Is It Normal to Lose Your Period Because of Exercise?

Missed periods can be a sign you're not eating enough

Contributor: Kate Patton, MEd, RD, CSSD, LD

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One question every woman athlete should ask herself is, “Have I ever lost my period?” Many people think amenorrhea, or halting of the menstrual cycle, is the norm.

But losing your period is not normal. It is one part of the Female Athlete Triad, a potentially serious syndrome of three interrelated conditions of health risk factors: amenorrhea, bone loss/osteoporosis and disordered eating. Female athletes with one risk factor are more likely to develop, or to already have, the other two.

The triad is relatively common among young women participating in sports and can have serious health consequences. The good news is that the triad is preventable and often reversible if you recognize the symptoms early and seek medical guidance.

Amenorrhea

Amenorrhea can be a sign of exercise-induced anorexia related to energy deprivation from not eating enough, from exercising too much, or from a combination of the two.

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The health consequences associated with amenorrhea are serious. The woman’s body is in a state of slowed metabolism, and stops ovulating to conserve energy. She cannot increase her lean body mass because building muscle requires energy. Her muscles may even break down in order to fuel more essential organs. Female athletes in this hypometabolic state also are more susceptible to injury and delayed exercise recovery.

Bone loss/osteoporosis

Bone loss or osteoporosis results from low estrogen levels triggered by amenorrhea.

Estrogen helps keep women’s bones strong, and when its levels decrease naturally after menopause, the risk of fracture rises. But bone loss can occur in young women whose inadequate calorie intake and excessive energy expenditures diminish the energy their bodies require for estrogen production.

Disordered eating

Disordered eating might begin as a female athlete restricts calories in order to lose weight. Some women may restrict eating unintentionally as they balance an excessive training schedule with the demands of work, school and/or family life. Over time, this food restriction may develop into an obsession with or a disordered approach to eating.

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Female athletes who are most susceptible to restricting calorie intake are those who are involved in excessive exercise, play sports that require weight checks or are involved in sports that encourage tight/revealing clothing. Teens with controlling parents or coaches also are at risk for disordered eating.

Achieving a healthy balance

For female athletes to train their hardest, they need to eat the right foods to fuel their bodies. This will build muscle and prevent injury. To prevent the serious health consequences associated with the Female Athlete Triad:

  • Eat three full meals each day.
  • Balance meals with carbohydrates, protein and fat.
  • Never omit certain food groups, such as fats; omitting food groups is a sign of disordered eating.
  • Eat within 30 minutes of finishing all workouts.
  • Eat post-workout meals high in carbohydrates and moderate in protein. Some good examples include sandwich & fruit, bagel with peanut butter and chocolate milk, energy bar and yogurt with granola, or spaghetti with meatballs, salad and fruit.
  • Have a minimum of three carbohydrate-rich snacks throughout the day.
  • When workouts last more than 90 minutes, eat 15 grams of carbohydrates or drink a sports beverage every 15 to 30 minutes.
  • Consume adequate amounts of calcium daily:1,000 to 1,300 mg per day.  Best sources include milk, yogurt, non dairy milk (such as soy, almond), cheese, calcium-fortified orange juice, and dark green leafy lettuce.

Female athletes who have difficulty building a healthy diet or increasing their calories should see a registered dietitian for professional assistance.

Many women are in denial about developing exercised-induced anorexia from disordered eating. But missing a period is a sign that they are not eating enough and need further evaluation.

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