 In my 20s, my period would randomly disappear—sometimes for three months, sometimes six, once or twice for a whole year. It did worry me, but at first, not enough to seek advice. Eventually, after it happened a few times, I went to the doctor. They told me it wasn’t a problem unless I wanted to conceive. I was 22, I didn’t.
It came back, so I stopped worrying. Then it went again. I saw a different doctor—they weighed me and checked my BMI and body fat. All within the normal range. They weren’t concerned. They suggested birth control pills to give me a monthly bleed. That didn’t make sense to me at the time, I wanted answers not a medically induced monthly bleed So I left, unconvinced. I was heavily active, I taught or did around 12-15 fitness classes a week ( and this was not my main job I worked in performance which I found mental and emotional quite stressful) For 15 years my stress release hobbies alternated between running and mountain biking. I ran 5k 10k 1/2 marathons, marathons and even an ultra marathon. I mountain biked most weekends and did regular bike race mtb events. I was part of a running club, climbing club, i had tennis lessons, swimming lessons. Thankfully I had a regular yoga and meditation practice and I honestly believe it was my Saving grace. I loved it. I loved it all, felt I was living my best life ……but my lack of period was my body trying to tell me something. So I started to do my own research, it was mid 2000s now, and I came across the Female Athlete Triad, ( a condition that affects female athletes where they suffer low bone mass density, weight loss and loss their periods) But did I fit the profile? I felt I ate all the time and my BMI and body fat were normal. I asked other fitness instructors—some of whom trained more than me and had lower body fat, if they suffered menstrual issues. They said they either menstruated normally or were on birth control (like the coil or implant), so didn’t bleed anyway. I was confused again. So I pulled back, put on a few kg but was doing less of the sports that made me happy and still no period, feeling depressed I went back to all the sports I loved and felt happy again. In my 30s, I started going on regular bi- annual three-week yoga and Ayurvedic retreats in India—and noticed that my period always came back. Despite eating less and losing weight when I was on these retreats. So I was less worried as I knew I could get them back but as soon as was back to my normal level of training they disappeared, I felt I ate all the time but looking back I was eating what I thought was healthy foods and back then 20years ago I still was of the belief that too much fat in the diet wasn't a good thing. So I was definitely undereating fats. Back to the doctor—this time they suspected early ovarian failure (a.k.a. The name for early menopause if you’re under 40). But that was ruled out as my FSH and LH levels were low, not high (see footnote to explain this). I did get a DEXA scan, which showed I had osteopenia, despite looking healthy being normal bmi and doing a ton of sport—how could my bones be weak? maybe I was suffering female athlete triad? Right, that got my attention. I’d done my Level 3 PT a few years earlier and knew weight-bearing exercise was key for building bone strength. So I added more weights into my routine, swapped out some cardio—even though I loved it and the big endorphin hit. But I knew change was necessary. I started eating more fats and meat again having been a vegetarian for ten years just incase that may help. My period came back. But cycles were still long—like 45 to 60 days—still outside the 25–35 day “normal.” and all it look was so life stress for them to get a bit longer apart. Finally, in 2014 the international olympic committee introduced a term called RED-S, a condition of long term low energy availability the arises from not balancing activity with sufficient recovery and fuel, that had much wider consequences across bodily systems and can affected men and women exercisers of all ages, activity and level. and then in 2016 I discovered the work of Dr Nicola Rinaldi (now Dr N Skyes) and her book No Period, Now What?