- Exercise-induced menstrual dysfunction (ExMD) is prevalent (6-79%) in active women and may result from low energy availability. Unfavorable lipid profiles have been reported in women with ExMD; low energy intake may also increase risk for poor nutritional status. PURPOSE: To compare nutritional status (diet, blood) and lipid profiles in active women with ExMD 1) before and after a 6-mo intervention that provided a daily fortified CHO-PRO supplement (360 kcal/d; 300 mg/d calcium [Ca]) and 2) to Eumenorrheic controls (EU). METHODS: Menstrual status was confirmed by measuring reproductive hormones. In the ExMD group (n=8; age=23±3y, VO2max=49±6 mL/kg/min, body fat= 22±5%), energy intake and expenditure were assessed at pre- (0-mo) and post-intervention (6-mo) using 7-d weighed food and physical activity records. EU athletes (n=10; age= 24±5y, VO2max=51±5 mL/kg/min, body fat=23±4%) were only measured at 0-mo. RESULTS: For ExMD women, the addition of a CHO-PRO supplement to the diet increased Ca intake (pre=1320±571 mg/d, post=1725±555 mg/d, p=0.02). Dietary cholesterol (chol) (pre=193±130g/d; post=339±240 g/d, p=0.04) also increased, but this was not due to the CHO-PRO drink (chol=15mg/325 ml). At 6-mo, Ca intake was significantly higher in ExMD vs. EU (1211±385 mg/d, p=0.04), but not at 0-mo. Vitamin/mineral supplement use was more prevalent in EU (50%) compared to ExMD (13-38%, range during intervention). At 6-mo, mean Total chol (188 mg/dL) and LDL-chol (103mg/dL) were higher in ExMD compared to EU (Total chol=154 mg/dL; LDL-chol=84 mg/dL; p<0.05), yet mean cardiac risk was similar (p>0.05; ExMD=2.6; EU=3.0) due to higher HDL-chol levels in ExMD (71 mg/dl) vs. EU (53 mg/dL). In the ExMD group, 25-38% had low iron status during the intervention vs. 20% of EU (0-mo). No other differences in blood micronutrient status were observed. CONCLUSION: Although, Total chol and LDL-chol were higher in ExMD vs. EU, overall both groups had low cardiac risk. Ca intake was higher in ExMD group due to the added Ca in the CHO-PRO supplement. No other group differences in diet or blood profiles were observed. In conclusion, ExMD may negatively increase some blood lipid parameters but this did not translate into increased cardiac risk.