High intensity exercise can lead to physiological and psychological adaptations that are detrimental to the athlete. These adaptations reflect the ‘overtraining syndrome’ (OTS) and can usually be identified via a persistent decrease in physical performance. In the female athlete the symptoms of OT are often exacerbated by the occurrence of athletic amenorrhea, or the loss of menstruation. The present review aims to identify the signs of the OTS, present tools for its diagnosis, and to establish the links between OT and athletic amenorrhea. Perhaps of greatest importance the review also discusses the prevention of overtraining with emphasis upon the long-term health problems the female athlete may encounter through OT and amenorrhea.