I recently wrote about how I lost my period for years, and how my eating disorder and competitive running contributed to it. I never thought much about losing my period because dozens of people—doctors, coaches, friends—normalized the loss of menstruation for someone so physically active. I thought it was convenient, and largely ignored the handful of people who did express concern. But my period was never regular, and at 24, I could count the number of periods I'd had in my lifetime on two hands.
Menstruation is a normal bodily function. When normal bodily functions stop, something is wrong. Think how you would react if you woke up one day and couldn’t speak or use your thumbs. You would take immediate action to discern the underlying cause of your problem. Unfortunately, menstruation is not conceptualized in a similar way, and as a result, women who lose their periods suffer a myriad of negative health consequences.
Catherine Gordon, MD, director of the Division of Adolescent and Transition Medicine at Cincinnati Children’s Hospital, explains "when your body doesn’t have enough energy to keep your systems humming, it shunts energy away from nonessential functions like reproduction and growth, including building bone, in the name of survival."
Menstruation is a vital sign of bone health, but it can also indicate longer-term problems. Women who lose their periods often suffer from estrogen deficiency, their livers become taxed, and their cardiovascular health may be compromised, which can elevate cholesterol levels.
My irregular menstrual cycle was extremely unhealthy and likely occurred for a variety of reasons. Despite what many well-meaning people told me, I didn’t lose my period just because I was running so much. Nancy Williams, professor of kinesiology and physiology at Penn State University states that inadequate caloric intake in conjunction with exercise is more often the real culprit. I didn’t lose my period simply because I ran 35-40 miles a week in high school, and later 50-70 miles a week in college. I lost my period because I also wasn’t eating enough for my body to regulate properly.
Nicola Rinaldi, author of “No Period. Now What?” writes that, on average, it takes six months for a woman’s period to return after she has lost it. I can attest that it did in fact take a long time, and required a great deal of patience, self-love, and compassion. So, how did I get my period back?
I fueled my body. When I first started seeing a therapist, we worked on not counting calories. I deleted the calorie tracking app on my phone and worked on listening to my body's natural hunger cues. This was extremely difficult, and after a few months my period still did not return. I started counting calories again, but for an entirely different reason; instead of restricting my intake, I counted calories to ensure I was eating enough. I focused on ingesting high-quality, calorie-dense foods with healthy fats like avocados, flax seeds, coconut, and nut butters. These were all foods I restricted before because of their relatively high caloric value. I also began eating carb-rich foods before exercising, giving my body the fuel necessary to complete, for instance, a five-mile run. And speaking of running…
I worked out much less. Anyone who knows me knows that I love to work out, but I had to cut way back. My body needed less movement and more rest. I stopped running entirely for a few months and slowly worked my way up to 20, 25, and 30 miles. This was a win-win. I felt so much better on my runs, and I wasn’t depleted afterward. By not overly-stressing my body, I also felt better in the days following exercise. More importantly, I allowed myself to rest. If I was tired, I didn’t make myself work out, and my body thanked me for it. I also began practicing yoga, which was less strenuous than running and positively affected my mental health.
I took a few supplements. I worked with my therapist and a nutritionist to figure out how to fuel myself, and they suggested I take a few supplements. First, I prioritized taking an iron supplement since my ferratin levels have always been low. I take 25 mg of Thorne Research Iron Bisglycinate each night before bed with a vitamin C gummy to help it absorb. I also took a probiotic, magnesium, and a low dose of zinc (I don't take these anymore). The vitamin industry is not regulated by the Food and Drug Administration, so I followed the advice of healthcare professionals I trusted, who could point me in the right direction. After a few short weeks of diligently taking my iron supplement, I noticed I felt less fatigued, and when tested, my ferratin levels were substantially higher.
Rest. The final thing I did was prioritize rest. Like many people, I often feel pulled in a thousand directions. Compelled to stay busy all the time, I filled my calendar to the brim with social activities, side gigs, work, and hobbies. It was almost uncomfortable for me to be idle or to spend time with myself. As I’ve moved through Recovery, I’ve grown to cherish my alone time and make it a point to get adequate rest. “Adequate rest” isn’t a one-size-fits-all situation. Some days I need 8 hours of sleep, some days I need 10, and some days I get by on 6. Some days my body can handle running 20 miles, and some days my body needs to remain sedentary. The best thing I have done for my physical, mental, social, and emotional health has been to prioritize rest.
After my period became somewhat more regular, I went to my gynecologist to talk about birth control. I'm currently on Nexplanon, a birth control bar that is inserted into my upper left arm. Nexplanon lasts 3 years, and I like that I don't have to remember to take a pill every day. My period has been a bit wonky since the bar was inserted, but it's much more regular than it ever has been.
I will end with a crucial caveat: I am not a doctor/dietitian/therapist. What worked for me might not work for you, and I highly recommend you work with a professional to safely and healthfully regain your menstrual cycle if you have lost it, or if you are struggling with any type of mental disorder or illness.
P.S. If you or someone you love is struggling with an eating disorder, contact the NEDA helpline at: (800) 931-2237, find an EDA (Eating Disorders Anonymous) meeting near you HERE, or find a treatment center near you HERE.