Losing a period, normal or not?
This question is one that is being asked more often in recent times! Historically (due to the lack of education on female physiology) it was thought that losing your period as a runner was considered ‘normal’ and even in some circumstances, ‘beneficial’. Well….this is not necessarily the case. Let's get into the truth.
The menstrual cycle
We need to take a step back and look at the whole menstrual cycle. The whole physiological system, including the choreography of hormones with their cyclical and dynamic fluctuations is considered one of the key markers of a woman’s health. There are many features of the menstrual cycle and having a period is just one of them.
How do I get a period?
A period occurs because we have metabolised (or broken down) our hormones, progesterone and oestrogen, and with the withdrawal of hormones we get the breakdown of the lining of the uterus. The lining of the uterus is then shed and this is what we call our period. Looking at it another way, our period arrives after we have had the hormones oestrogen and progesterone in our bodies. When we stop having periods this is because our hormones are low and we are no longer getting the hormonal changes that we should be. Generally in clinical practice and research not having a period for 3 months or more, is formally also known as secondary amenorrhea.
Because the menstrual cycle is a physiological system it is wonderfully complex, the system interacts and is influenced by so many internal (in the body) and external (outside of the body) factors. This means that there are many factors that in isolation and in combinations with each other can suppress the large and dynamic fluctuations in our reproductive hormones within our menstrual cycle and even the signals in our brain that initiate the cycle. Some of the well researched factors in a sport that cause the suppression of our menstrual cycle include stress (e.g emotional, psychological, social stress and the increase in cortisol), nutritional intake and overtraining. When suppressed we no longer get the change in progesterone and oestrogen concentrations (from high to low) that cause the breakdown of the uterus lining. As a result, we don't get a period. Sadly, this means that losing a period isn’t normal and instead can be seen as the menstrual cycle going into ‘sleep mode’ while the body is stressed.
What does it mean to lose my period?
Losing a period can be a really good indicator to go get some medical help and support. This support can help identify what factor/s could be contributing to the suppression of your menstrual cycle. Then you can work with a healthcare team (e.g. Dr and psychologist, or Dr and nutritionist) to help you manage the stressor that for you in your life is causing the suppression of your reproductive functioning.
I will note that there are other times when we may not expect to have a regular menstrual bleed or period. The first is when we are breastfeeding. The hormones that allow us to breastfeed can suppress a regular menstrual cycle.
What about contraception?
Finally, women who are using hormonal contraception can also not have regular withdrawal bleeds (yes there is a difference to women who are naturally menstruating and have a period but probably for another post). Regardless, irregular periods may be because they are using pills continuously and purposely skipping their withdrawl bleed, or because they have the hormonal IUD or hormonal implants. Regardless, they may go a few months without a withdrawal bleed. Hormonal contraception will provide a dose of synthetic or man made hormones that suppresses our natural oestrogen and progesterone. When using hormonal contraception, women may not know if they are missing their period or not. This is not to say that every women should not stop using hormonal contraception. But rather, when you are chosing what hormonal contraception is best for you, make sure you have some of these discussions with your doctor.
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