Menstrual function can be affected in female athletes with high training loads, ultimately resulting in functional hypothalamic amenorrhea. Can athletes overcome the effect of high training loads while maintaining a busy training and competitive schedule?   Since early reports of high prevalence of amenorrhea in athletes in the 1980s, decades of research support the idea that it is not training load per se that induces menstrual dysfunction. Instead, the aetiology of this condition may be the decreased energy available to sustain normal physiological function, what has also been referred to as ‘low energy availability’.   To recover from the chronic effects of the energetic stress induced by low energy availability, it is theorised that athletes have to decrease training load, increase energy intake or both. However, due to the nature of competitive sports, elite athletes are often reluctant to decrease their training load so as to maintain a competitive advantage. Also, because access to elite athletes is very limited to researchers, there are no strictly controlled laboratory-based studies in elite population looking at recovery from low energy availability.   While decades of research have helped developing an understanding of the aetiology of menstrual disturbances in athletes, there is limited research on how to best recover from this condition and a definite answer to this question remains elusive. This invited talk will provide an overview of this topic and present evidence from a recent case study documenting recovery of menses of an amenorrheic elite road cyclist during a 5-year follow up after an episode of significant weight gain, while maintaining —and increasing— a high training load, physical capacity, and remaining competitive at an international level.