I'm about to make a sweeping generalisation: there aren't many women who relish their period. But, between the cramping, mood swings, and general discomfort of having to change products every few hours, skipping a period or two might feel like that universe is giving you a welcomed break.
But is skipping your period something to be ignored?
Women who train hard and dramatically restrict calories may experience this unexpected cessation of their cycles. They may even secretly rejoice at their lack of regularity; it's one less thing to get in the way of their fitness. However, I would like to urge a word of caution; if a natural process stops, it's worth knowing why.
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Let's introduce an example. Let's call her Archana. Archana is an avid gym-goer. She hits up the CrossFit box regularly, and when she isn't slamming medicine balls, she is hitting the pavement for a run. She is fit and on fire. Her discipline extends to her food, and she is notorious for choosing only healthy restaurants and low-calorie foods to eat.
Archana, like many other women, didn't notice her skipped period at first. She wasn't trying to get pregnant, so the mysterious disappearance of her period was promptly dismissed as a random occurrence.
But then, some other symptoms started to occur.
She notices that she gets tired quickly, and it's difficult to recover from her workouts. Her sleep is disrupted at night, and she is starting to wake up at odd hours. She may lose a bit more hair than usual, her hands and feet may feel a bit cold hands, or maybe she experiences more injuries or chronic pain due to inflammation.
A skipped period is one thing; however, these pesky and pervasive symptoms of a hormonal imbalance are quite another. More often than not, these are the symptoms that will drive Archana to get help, not investigating her skipped period.
Like other women, Archana may not prioritise her period health alongside her health and fitness priorities. The general advice to women has always been to simply "listen to your body," which directly contradicts the "no pain no gain" mentality of the hardcore fitness and dieting worlds. These conflicting points of view can dissociate a woman from what she is physically experiencing, causing her to dismiss or undermine her physical signals as "not a big deal."
The reality is it could be. That also means that we must provide women with the language our bodies speak and teach them how to respect that message.
With that being said, here is the biological 101 of what Archana is experiencing.
Because Archana is expending a lot of calories through exercise and not replenishing those calories via her diet, she may be chronically operating in an energy deficit. Moderate energy deficits are ideal for weight loss, but dramatic energy deficits can impact a woman's fertility hormones.
Women's bodies are highly tuned to protect a potential pregnancy, so they are constantly on high alert and quick to respond to changes in their energy balance throughout their monthly cycle.
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The way a woman's body responds to dramatic energy dips is to initiate what's called hypothalamic amenorrhea. This is a condition where her hypothalamus, the reproductive control centre in her brain, decides that she is not getting sufficient energy to support a healthy pregnancy. According to the Medicine and Science in Sports and Exercise, in response to this, the hypothalamus will halt the ability to get pregnant until conditions are more optimal by limiting the release of a hormone called the gonadotropin-releasing hormone.
Limiting this hormone will have a domino effect on all the other reproductive hormones which influence a healthy period cycle, such as follicular stimulating hormone, luteinizing hormone, progesterone, and estrogen.
If this is your situation, you may be saying, "I'm still young, and I don't want children. What's the big deal if I skip a few periods?" Although this cascade of events may affect fertility, it eventually impacts vital structures such as bone health, exposing you to stress fractures and injuries.
The American Council of Sports Medicine reports that a woman without menses during her critical teenage growth period may have bone mass typical of a 70-year-old woman, predisposing her to stress fractures and fractures later in life.
Yikes.
This phenomenon is so common that it's known as the 'female athlete triad' in sports medicine circles. Of course, skipped periods don't always result from the Female Athlete Triad. There could be other reasons, such as polycystic ovarian syndrome and thyroid issues, so consulting your doctor is essential.
However, it does affect many young women. According to the American Family Physician, the female athlete triad contains three components: amenorrhea (no period for over three months), osteoporosis, and disorderly eating.
This means that although Archana is well-intentioned in her journey to become fit or lose weight, she can create a fundamentally unhealthy body in the process.
If this is you, where do you go from here?
First, visit your primary care physician; they will be able to uncover the underlying issue by investigating your symptoms and asking for more information regarding your missed period. Your doctor may ask for blood tests that will determine your hormone and vitamin levels. Your primary care physician may suggest direct supplementation for Vitamin D and calcium as these vitamins support strong and healthy bones.
Secondly, let's talk about food. To determine what range of calories are ideal and healthy for exercise, recovery, and thriving, you'll need to determine how many calories and what macronutrients you need for your unique body, and slowly increase your daily intake until you feel you're best.
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As for your workouts, scale back higher intensity workouts to include more rest and recovery.
Remember the adage you must recover as "hard" as you train.
Jen Thomas is a woman's weight loss coach based out of Chennai, India
