Question for competitive female runners? (Read 1084 times)

Hey - I haven't posted here before; just been hanging around since I joined a week or so ago... but I was wondering what ppls input would be on the subject of competitive female runners and amenorrhea... Personal background: I'm 22 yrs old, and have been running competitively since middle school with varying degrees of success. My genes predispose me to be relatively tall and thin, but all through high school I never had a problem with skipping periods. High school running was fun, 6ish days a week, nothing crazy mileage-wise, and I ate as I pleased, though always grew up on a healthy diet (& with no red meat). I took the winter season off each year, and by the time I was a senior, I'd filled out so as no longer to be a "skinny runner," but was still fit and athletic. Freshman year in college I ran, but was sidelined by injuries due to jumping straight in to much higher mileage-- and running wasn't top priority at that point either - partied a bit, socialized a lot, immersed myself in classes, etc. After my freshman year, I definitely didn't look like a skinny runner, but wasn't worried about it too much... I decided to take a year off to work with an Olympic Equestrian in Europe. Gained a bit of weight eating a diet of nutella, white bread, peanut butter, honey... meat and potatoes. Belgium.... Stuck it out there three months before moving on and ended up traveling all over the world, riding, working, having a blast... arrived back in Los Angeles for the summer and the last three months of my year off, to ride with an American olympian-- and due to various things I developed an eating disorder, lost a ton of weight, started running again a bit. I returned to college that September, only to find myself out of control w/anorexia, and chose to come home to New England - it'd been a while since I'd been home, anyway. Stopped getting my period at the end of that summer, age 20. Coming home didn't solve anything, and I was hospitalized for a week that December (21st bday in the hospital... woo). While in hospital, I decided to join a research study on bone density, anorexia, and amenorrhea. They put me on an estrogen supplement and did a lot of bone density testing.. I have very healthy bones I transferred to a new University for the spring semester, and struggled my way through trying to get over disordered eating issues... I live four miles from campus, and because I wasn't allowed to have a bicycle ("no exercise" while I was "in recovery") - I chose to run to class instead of spending an hour on public transportation. Needless to say, I wasn't exactly in a recovering mindset, but I managed to stay out of the hospital. When it came around to summer break, I was really into running. Not so much into eating. As I was living at home, I decided that I'd try "normal eating" by eating exactly the same as my mother. She is... not a runner... sixty years old... and used to be a model. So, I spent the summer living on around 1800 cal/day, but running, bicycling, swimming, hiking, working, riding.. everything. I was always nervous, anxious, stressed.. and whenever I stopped moving, I would just shut down... resting heart rate in the high 30s. Body fat 6-10%. Cold. In contrast to the low weight, I actually got a few periods, due to the estrogen supplements. But then I decided I didn't want to take the pills anymore, and needless to say, my periods didn't continue. Toward the end of the summer, I actually did up my intake, as I was threatened with hospitalization again... With the increased energy, I realized that I was actually... a pretty fast runner. I didn't know how fast, as I never timed myself over any distances, and my "workouts" were just up-tempo intervals for short timed periods. With the fall semester approaching, I wondered if I had a chance at running for the Div I team at my university. I called the coach up a few days before class started, and he sounded doubtful but agreed to let me come run, so long as I passed the health screening and NCAA regulations... I was honest about my anorexia during the health screening, and convinced a few doctors that I was healthy enough - I actually had become much more excited about running than about not eating, so I had been fueling up pretty well. Fast forward a bit thru the season... I raced really well, setting huge PRs and earning top placings, but stayed extremely stressed and anxious. The coach & team were amazingly laid back, never putting pressure on me, especially as I was just a "walk-on." Anyway, I managed to keep my weight pretty stable, but was certainly running a lot of miles, and not expecting to get my periods back. I addressed my captain about it at one point, and she said that pretty much nobody on the team got their periods regularly, unless they were on birth control. Maybe one or two other girls on the team had eating issues, but for the most part, they were a happy, normal bunch of talented runners. One exception is a girl who's actually the tallest and skinniest of us all (and a 4:44 miler as well!), who gets her periods every month, without fail. As cross-country shifted into indoor track, my racing anxiety increased, and track workouts seemed to inevitably lead to tears and panic attacks. No reason for it, as there was so much support and fun on the team, with my coach being one of the most inspirational but relaxed coaches I've ever encountered. In February, I chose to stop running with the team, as I felt that I was actually in a much healthier mind state (regarding eating etc), and ready to find more balance in my life. I love running, but track was becoming a huge monster for me, and it seemed best to try and just chill for a bit.... So here we are in March, I've been running on my own, but nothing crazy. I eat like a horse, and have been eating well since the cross-country season. Calorie-wise I probably average around 3000/day, but I don't obsess. I bicycle to school and back every day, but I actually relax now about classes and try to de-pressurize as much as possible. Body fat has been 20-23% all through the running seasons... I've heard that it has to be above 21% to maintain periods? So... that's a bit of a long background with a lot of extraneous info, but at this point, I'm wondering what my attitude should be towards my lack of periods. It's been a total of a year and a half without them. I still have above average bone density, and I'm no longer "classified" as underweight, and don't think I've been underweight since last summer, just borderline, with a lot of running. Weekly mileage with the team was probably around 70mpw, but for the past month I don't think I've really been above 50. It seems to me that male doctors tend to think that if you don't get your periods there's something seriously wrong with you... but is there actually damage being done? I feel healthy... is it just a matter of time, now that I'm finally treating my body well and not being so stressed? I wish I'd been able to find balance while on the track team, and I'm still hoping to run again next fall for cross-country (my last season!) -- I've heard some say that skipping periods is just an adaptation... my body is prepared to run races, not to carry a child right now - which is fine with me at the moment, but I don't want to jeopardize my future as a mother. Oh, and-- my mother at my age was definitely very skinny as a fashion model, but she was never anorexic and never lost her period. Fashion models in the sixties did not quite pursue the same extremes as models do today. K - sorry that's so long... and not much of a good introduction to who I am, focusing on my silly issues! But I'd love to hear any input from other high-mileage females, or anyone who's had any experience with this topic. Thanks!

