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Fitness & menstrual health: How to stay lean, healthy, and fit without losing your period. |

It is no secret that women have periods and often have a ‘moody’ phase during their period. Did you know that it is actually a good thing for you to have this cycle? During this time, your body’s hormones are balanced, your skin is looking its best, and your body is not as receptive to weight gain and other unhealthy behaviors.

While women’s health is a topic that is often taken for granted, it is one that can have a tremendous impact on how you feel, not to mention on your daily routine. If you have been diagnosed with PCOS, for example, you may find that the symptoms of excess weight, lack of energy, and menstrual cycle anomalies can significantly impact your day-to-day life. In addition, treating one or more of these conditions can be difficult, as your symptoms are often not visible to the naked eye.

When your body is working well, it’s easy to stay lean, healthy, and fit, year-round. But as soon as you’ve hit a plateau, things can get tricky. To help you reach your fitness goals, here are some tips to help you remain lean, healthy, and fit, even if your period is MIA.

When working out hard or dieting to lose weight, fit women frequently miss their period. While some may believe it is unimportant, nothing could be further from the reality.

We’ll look at why losing your period can be a bad thing in today’s article. We also offer some advice on how to keep thin and fit while maintaining hormonal balance.

[Note: this article is also available to listen to as an audio recording.] So, if you’d rather to hear the piece, go here.]

Maryann is a young woman who is active and appears to be in good health.

She follows a “clean” diet, according to her. She lifts weights twice a week and runs for two hours four or five days a week.

She stopped getting her periods a year ago, at the age of 27.

She didn’t tell her trainer about it. And it never occurred to her to seek medical advice.

In truth, she was relieved in secret. She didn’t want to get pregnant, after all.

Dealing with her monthly cycle had also become a chore. Her fitness routine was disrupted as a result. Her psyche was also tampered with by her weight fluctuations.

So there’s no problem if you don’t have a period. Right?

Wrong.

The menstrual cycle should be understood.

The menstrual cycle is a sequence of changes that women’s bodies go through as they prepare to become pregnant.

This is how it works…

One of the ovaries releases an egg once a month. (This is referred to as ovulation.)

At the same time, hormonal changes throughout the body prepare the uterus for pregnancy.

To begin, the hypothalamus sends a hormone called gonadotropin releasing hormone (GRH) to the pituitary gland.

The pituitary releases two additional hormones as a result of this cellular cross-talk: follicle stimulating hormone (FSH) and luteinizing hormone (LH) (LH).

The ovaries are then told to create estrogen and progesterone by these hormones.

Of course, the amount produced is determined by the stage of the menstrual cycle in which one is (i.e. follicular vs. luteal).

If ovulation occurs but the egg is not fertilized, the uterine lining sheds via the vaginal opening. And this is what most people think of when they hear the word “period.”

Here’s a visual representation of the procedure.

precision-nutrition-fitness-women-hormones

Menstruation and energy balance

Returning to Maryann… What went wrong with an otherwise routine procedure?

(And why is it that so many female exercisers experience this?)

A woman’s body is particularly sensitive to energy swings, to put it simply.

When a woman eats a restricted diet (especially if she fasts or skips meals) or exercises vigorously for hours every day, her body perceives a threat to her survival.

As a result, it disables “non-essential” bodily functions like reproduction. In other words, she loses her ability to conceive. Hypothalamic amenorrhea is the medical term for this.

Leptin’s Function

Girls nowadays have their first menstruation (also known as menarche) earlier than our ancestors.

This could be due to the fact that today’s children are, on average, heavier than in the past.

However, in order to comprehend this, you must first comprehend the link between the hormone leptin and the hypothalamus.

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Leptin is produced by body fat. When a child reaches a certain weight, a certain amount of leptin is created, signaling the hypothalamus to start the first menstrual cycle.

Because children are gaining weight faster than they used to, their periods are beginning earlier.

The converse is true for women who become overly thin or restrict their calorie intake excessively.

The quantity of leptin circulating in the body is reduced when you get too thin. As a result, the hypothalamus’ activity is reduced.

Maryann’s period loss could have been caused by a number of causes, including calorie restriction, exercise virtually every day, and body fat loss.

The importance of stress

Women’s physiological sensors are highly tuned in to sensory inadequacies, as previously mentioned. Women’s bodies respond swiftly to inadequacies, whether it’s in energy balance, critical nutrients, or body fat.

The “deficient setpoint” will differ from one woman to the next.

While remaining hormonally healthy, some women can be naturally thinner, train exercise at a higher volume and intensity, or eat less calories.

Women’s systems in other countries are more sensitive to perceived restrictions.

Of course, stress — any form of stress — will exacerbate the situation.

The demands of training and competition, pressure to perform, and other typical life stressors such as jobs, education, income, relationships, and so on can combine with dietary and physiological stressors to cause the system to shut down for many female athletes (or even just active women).

