Too Much of a Good Thing – Exercise Associated Amenorrhea

by Staff

There are many reasons a woman may have a late or missed period. It can result from stress, birth control pills, perimenopause, pregnancy or illness. Life can get in the way of what is “normal” and your menstrual cycle can be affected. Hormonal shifts as you age can cause your periods to be closer together or further apart. Drastic weight changes and change in the intensity of exercising can also have an effect.

Taking It Too Far

The past couple of decades have seen women who were otherwise sedentary head for the gym or take up a sport to get fit. Younger women, particularly, driven by the pressure to have the perfect body, or to get back into shape after the birth of a baby, sometimes exercise so much they stop menstruating. This is called amenorrhea. With the cessation of menstruation, there’s a problematic thinking that accompanies the physiological issue and that is that if you’re not having a period, you can’t get pregnant. However, that, as we have implied, is not true. Although women with amenorrhea don’t menstruate, or at best miss periods, relying on it as a means of birth control is tricky. You can’t accurately determine when an egg will be released from the ovary into the fallopian tube, and as a result, it is possible to get pregnant. If you are sexually active and don’t want to become pregnant, be sure you are using birth control.

Your Body is Warning You

While amenorrhea may be caused by a medical condition, like PCOS or hormonal or thyroid problems, it can also be caused by excessive exercising and dieting. Excessive exercise can cause menstrual abnormalities such as late or missed periods. Your body requires a certain number of calories, protein and body fat in order to maintain menstruation. When there is a drop in weight and it is accompanied by an excessive exercise program, then the result may be amenorrhea. Amenorrhea is not just a missed or late period, it is actually a warning from your body that too much energy is being drained. Your body stops menstruating in order to preserve itself and conserve energy.

Interrupting the Function of the Organs

Researchers believe the cause of exercise associated amenorrhea (EAA) has its genesis in the hypothalamus – the master gland of the body. When there is a major energy drain as is the case in a woman with amenorrhea, all of the hormonal signals from the hypothalamus to the pituitary and then to the ovaries are shut down and the energy is directed to other organs, like the heart and lungs. The hormones generated by the pituitary gland, luteinizing hormone (LH) and follicle stimulating hormone (FSH) as well as the ovarian hormones of estrogen and progesterone, are extremely low which means there is little or no ovulation and few if any periods (oligomenorrhea).

Infertility and Loss of Bone Mass

There are some serious long-term consequences of estrogen and progesterone deprivation in a woman’s body. The obvious negative consequence is infertility. Along with infertility, loss of bone mass creates an environment for increased risk of spinal and hip fractures. The vagina atrophies and the breasts stop developing. When younger girls over-exercise and eat minimally, they will often be slow at developing during puberty, not growing pubic hair nor developing breasts. The loss of or lack of development of bone mass is very critical because it is the precursor to osteoporosis, a crippling disease that is irreversible.

Treating the Problem

The treatment for EAA and late or missed periods due to excessive exercise or weight loss focuses on lifestyle changes. By decreasing the intensity of the exercise program between 5 and 15 percent, and lowering the amount of time spent at exercise, the body can begin to repair and become restored. A healthy weight is necessary for menstruation and so, if you are excessively underweight, a meeting with a nutritional counselor may be of great benefit. Often, just gaining five pounds is enough to get the body going again. In some cases, when the damage is well established, hormone therapy may be used in order to increase the levels of estrogen and progesterone.

Are you having problems with your menstrual cycle? It is important to see a qualified professional for an expert opinion of what the issues may be. You may not have EAA; you may be affected by a problem that requires specific treatment. Learn more about the reasons for a late or missed period in this section.


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