—and suddenly it all made sense. I knew I had hypothalamic amenorrhea: a condition where menstruation stops due to suppression of the HPO axis. AKA longe term stress + long term under-fuelling = period stops and a cascading affect of other systemic issues. Hidden Stress was the the thing I never addresses plus id just been drastically underestimating my calories needs for too long. NOTE : Weight. ( bodyfat and bmi) is irrelevant it can happen to women of all sizes and shapes. so that fact I never had low body fat relative to my female colleagues was irrelevant. Under-fuelling is slippery. Calorie counting is basically guesswork—fitness trackers are wildly inaccurate (especially for “afterburn” or day-to-day life). And there’s a big gap between what you eat and what your body actually absorbs. NOTE: You can be under-fuelling and not losing weight. You can be underfuelling and undernourished without being underweight By now I was working full-time as a fitness instructor at a club, rather than being a part time freelance instructor. When I was told I couldn’t cut down my hours or my level of cardio classes, I quit my job . This honestly broke my heart—I loved that job and not teaching brought a wave of emotional stress, which definitely didn’t help my overall stress levels. Eventually, I had to stop all cardio . Just weights, lots of yoga, meditation, slow loving, walking. Lock down helped me to slow down as clubs closed so I was teaching less fitness classes, however I missed the emotional and social benefits I got from face to face training and teaching. By the age of 40, my periods were regular every month—and they’ve stayed that way for years now. I gradually added cardio back in, always checking that my cycle stays regular. Like a barometer. And my dexa scans show I no longer have osteopenia. The real game changer for me, I believe, was becoming aware of and managing with my internal stress, prioritising eating multiple times a day, taking time off work without any guilt. AND not comparing myself to other people in terms of what they eat and do. NO more fasted exercise for me! Thats why my period came back on those yoga and Ayurvedic retreat because I got deep relaxation and stress release, but everyone is different. There are various factors involved in why someones period can disappear. Some of us are just wired to be more stress-reactive. I know I am. And I now know how to take care of that part of myself. How? ( more blogs on this, one I’ve already published on Internal rushing syndrome ) but loosing my Mum to cancer was a big learning curve for me on my relationship with stress. Inner child work, Micheal singer podcasts, Meditation, Yoga retreats (participating in not leading) , BWRT with Helen Goad all massively helped me, but we are all different in our needs. So that’s my story, and i'm still learning, getting it wrong then recalibrating. Had I been on birth control all those years, I’d never have known any of this. My energy levels and body composition stayed fairly steady—but underneath, something was off. And I wonder how many other women are in the same boat, unknowingly masking symptoms with birth control. This experience made me passionate about understanding hormones and cycles—not just from a medical view, but as a powerful tool. Like an internal dashboard, giving feedback about how your body’s really doing. It’s like the frog in hot water analogy—we don’t always notice the slow boil our periods can tell us ladies. Men? read my blog on RED-s in males blog. Since then, I’ve studied courses and read numerous books on female physiology. I’m so glad the conversation has opened up over the last 10 years around training for a female physiology . For too long, sports science was based solely on young college-aged men. Women were seen as “too complicated” to include in studies. That’s finally changing. If you think you may be suffering from HA I HIGHLY RECOMMEND reading the book 'now period, now what?' by Dr Nicole Rinaldi (SKYES) Check out my other blog posts at katestannardfitness.com, and come on your own journey with me. ( there are already some blogs on stress management “internal rushing syndrome” and “understanding your cycle and hormones” for premenopausal women, RED-S in males they you may find of interest). Footnote LH (luteinising hormone) and FSH (follicle-stimulating hormone) are produced by the pituitary gland, not the ovaries. They signal the body to grow a follicle (which matures an egg) and then to release the egg. In peri-menopausal women, LH and FSH levels are typically high due to a reduced ovarian reserve (fewer eggs) so LH and FSH. Are working hard to try to drive the process. In contrast, in hypothalamic amenorrhea (HA), LH and FSH levels are usually low, showing that the lack of ovulation is due to insufficient stimulation from the pituitary gland, which itself is regulated by the hypothalamus. Secondary amenorrhea, which is defined as 3 months absence of menstruation, occurs in approximately 3–5 % of adult women. According to the American Society of Reproductive Medicine, FHA is responsible for 20–35 % of secondary amenorrhea cases and approximately 3 % of FHA cases of primary amenorrhea [6]. The incidence is higher in athlete women. DeSouza et al. [7] estimated that approximately 50 % of women who exercise regularly experience subtle menstrual disorders and approximately 30 % of women have amenorrhea. https://pmc.ncbi.nlm.nih.gov/articles/PMC4207953/ Comments are closed.
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