The latest research on ammenhorrea suggests that it may be an energy deficit. If you search this forum, we've had some posts on this, including the ACSM's position statement on Female Athlete Triad - of which amenhorrea is one component.

How many calories do you eat a day? How much dietary fat do you get? Both of those are important factors.

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Caloric intake ranges a lot based on what I'm doing that day for workouts. Ranges from 1800-2800 or so. My diet is awfully carb-heavy, but I've been trying to up my MUFA intake lately.

It might be worth your while to see a registered dietician, and hopefully one who is knowledgeable about athletes.

You are right to be concerned.

Make sure that you are getting 1500 mg of calcium a day, and at least 800 IU of vitamin D. Amenhorrea spells trouble for bones, and you need to protect them as much as you can.

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

I'm a dietitian and from my training you are spot on in that if you aren't consuming enough energy you can have athletic amenorrhea without being ultra lean. Of interest, underfuelling can also lead to higher body fat levels.

---

Pain is inevitable, suffering is optional.
Check out my website http://www.transitionhealth.ca for sport nutrition articles and tips.

sorry this may be off the subject slightly but reading what you wrote that underfuelling can lead to higher body fat levels grabbed my attention - so I checked out your website. I think I am the athlete that under eats. My question is over the past week I have been trying to take in more calories (I was about 1900 a day I am now aiming for 2500) I am just curious I have totally put on weight this past week and curious usually how long does it take your body to stop "storing" these extra calories? oh and I am training for IMKY in just over three months so I am doing a lot of training.
thanks

From my experience the weight will go up a few pounds initially (usually not more than 5). There isn't a lot of research in this area so it's difficult to say how long until the body adjusts. I find you have to eat closer to expenditure consistently (no big fluctuations from day to day, starve then binge etc) for several months until the body gets the message. Any more would require me to do an assessment to make sure we're on the right track.

---

Pain is inevitable, suffering is optional.
Check out my website http://www.transitionhealth.ca for sport nutrition articles and tips.

Some of it may be your body storing water with the increased intake [especially carbs].

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Did you have your Prolactin levels checked? They usually don't do that with just the "normal" bloodwork.

Elevated Prolactin will cause to lose your cycle. Might be worthwhile checking, maybe see an endocrinologist rather than a dietician..
Good luck.

I am less than two months out from my Ironman and for the past two months I have not gotten my period....

NOT PREGNANT

my question though is when talking to a friend she said that my chances of getting a stress fracture are really high at this point... what can I do to avoid this?
Is taking calcium supplements enough?

thanks

Calcium supplements are not enough. Your body is not producing hormones as it should. Make a doctor's appointment and ask, while you're there, for a referral to a dietician. It may mean increasing caloric consumption and/or fat intake.

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

I'm going through the exact same thing now - went off the pill in Nov, had 4 periods total since then but have not had a period in over 100 days. I lost some weight over the winter - 135 to 125 (also 5'5") and train 10-15 hrs per week. However, I usually eat at least 3000-4000 cal per day. I've been to the gyno and she put me on Provera - still no period so I go back on Tuesday. In the last month I've increased my fat intake (good fats like nuts) and decreased my training and have been able to get my weight up to 130. Not sure I'll be racing as fast as I could, but hopefully the tide will start flowing again soon.
CurlyElle - any change since April?

---

Team Danbury Audi - Triplet Mommy!!!

Regardless of the reason, not having a period is not OK. Continue to get it checked. You are at a higher risk for injury, bone loss, and long term medical complications. Ensure that you are getting your body fat measured accurately, not just with BMI indexes. Good luck!

---

________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl

Most of my initial work started out with weight category sports and my interest quickly turned to the females as it is here that the most issues arose. In sports such as Olympic weightlifting, Paralympic powerlifting, light weight rowing etc where the most successful females are those with male-like body composition Amenorrhea is a big issue. We're currently gathering a large amount of data on our athletes and their menstrual cycles, total body water (TBW) fluctuations, body fat, BW etc in an attempt to use this to maximise performance... Hence this topic grabbed my attention.

In particular your comment on your 'carb-heavy' diet shows that you are addressing the issue... I can't stress enough how much of a difference you can make by increasing TOTAL fat intake, do not only go for P/MUFAs, you need saturated fat and in particular cholesterol. You may have seen the recent movement to challenge the common misconception of 'fat is bad' and if so, you'll have more of a basis for why I say this.

