us about the missing info. I never put their SSN on any forms.
As far as physicals, all the school cared about was a vaccination record. I think for the physical I had it done for $35 at Walgreens once a year. No big deal.
If it was about the health of the students, there would be more mental health professionals in the schools. There are more suicide concerns in schools then there are nutritional deficiencies.
If there was a problem with menstruation or nutrition to a point that it prevented the student from participating in a sport then the student would not be playing the sport and the school would not need to know.
Third NO ONE in a school is qualified to ask a female about her menstruation or her reproductive health, nor are they qualified to monitor these concerns, NOR are they LEGALLY BOUND to protect that students health information.
Fourth, if the schools were truly concerned about the nutrition and overall health of a student the FIRST thing they would do is make sure the athletes are getting enough sleep and balancing their school work. Instead athletes are arriving at schools 5am/6am to train, and later that same day staying after school to practice, or getting home late from games, and staying up to finish homework after game and waking up early the next morning to do it all again. The pressure on students now to maintain a high GPA, take honors classes, take AP classes and tests is what is causing nutritional deficiencies and poor health which lead to menstrual problems.
Fifth, if they are so concerned with the nutrition of athletes, why aren’t they drug testing males and females for steroids and PED’s?
Having a school monitoring a female’s menstruation seems like a back door opening for another agenda.
I know I shouldn’t be, but I was always extremely embarrassed about menstruation, I would hide hygiene products in my shopping cart and never checked out with a male at the store. I would have been mortified if my high school basketball coach had information about my cycle. I would have not been able to participate in any school sport. I’m now menopausal and this embarrassment has stayed with me for 40 years. It’s very intrusive and not necessary.
Unlike in some other states mentioned above, it seems like the Pennsylvania Interscholastic Athletic Association requires section 6 of the form linked below with the specific medical questions (including menstrual history) to be turned into the school:
Still does not seem like a good idea, since the school or coach do not seem to be the ones qualified to interpret that information (as opposed to the physician’s statement of clearance or not, with or without restrictions, conditions, or notes), and keeping and securing such information is just another burden.
Or torsades.
If they cannot diagnose/treat then how are coaches/trainers qualified to give medical advice relating to reproductive health? How would a preseason form relating to reproductive health aid in this regard?
No different than asking that teachers be children’s mental health counselors or social workers. In reality coaches and trainers are not diagnosing but can often be first line in athletes damaging their bodies with improper nutrition, eating disorders, or over exercising. People here are jumping the gun like the coach will announce the girl’s menstrual cycle during morning announcements when in reality it may be the first clue that raises the question, “are you/your child alright?” Everyday in this society we push it on teachers and educators to report something seen in a student that may be signs of depression, suicide, violent tendencies, etc. When something happens we ask, “why didn’t anyone see this?” Teachers aren’t mental health counselors either but I bet most of you want them to be watching out for the well-being of your kid yet the tables are turned for your athletes against coaches and such? Quite hypocritical to say the least.
The issue is that this form is for the school district, not a doctor
And when they have to transport your unconscious kid with a head injury to the hospital that isn’t affiliated with your doctor, having accurate information about your child’s medical forms can be the difference between life and death. Whether your husband has an MD is irrelevant except for the fact that that hiding medical information is the most irresponsible medical advice to give anyone.
It’s pretty contextual, I can understand why you didn’t question it at the time.
An optional question is also different though from a required question; some other states do have optional questions.
It’s also different if their menstrual records and dates are turned over to the child’s school - which the Florida proposal does.
And, contextually, that they are also currently pushing to restrict abortion to only before six weeks after the last menstrual period…handing this information to the school and state would be opening these teenagers up to being investigated and potentially prosecuted.
I am being specific with my wording here, as many people hear about a “six week” abortion ban and assume that that means six weeks after being pregnant, i.e. that you’d have six weeks to come to a decision. But if you remember how a pregnancy is “dated” - it is back-dated to the first day of your last menstrual period. (Yep, before conception.)
Would you feel comfortable with your teenager being investigated by the state for possibly terminating a pregnancy any time she had a longer cycle? Yikes.