When the sympathetic nervous system (SNS), sometimes known as our “fight-or-flight” response, is overworked, the same thing might happen. Consider the following example:

  • if we are overly reliant on stimulants like caffeine
  • If we don’t relax and recuperate frequently and deeply enough, our parasympathetic nervous system (PNS), sometimes known as the “rest and digest” system, will get activated.
  • If we’re continuously self-critical, “had to do everything myself,” control-freak, or perfectionist,
  • If we don’t get enough good sleep, our health will suffer.
  • If we miss meals or fast in an excessively restrictive or frequent manner (which increases our stress hormone production),
  • If we overwork ourselves with too many, too strenuous high-intensity workouts (like Crossfit, MMA conditioning, or sprint intervals),…

…then our stress hormones are constantly on “high alert,” warning our bodies that danger lurks around every turn and that reproduction is not safe.

Because many female athletes or leisure exercisers are also ambitious, high-achieving individuals who seek out stress and challenge in order to improve… It is, after all, occasionally the ideal storm.

What is the significance of hormonal health?

Infertility and missing your period may not seem like a huge concern until you’re trying to start a family. In fact, it may appear to be a welcome respite from the annoyance of periods.

Not so fast, my friend.

Keep in mind that your period isn’t just for pregnant women. Rather, it’s a result of regular hormonal balance.

In other words, missing your period (or having significantly irregular periods) indicates a hormonal imbalance.

Consider your menstruation as a warning signal on your car’s dashboard. The light starts blinking when you lose it: Hormonal health alert! You should also pay attention.

Those messages we discussed before — from the hypothalamus to the pituitary to the ovaries — are greatly reduced in hypothalamic amenorrhea. As a result, hormone production, such as estrogen and progesterone, is dangerously diminished.

What’s the big deal about that? These hormones are necessary for bone health.

(They’re also essential to maintain you psychologically healthy, vibrant, and balanced.)

Because estrogen, progesterone, and bone health are linked, many fit young women who miss their periods end up having weaker bones than their eighty-year-old grandmothers.

Yes, it includes people like Maryann, who engage in weight-bearing exercise on a daily basis and eat a diet high in calcium and vitamins D and K.

Strength training and appropriate diet are insufficient to compensate for hypothalamic amenorrhea.

The thigh bone is related to the brain bone.

Unfortunately, many young female athletes are unaware of their bodies’ estrogen requirements, so they take it for granted when they miss their periods as part of their training.

In fact, the cessation of menstruation is rarely the initial issue that brings women like Maryann to the doctor. It’s an unexplained ache in one of their thighs.

A stress fracture is the cause of their pain, as their doctors may easily find with a little inquiry.

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The Female Athlete Triad is a phenomenon that occurs so frequently that it has its own name. (This is abbreviated as FAT.) Which is paradoxical, given that the vast majority of these patients are anything but.)

The Female Athlete Triad’s main symptoms are:

  • amenorrhea is a condition in which a woman is unable to (being without a period for three months)
  • reduced mineral density of the bones
  • a shortage of energy (including disordered eating)

But the good times don’t end there.

Estrogen and progesterone, as well as other sex steroid hormones like testosterone, have a broad range of impacts in our bodies.

As a result, if your hormones are interrupted, you may suffer the following symptoms:

  • weariness and exhaustion
  • Sleep disturbances (such as difficulty getting or staying asleep, as well as the dreaded 3 a.m. “blast out of bed”)
  • hair thinning (or for some women, facial hair growth)
  • frigid fingers and toes
  • Dry skin or acne flare-ups are examples of skin issues.
  • Weight fluctuations and alterations in body fat distribution (e.g. more accumulating around your middle)
  • Inflammation increases as the injury heals slowly.
  • Anxiety/OCD, low self-esteem, and/or depression are all symptoms of depression.
  • Carotene levels in the blood are high.
  • anemia
  • hypotension in the orthostatic position
  • Irregularities in electrolytes
  • Tissue thinning or vaginal dryness
  • bradycardia is a condition in which a person’s heart (slower than normal heart rate)
  • (Even if it’s just a general ache or discomfort) chronic pain
  • alterations in digestion (such as constipation or bloating)
  • Changes in your breast size or shape (which you’d presumably notice as your bras suddenly don’t fit quite right)

I can’t tell you how many young female athletes have visited my clinic with thigh pain and, to their amazement, no periods. In most cases, further investigation reveals a pattern of restrictive food or excessive activity. Not to mention a slew of other signs and symptoms.

It’s a big pity. Because, in addition to their periods, these young women are losing the most important thing in their lives: their health.

But hold on… Men are also at risk.

Despite the fact that the disease is known as the “female athletic triad,” boys are not immune to a comparable occurrence.

Do you recall my customer, Jason’s story? For a normally healthy personal trainer, a low-calorie diet paired with excessive stress resulted in severe tiredness.

When a man’s energy availability is chronically low, his hormonal health is jeopardized, just as it is in women.

This manifested itself in Jason’s situation as a thyroid issue. We frequently notice testosterone levels decreasing as well. The same hypothalamus-pituitary-ovary/testis connection is to blame. It’s the same pattern of disruption.