The trick in endurance athletes is being able to have enough carbs (CHO) to train properly, whilst eating enough fat to recover properly! ...and at the same time manage body composition. My advice to you is to incorporate Protein and Fat (+veg) only meals in your diet where possible. This also has the benefit of further up-regulation of insulin sensitivity therefore better glucose disposal, therefore greater potential for fat burning when NOT training, let alone when training.

I definitely agree with ‘tigerchik’ and ‘ironrd’ that energy deficit is a possible issue, as well as lowered bodyfat levels, however, this is not the whole story. Adding bodyfat doesn’t always solve the issue... and I’ve found that even at these low bodyfat levels, menstruation is possible if energy intake is maximised (whilst maintaining body fat/weight). This ties in with what ‘ironrd’ says here:

This is in my opinion one of the greatest issues with endurance athletes that do not have a consistent and well planned diet. They go through phases of ‘relaxed eating’ the extra peice of chocolate or cake here and there, greater alcohol consumption etc where bodyfat increases more than necessary, then they go into a phase of undereating (not structured dieting) to get the weight off ASAP, and voila, sub optimal nutrition = sub optimal hormonal milieu = sub optimal recovery so on and so forth. This then leads to a lower energy intake needed to maintain bodyweight at this lower level. Less energy... and the body needs to stop energy expensive processes and voila amenorrhea and alike.

As you can see this is an area that fascinates me, over 75% of my endurance clients are females, and I believe this is in part because they see the issues with poor nutrition in a more prominent way than men do...Which is both a positive and a negative, women then do something about this issue while men just carry on not knowing their hormone levels are out of kilter and therefore recovery /performance potential is diminished!

Anyway, that's enough for my first post; it’s almost turned into an article, think I’ll be posting this on my forum!
--

---

--
Martin MacDonald
Performance Nutritionist

http://www.Mac-Nutrition.com

Thanks for this post Martin.

I've been working with an RD this year due to some other issues, but obviously endurance sports plays into the picture. She's been very helpful, especially in her evaluation of my 3 day eating diary. She's also helped me to plan out my snacking for the day to ensure the snacks are balanced and to make sure I'm generally eating a variety of vegetables. After her suggestion that I was eating too little, I have worked in fueling for those longer workouts and it's made a big difference for me. I've read countless articles and forum posts on nutrition and know all these things, but it's not until I sat face-to-face with her that things really changed.

I'm about to do my 4th IM and I'm definitely at my leanest. I don't know about BF% (maybe ~19%?) but I can say that new veins are popping out of skin on a daily basis and I weigh less today than when I started high school. Even though my other pre-IM weights have ranged from 5 to 15lbs heavier than now, this is the very first time I have made it to race day without missing a single period. My joke used to be that I should get "First Response Pregnancy Tests" on as a sponsor! I'm training just as hard and probably have more demands on my daily life, so the only difference in this case is the eating habits.

Good work! Sounds like you're on the right road, so how come you aren't you posting the answers on the forum? :-)

Great testimonial for your RD! Does she work with sports people on a regular basis?


Isn't this just the truth! Those with an active interest in nutrition can find out so much with decent articles now being posted around the internet (I say that because common media and government nutrition guidelines are generally terrible) but until they sit down with someone who tells them what they already know it doesn't ever translate into lifestyle. Accountability is a powerful thing... so is getting the most out of ones money...... i.e. you listen to the advice because you've paid for it! haha

---

--
Martin MacDonald
Performance Nutritionist

http://www.Mac-Nutrition.com

The RD I saw is one of the best in BC. She works with a lot of athletes, coaches and has some books published. The discovery about eating too little was really just a side discussion in my meeting with her. Stress, IBS, low ferritin/iron and IM training have been pretty high since January and the weight loss is likely all of the above.

I'm not sure if I've ever had serious amenorrhea like the original poster, I just a few missed periods during heavy training loads. It's usually come back the following month so I've never needed medical advice. Given that my BF% is lower than ever and I've trained really hard, I fully expected to miss this month's period. Apparently not. We'll see on the 29th of August after IMC if I'm truly a "success" story but I can say that in my case, weight/BF% is definitely not a predictor of whether I'd miss a period but caloric intake probably is.