Unlike Trent, I'm not a doctor and I do not have an answer, but I have one piece of advice: if you dont trust a male doctor, go see a female one! Its great that doctors come in both genders these days! (I am kind of curious what the answer is - I have a guess, but I wouldnt mind hearing it.) It seems like you have a lot going on right now medically (even if you think you are "healthy" and fine") and finding a good doctor who you trust is probably really important for your long-term health. Go and be honest with him or her, tell him or her what is going on, and listen to what he or she has to say. But then again, if you don't want to hear it and wont follow the advice anyway, there is no reason to go and waste your time and money and his or her time. I would also add that just because the women on the cross-country team seemed healthy and didnt get their periods doesnt mean that they were healthy or werent exagerating - there is a difference between skipping a period every now and then and not having one in a year. Likewise, people on running boards also do not always have the best advice. There are some exceptions - I have followed Trent's medical advice before and would recommend family members do the same. (I judge my respect for a physician based on whether or not I would send a family member to see him or her.) But it is hard to know who is who. If I were you, I would be asking for some referrals - either to an ob-gyn or an adolescent med specialist, though a good internist would be fine too. Your student health center could also probably point you in the right diretion, or your coach (who you describe as inspirational and supportive), or someone you have previously seen. Finding someone you trust is key.

(BTW, abbaroodle is not a male and she will be a doctor. I do not think she will be a male doctor...)

Thanks for the vote of confidence Trent! Some days I doubt whether or not I will make it through another year and a bit! It is actually only the bit part that worries me. I need a nap.