So, if you’re a man, don’t dismiss this piece as uninteresting.

In fact, you should use extreme caution. After all, you don’t have that obvious warning sign – a missing period — to alert you to the fact that you’re in danger.

As a result, we must all maintain a healthy balance of energy or our health will suffer.

Is it a nutritional shortfall or an energy deficit?

Although energy deficiencies are the most common cause of amenorrhea in female athletes — and reduced thyroid hormone/testosterone production in men — they aren’t the only explanation.

Minerals and vitamins

Dr. John Berardi of has dealt with a number of fitness and figure athletes who have gone without a period while training for a competition.

Their periods reappeared after taking a few vitamin and mineral pills.

Negative energy balance and nutrient deprivation are, of course, inextricably linked. You’re probably missing out on specific micronutrients if you’re not eating enough overall.

Dr. Berardi was somewhat aback by how these athletes responded to just vitamin and mineral treatment (without additional calories).

“When we tried it out, I was blown away. Several times, we removed and reintroduced the multvitamin/multimineral. Periods reappeared once the vitamins and minerals were added. Menstruation ceased when they were out.”

This made him think that, at least some of the time, energy deficiency wasn’t as much of a concern as nutritional lack.

Carbohydrates

In the Coaching program, the PN Team has discovered that including a handful of slow-digesting carbohydrates in most meals, as well as ensuring adequate carbohydrate intake after a workout, can help.

Many health-conscious women limit carbohydrates, especially starchy or sweet carbs (like potatoes or bananas), because they believe carbohydrates are “bad” or that low-carbohydrate diets are “good” for everyone.

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Hormonal disturbance, amenorrhea, and a physiological stress reaction to what the body perceives as deprivation are all common outcomes.

Carb cravings during the luteal (or premenstrual) phase of the menstrual cycle may have a valid reason: Carbohydrates may fulfill a physiological demand in women that we are still learning about.

That again, specific vitamin deficits — or even a relationship between carbohydrate intake and amenorrhea — are only theories. However, that is certainly fuel for thought.

Amenorrhea can be caused by a variety of factors.

A string of missed periods should not be overlooked. You could be dealing with a number of major underlying concerns in addition to dietary deficits and energy imbalance.

These are some of them:

  • polycystic ovarian syndrome (PCOS) is a type of polycystic ova (PCOS)
  • thyroid issues
  • scarring of the uterus
  • tumors of the pituitary gland
  • menopause in a young age

Not to terrify you, but this is why it’s critical to see your doctor if you haven’t had your periods in a while. Even if you don’t want to have a child.

Getting to the bottom of the problem

So, what went wrong with Maryann?

She reduced the amount of cardio she did. (Of course, she didn’t completely eliminate it.) She also increased her daily calorie intake by 500-1000 calories.

She did gain a few pounds after a few months. We replaced some of her aerobics with weights, so the majority of her increase was lean.

In any case, we enhanced her strength and lean mass without creating fat gain, as well as her hormonal health, lowering her likelihood of developing other health issues.

What you can do to help

Take heed if you’re a health-conscious woman who exercises out and eats well: Missing your period isn’t something to take lightly.

If your menstrual cycle becomes erratic or ceases entirely, do the following steps:

  • Make sure you’re getting enough energy for your body.
  • Increase your calorie intake or lower your workout by a small amount.
  • Check to see if you’re getting enough sleep.
  • Take a high-quality vitamin and mineral supplement.
  • Consider increasing your carbohydrate intake by a handful of slow-digesting carbohydrates at each meal. (And possibly even more, depending on your athletic requirements.)
  • Examine your thoughts. It is crucial to have the right mindset. Hormones react to thoughts and feelings, as well as nourishment and physical exercise.

Also, visit your doctor to rule out any underlying issues.

It’s never too late to begin making better decisions. Because, even if you don’t want to start a family right now, you’ll want to be walking on those bones in the future. For the rest of your life.

precision-nutrition-fitness-women-hormones-bone-health

References

To see the information sources mentioned in this article, go here.

SL Berga, TL Daniels, and DE Giles. Cortisol levels are higher in women with functional hypothalamic amenorrhea than in women with other types of anovulation. 1997 Jun;67(6):1024-30 in Fertil Steril.

B. Couzinet, J. Young, S. Brailly, Y. Le Bouc, P. Chanson, and G. Schaison. Functional hypothalamic amenorrhoea is a nutritionally induced partial and reversible gonadotrophin shortage. 1999 Feb;50(2):229-35 in Clin Endocrinol (Oxf).

Warren MP, Voussoughian F, Geer EB, Hyle EP, Adberg CL, Ramos RH; Warren MP, Voussoughian F, Geer EB, Hyle EP, Adberg CL, Ramos RH; Warren MP, Voussough Hypoleptinemia and disordered eating are symptoms of functional hypothalamic amenorrhea. 1999 Mar;84(3):873-7 in J Clin Endocrinol Metab.

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Written by Vaibhav Sharda