I've lost my menstrual cycle from exercise! Yay...right?

Some female athletes rejoice when they no longer get a monthly menstrual cycle. (No more cramps and discomfort!) They may even misinterpret the loss as a sign they are training hard, like an athlete should. But I'll caution you, this isn't necessarily a cause for celebration.

The issue

The main reason female athletes stop ovulation and menstrual cycles (amenorrhea) are because of excessive exercise and a calorie deficit. Women most at risk for losing menstrual cycles are athletes participating in sports where low body weight is considered an advantage; examples include running, ballet and figure skating, but it can happen any time there is an imbalance in the energy expended and caloric intake. The key to menstrual cycles stopping seems to be a relative caloric deficiency, in other words not enough calories taken in for the amount of energy expended. Women with a history of restrictive eating patterns or eating disorders may be more at risk. 

The concerns

If you are among the female athletes who have stopped getting your menstrual cycle, stop rejoicing. You are at risk for any of the following:

• Inadequate nutrition:  Your body is not getting enough energy from the food you are eating. This could be a result of not eating enough calories throughout the day or not eating enough healthy fats. Healthy nutrition is needed to fuel your body for exercise and to maintain regular periods.
• Low bone mass density:  Nutritional deficiencies and low estrogen levels lead to a decrease in bone mass density, which means your bones are weaker than they should be. Low bone mass density can put you at an increased risk for stress fractures (often seen in runners).
• Infertility:  Exercising too much can also lead to problems with ovulation and getting pregnant. 

The solution

Inadequate nutrition, low bone density, and infertility are usually reversible with a decrease in exercise and an increase in caloric intake by getting the body back to a place of homeostasis. Increasing body weight to a healthy body mass index (BMI) is important. Hormonal feedback loops function optimally when the body isn’t too stressed and getting the right nourishment.  

If you are experiencing periods at erratic intervals or you are skipping periods all together, you should see your gynecologist, women's health practitioner or primary care doctor to determine the cause. We will be able to help you:

• find a healthy weight
• make a plan for adequate nutrition based on your activity level
• determine if you have low bone mass density

For most women, the benefits of exercise (decrease in cardiovascular risks, controlling weight, strengthening bones and stress reduction) far outweigh the risks since amenorrhea is more common in female athletes than the general population. To stay healthy it is important to find the right balance of activity, nutrition and body weight.