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Cessation of Menstrual Cycles In Female Athletes

By Kevin Richardson,Founder Naturally Intense System of Diet & Exercise™

About two years ago I began writing an article on menstrual cycles in women that have been able to achieve a high degree of muscularity, and a low level of body fat. It has always been my experience working with so many women over the years that their menstrual cycle is very much an issue, and that there really isn't any real literature out that issues the problems that they often face.

The need for increased focus on female health issues:

There is admittedly,a very male slanted information with regards to getting into shape, as even the magazines designed for women still don't address all of the very relevant topics. Perhaps it is a matter of certain health issues being almost taboo in our culture, but nonetheless, they do need to be addressed.

I started this article relying on my own experience training women and getting them into peak shape, as well as my experience with traditional Eastern medicine, however upon reflection, I realized that my theories and observations were very much limited, even though I have trained an impressive number of women over the years. I wanted to ensure that what I was seeing was universal to at least some degree, and so I put out a call for as many female competitors, fitness models and serious trainers to write in to share their experiences, before I made any observations on my own.

How information was collected:

I received an overwhelming amount of really helpful information from almost two dozen women, many of them natural athletes, as well as some input from several coaches and trainers as well. I would like to thank each and every one of them for taking the time to share their personal experiences with me. It is to them that I dedicate this article and hope that it helps give some insight for all women into the menstrual changes that tend to accompany below average body fat levels.

Many women will have irregular or absent periods when subjecting themselves to the conventional methods of body fat reduction; namely high intensity resistance training coupled with extensive aerobic exercise and calorically restricted diets. Many also employ over the counter fat burning drugs, with others resorting to prescription only thyroid medications, clenbuterol, anabolic steroids and diuretics.

What is amenorrhea?

Amenorrhea is a menstrual condition characterized by absent menstrual periods for more than three monthly menstrual cycles. Amenorrhea may be classified as primary or secondary.

 primary amenorrhea - from the beginning and usually lifelong; menstruation never begins at puberty.

 secondary amenorrhea - due to some physical cause and usually of later onset; a condition in which menstrual periods which were at one time normal and regular become increasing abnormal and irregular or absent.

(For the purposes of this article we will deal only with secondary amenorrhea and all references to amenorrhea will refer, of course to this type.) While cessation of menses during pregnancy and lactation periods is a normal, within the context of females striving at all cost for lower body fat levels it is brought on primarily by malnutrition as a result of an inherently unhealthy diet, or endocrine dysfunction, brought on by the use of drugs and an unnaturally low body fat level.

Menstruation is the process of changes in the endometrium, regulated by hormones from the hypothalamus, anterior pituitary gland and the ovary, and is very much a natural female monthly phenomenon. Anything that would hinder the way in which the body naturally works can be dangerous.

Birth control pills are often used as well by the general population as a means of convenience for delaying, reducing or in some instances avoiding menses altogether. Athletes employ them as well so as to not interfere with performance during key competitions, and the same applies to physique competitors as well. But is it a safe practice, and is it a healthy one?

Periods can often come with breast tenderness, painful cramping, bloating, mood swings and severe bleeding, and most of this can be avoided through the use of birth control hormones.

Birth control pills do have side effects, as do all the other drugs and practices used that suppress periods, however it is not within the context of this article to make any final judgment on the long term effects on the body. All I can offer is the very common sense based treatise that our bodies behave as they do for a reason, and that disruption of that which is natural can, as I said before, be dangerous.

Reported Experiences:

That being said, here is a synopsis of the patterns, trends and experiences among those that I have worked with as well as those that shared their experiences.

Most of the women that engaged in what they described as a severely restrictive diet, to reduce their fat levels did not menstruate for a month or more, with one third of respondents reporting clinically defined amenorrhea.

Of those that experienced menstrual irregularities, all of them engaged in extensive exercise routines, with weight training and aerobic exercises for a group average of one and a half hours five times a week. (Many trained more often, with one respondent reportedly training everyday for two hours).

Almost all surveyed reported using fat burning drugs of some sort, however doses were not given. What was significant; however is that of those that admitted using illegal drugs to increase their body fat loss, all of them had menstrual irregularities that continued well after their contests. One reportedly had never regained her menstrual flow and was seeking medical intervention as a result.

