Could your workout be responsible for missed periods?

This time of the month is terrible for most of us, and even getting out of bed becomes a chore. Still, we put on our brave faces and get on with the days.

Those who struggle with irregular periods are often advised to get more exercise. But what happens when your workout becomes responsible for missed periods?

We’re not making this up; this really happens. Women who are not pregnant or menopausal and do vigorous exercise regularly may face missed periods. It’s called amenorrhea.

Learn from the experts

“Exercise-induced amenorrhea is a well-known phenomenon in athletic women. Any form of extreme exercise can cause a variety of menstrual dysfunctions,” says Dr. Nazia Dalwai, gynecologist, HCL Healthcare, Mumbai.

However, it’s not just exercise that you should blame for missing your periods, as it’s a combination of working out and not eating enough.

A study in Endocrinology and Metabolism that analyzed the relationship between calories, exercise and periods showed that a deficit of 470 to 810 calories per day for three cycles was enough to cause menstrual disturbances.

Basically, what happens is that when you exercise more and don’t eat enough, you create an energy deficit, and if your body doesn’t have excess fat, it starts to compensate by shifting energy away from certain bodily functions, like reproduction .

Also, Dr Nupur Gupta, director of obstetrics and gynaecology, Fortis Memorial Research Institute (FMRI), Gurugram, explains that excessive exercise can disrupt the menstrual cycle for several reasons:

• Change in body fat percentage: Vigorous exercise reduces body fat to levels that disrupt normal hormone functions and the production of estrogen needed for the menstrual cycle.
• Energy availability: High levels of physical activity cause excessive energy consumption, causing a disruption of the body’s energy reserves and a hormonal imbalance.
• Stress: Intense exercise can cause physical stress on the body, causing the release of cortisol and adrenaline, which can interfere with reproductive hormones.

Is it age related?

Experts believe that age may play a role in how exercise affects menstruation.

• Adolescence: Young women in their teenage years experience more pronounced effects of vigorous physical activity on menstruation. This is partly because their reproductive systems are still maturing and experiencing more imbalance due to high levels of physical stress.
• Reproductive age: At this stage, women may experience interruptions depending on factors such as training intensity, general health and nutrition. Therefore, maintaining balance is essential.
• Perimenopause and menopause: As women approach menopause, hormonal fluctuations occur. During perimenopause (the transition period to menopause), women notice more menstrual irregularities, which can be aggravated by extreme physical activity. The natural decline in reproductive hormones can make the menstrual cycle more sensitive to exercise.

“In all age groups, the key is moderation and balance. Adequate nutrition, adequate hydration, and a well-adjusted exercise regimen are essential to avoid hormonal imbalance. If menstrual irregularities occur, consult a gynecologist to assess the situation and get advice,” says Dr Gupta.

Don’t miss the signs

If you’re wondering how you can tell you may be experiencing amenorrhea due to overtraining, watch out for these symptoms:

• Missed periods: The most obvious sign is no periods for three or more consecutive cycles.
• Changes in the intensity or frequency of training: Recent increase in intensity or frequency of workouts, if coincident with missed periods, could be an indicator of exercise-induced amenorrhea.
• Fatigue and sleep disturbances: Overexercise can cause excessive fatigue, not normal fatigue. Next to this, sleep can be disturbed.
• Altered eating habits: An increase in exercise often comes with changes in eating habits and energy deficits.
• Weight loss or low body fat: Excessive exercise can cause significant weight loss and unusually low body fat percentages, affecting hormone levels.
• Emotional or psychological stress: This can also be due to excessive exercise.
• Physical signs of overtraining: This can include persistent muscle pain or injury.

According to Dr. Gupta, management of exercise-induced amenorrhea requires a multidisciplinary approach, including medical evaluation, dietary changes, and sometimes psychological counseling.

Is it a cause for concern?

Missing periods when you should normally have them can be cause for concern. Amenorrhea can be a sign of an eating disorder. It can also indicate low bone density.

It can also mean that your body is not in shape. We’ve often heard that we should eat less and move more, but if you’re restricting calories so much that you’re skipping your periods, it could mean your body doesn’t have enough fuel to function properly.

How to reverse it?

“For amenorrhea recovery, treat the cause,” says Dr. Dalwai.

The doctor adds: “In case of exercise-induced amenorrhea, eliminating stress, consuming a good nutritional diet, having a BMI of 17 is necessary for the maintenance of menstruation. Malnutrition or overfeeding are also not good for to menstrual functioning”.

What to do to avoid amenorrhea

• Avoid excessively long or intense training sessions without adequate rest. Balance your exercise routine with moderate intensity and varied workouts that include strength training, cardio and flexibility exercises.
• Pay attention to your body’s signals such as persistent fatigue, difficulty sleeping, irritability, or decreased performance. These are signs of overexertion. Adjust exercise intensity and timing if these signs appear.
• Consume a balanced diet that provides enough calories to match your energy production. This includes carbohydrates, protein and healthy fats. Carbohydrates help fuel longer, more intense workouts, while protein aids muscle recovery and repair.
• Dehydration can affect exercise performance and overall health. Ensure constant hydration before, during and after workouts.
• Recovery is just as important as training. Rest days in your weekly exercise program help your body recover and repair itself. Rest days, yoga, mobility stretches or quiet walks are beneficial.
• Manage stress through techniques such as yoga, meditation, mindfulness, or engaging in hobbies and activities you enjoy. High levels of stress can cause hormonal imbalances.
• Regular visits to a health care provider help monitor your health and ensure that exercise is not negatively affecting your reproductive health.
• Be aware of any changes in your menstrual cycle and consider how your exercise routine may affect your health.

“Following these guidelines can help you maintain a healthy balance between staying active and preserving your menstrual health,” adds Dr. Gupta.

However, it is still advisable to seek professional medical advice to tailor the plan that best suits your health needs.