My experience with menstruation doesn't come from a running stand point but I do know that usually if you take away the thing that is stopping your periods they return. Everything that I have read would suggest that when you ease up on the running your periods come back. I've not heard of amenorrhea on your level of mileage though? I'm wondering if your eating is more of a cause too. Hugs honey. Eat well, be merry, run miles. Life will be just peachy and interspersed with regular, annoying bleeding episodes then. Claire xxx

I'd definetly get in to see your ob/gyn! I've NEVER lost my period (except when pregnant or breastfeeding). I run a decent amount of miles each week as well as weight lift 3-4 times a week and am around 11% bodyfat and Aunt Flo seems to find me each month. Oh and from my thoughts of amenorrhea, it's more about not eating enough then overexercise (just my take from people I've known personally who've been through it). Hope you get things figured out!

Thanks for the responses so far - I want to respond to everyone at once, but I'll try to keep it short yeah, I did 'spit out a lot of information' just to a running message board, but in a way it was sort of trying to amass all of the details for my benefit as well. Sometimes you realize you can answer your own questions when you actually compile the relevant information... My answer to myself would be... run too much, still 'concerned' about eating, and not nearly patient enough ...have a laugh, take some time off, plenty of chances left to get back into running later. But that answer doesn't really make me happy, as... I like running, I miss running with the team, and ideally I should be able to find the proper balance in my life while still being able to run. "I'm a male doctor. I guess that means that my thoughts don't count for this subject. " Lol. Trent, of course you're allowed a response. It's pretty strange to re-read what I've written from an outsider's perspective. To me, it's just 'my story' and completely normal. I think a large part of EDs is trying to justify your behaviors as being entirely rational even tho all evidence points to the contrary. The advice to see a doctor/therapist is good. My school definitely has the facilities available... I think also from the ED standpoint, you tend to see all solutions in terms of +/- food. I think the truth of becoming healthy is definitely more to do with what muse_runner said - "An eating disorder is far more than the behavior or the symptoms. It's what's going on in your head and heart." My head and heart definitely wish I was totally relaxed and "normal" - but in that wishing, I think I realize that I'm still not quite there yet. "I would also add that just because the women on the cross-country team seemed healthy and didnt get their periods doesnt mean that they were healthy or werent exagerating - there is a difference between skipping a period every now and then and not having one in a year." I guess I would edit what I said a bit then - my captain implied more that they sometimes got their periods, just not all that frequently... a few per year, at least. And I do trust that they are healthy. "Are you still in therapy for your ED? ....you refer to your very serious ED as a silly issue. .... so I wonder how close to the edge you are playing." mmm. not currently in therapy. I found that being in therapy constantly made me analyze everything I was doing in my life, rather than just.. living. I've had really good therapists, and I know the ED stuff is not just a "silly issue" - but these days it seems that every other person my age has an eating disorder. Not trying to make light of a serious issue, but .. eh. it is a silly issue, in a way. There are far greater things to be worried about in the world than.. getting mixed up in striving for personal "perfection" I think that it takes finding something outside of yourself that makes you truly happy, gives fulfillment, etc - to pull you out of your inward destructive spiral... shoot, gotta go - more to say later - but thanks again for responses... I think posting this has actually already helped put things in a different perspective.

Glad you returned... Sounds like you dislike the overly analytical part of treatment but you crave peace of mind. I'd be selective when you choose someone you want to work with. Go ahead, be picky. You are incredibly insightful already and this gives you an edge but it also means that you want a therapist who is good at working with very intelligent clients. And the biggest thing I'd recommend for you is telling your therapist on the first session what you want to get out of treatment. You are the person doing the growing, and how you crave growth isn't going to be obvious to the therapist. You have to tell him/her what you want to get out of it. Then through working through the problems the therapist can direct you towards more clarity. Does that make sense?

is there damage being done by not getting my periods?

Yes. But not from the lack of periods per se. Rather, that which is causing you to have amenorrhea is also causing damage to your body. You are doing real damage to your bones (even though they are fine now), to your ability to reproduce in the future, to your electrolytes and possibly to your heart, kidneys and liver. This is very serious. The physical changes may be the result of an underlying psychological problem. Both need to be addressed. Aftor a serious ED, especially with years of starvation, your body may need 3000 kcal - 4000 kcal per day to recover. Yes. I am a male. But that does not change your physiology.