An unexpected and interesting occurrence, was the report of one woman who experienced minor abnormalities while preparing for a contest, but losing her menses completely when she gained a total of 15 lbs within the course of two weeks, from engaging in binge eating after ending her rigorous diet.

Of those that did not suffer from menstrual cessation, all of the women that I worked with did report a decrease in the intensity of their menses, in the form of less cramping, reduced blood flow and shorter periods overall.

Of those that did not engage in calorie restricted, crash type diets, only one reported any cessation, (she skipped one period immediately before the contest).

Of those that did not restrict their fat intake during their diets, only one reported any cessation.

Of those that trained on average three to four times a week for less than an hour and without aerobic exercise, only two reported temporary menstrual irregularities.

Some conclusions and thoughts:

From the information presented to me there are some very strong conclusions that can be made, although I will preface any conclusions with the fact that this was not a scientifically conducted study and that there very well may be individuals whose personal experiences contradict what is published here, and I invite anyone with different experiences to share with me as well. However there are some very stark patterns that emerge from a gathering of enough participants that I would call the findings significant and worthy of consideration. Here are the conclusions:

Severe Dietary Restrictions As A Causative Factor:

In general women that drastically dropped their calories and increased their exercise frequency through almost daily aerobic exercise had major menstrual changes. This can be attributed to the fact that many women are indeed malnourished when focused on cosmetically reducing their fat levels and increasing their overall muscularity. That menstrual cessation occurs early on for many women, (before we can assume they attain their sought after low body fat levels), we can infer that it is very much a matter of the body not being sufficiently nourished being a contributing factor, although as well, we must include the increased exercise frequency as a cause as well.

It is known that when the body is not properly nourished, as a preventative measure against an pregnancy that cannot be supported, menses will stop, and it is also known that extreme stress can also bring about a stoppage. In either case, I think it wise that many women reconsider their dietary habits, as in the carbohydrate and calorie reduction methods used may very well be a cause of malnutrition.

Also of note is the extreme amount of time exercising both with weights and cardiovascular type exercise. In one respondent that was not at all a competitive athlete, but who had a similar exercise regime, she found that her periods would become erratic and eventually cease when she kept up her daily marathon sessions of an hours of weight lifting followed by at least an hour and a half of aerobics.

Overtraining As A Causative Factor:

Overtraining thus, can be figured in as a contributing factor in bringing about menstrual irregularities and cessation. This is underlined by the reports of those that did not have any menstrual abnormalities while reducing their body fat levels, which leads to a rethinking of the commonly accepted notion that menstrual cessation is an inevitable result of a woman significantly reducing her overall body fat.

Pharmaceuticals As A Causative Factor:

Arguably, none of the respondents, nor subjects that I worked with personally achieved the degree of body fat reduction commonly displayed by the women admitting to pharmaceutical means to bring about their desired bodily changes, but many were good enough to win or place well in regional level contests. Perhaps, thus, there is a built in cut off point whereas menstruation ceases altogether regardless of what intervention was used to effect the body change, one that perhaps as well cannot be attained by a woman through conventional means.

That question lies out of the scope of this article; however there is the very major difference in preparation among those that did suffer from degree of menstrual interruption and those who did not.

Time seemed to be a very significant factor among those that had no reported irregularities. All but one of those reporting who lost weight over a longer period of time, and who stayed in shape or within a few pounds of their desired weight at all times had any menstrual changes. Also all but two of those surveyed had no changes from their reduction when not employing any cardio and training no more than 4 days a week. The same number applies as well to those not using any type of pharmaceutical interventions, with only two reporting menstrual cessations at any time.

Fat Loss Without Menstrual Irregularities Does Seem Possible:

To summarize, it is indeed possible for a woman to get into shape without any menstrual irregularities, however it does require more time, and a more consistent and balanced approach, one that many would do well to explore. It is my hope that there is more solid research done on this subject, and that this article at least begins a movement towards more female issues being addressed and researched in health and fitness publications.

Again, my thanks to all that took the time to report, and I hope that the article is useful for both female athletes and their trainers.

Information contained in this article is not meant to treat, diagnose illness, nor substitute for medical counsel and is intended for purposes of information and education only. Consult your physician before modifying your diet or starting any exercise program. Copyright 2009 by Kevin Richardson, Naturally Intense NYC Personal Trainer.

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