Can Too Much Exercise Stop My Periods?
Hello friends! Have you ever noticed that exercising more made your period come less often or stop all together? While not having monthly visits may sound nice, it can actually a warning sign that your body is not working the way it should. This week we are going to talk about a condition known as relative energy deficiency in sport (RED-s). This condition used to be call female athlete triad due to its high prevalence in young female athletes, but the name has been changed because it can affect both males and non-athletes as well.
RED-s has three components that help to define it: low energy availability, menstrual function, and bone health. Let’s talk about each one.
Low Energy Availability: This happens when you are consuming less energy (calories) than what your body is using daily. The average recommendation for intake is 2,000 calories per day for an adult, but if you are exercising heavily this need goes up. This happens often in endurance sports like long distance running. Your body needs energy to do all of the functions it was designed to do, like digestion or keeping your immune system fighting off infections. When it does not have enough energy, it must choose which functions are most important. You can think of it like a brown out.
Menstrual Function: Since menstruation is a part of reproduction, it is one of the first things the body stops supplying. When you have low energy availability, your body won’t produce as many hormones like estrogen, progesterone, and other gonadotropin-releasing hormones. To your body, reproduction is not important if your organs and functions that keep it alive are not working. When your body stops supplying reproductive function, this can lead to either amenorrhea (not getting periods at all) or oligomenorrhea (35 days or more in between periods or less than 9 periods per year). Contraceptives are often used to treat irregular periods; however, these only cover up the symptoms and don’t address the underlying problem.
Bone Health: With low energy availability and not getting enough nutrients into your body, it can affect the health and density of your bones. RED-s leads to lower levels of the hormone estrogen which in turn thins and weakens bones. It can cause osteoporosis (also known as brittle bone disease) and osteopenia. With weakened bones, you have a higher risk of developing stress fractures or breaking bones.
Why is this important? RED-s disrupts the normal functioning of immune system, heart, and other systems of the body, which can put you at higher risk for getting sick and developing chronic medical conditions. It is also associated with an increased risk of muscle and bone injuries.
Talk with your provider if you have any signs of RED-s. Working with a registered dietician can be a great first step to make sure your body’s energy needs are being met.
To learn more about the pelvic floor check out these resources below:
Ask your healthcare provider for a referral to a pelvic therapist.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
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What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.
Written by Emily Reul, PT, DPT
1. Rothschild CE, Schellhase KC. Considerations for the adult female endurance runner: a survey analysis. J Womens Health Phys Therap. 2020;44(1):3-8.