no period..

[maillotpois]

I didn't get a period for about a year between college and grad school. Over the course of a year I lost 60 pounds and was running regularly. While I was healthy, I wish I'd been more cognizant of the effect of missing periods on bone density, etc. Your body apparently can't absorb calcium without the hormones (estrogen I believe) present in a regular menstrual cycle.

so... You may be perfectly healthy amenorrhaeic, but see your doctor to be sure they don't want you supplementing with some hormone to make up for the loss.

Interesting that your base training is 100 miles per week higher than your race period (so to speak).

[ehirsch83]

I didn't get a period for about a year between college and grad school. Over the course of a year I lost 60 pounds and was running regularly. While I was healthy, I wish I'd been more cognizant of the effect of missing periods on bone density, etc. Your body apparently can't absorb calcium without the hormones (estrogen I believe) present in a regular menstrual cycle.

so... You may be perfectly healthy amenorrhaeic, but see your doctor to be sure they don't want you supplementing with some hormone to make up for the loss.

Interesting that your base training is 100 miles per week higher than your race period (so to speak).

I need to start taking calcium!! Thanks for bringing that up. I had thyroid cancer a few years ago and had a total thyroidectamy. So along with no thyroid, some of my parathyroid glands were destroyed. So that plus this added up means I really need to see a dr. and see about supplementing.

During race season I focused more on 2 hour rides, since crits here are 45 min +3 laps. Now that race season is over, I have switched to slower longer endurance rides and am not working on power like I was.

[indysteel]

I would definitely recommend seeing a doctor. Taking a supplement won't do any good if your body--because of low estrogen levels--can't absorb it.

For the first time in my adult life, I missed my period this month. And believe me, I'm not pregnant! I'm hoping it's a fluke, but I lost 5 pounds during my bike trip to Tennessee. While my weight in still in the "low normal" range for my height, I have to wonder if the weight loss is to blame. I've been eating to beat the band since getting back a month ago, but to no avail. Now that my braces are on (as of yesterday), I'm a little concerned that I will lose even more weight given that eating is a bit of an ordeal.

[maillotpois]

Ditto on the seeing a doctor and not just relying on the supplement - she's right - your body simply won't absorb it without the hormones.

And duh on the race/base - I was a bit distracted yesterday.

[velogirl]

but still, 20 hours a week? are you a pro? I've got CAT1 and CAT2 male clients who don't train 20 hours a week. that's an awful lot of saddle time.

[Eden]

but still, 20 hours a week? are you a pro? I've got CAT1 and CAT2 male clients who don't train 20 hours a week. that's an awful lot of saddle time.

I'll agree, that is a lot of time. It can be hard, because I like long rides, but my coach gives me few of them. Because our races are generally shorter, its felt its best to train to those distances. This year I'll be doing some longer training rides, as now in the 3's the race distances will be averaging 50-60 miles rather than 25-35 for the 4's, but still I'm certainly not putting in 20 hour weeks, especially not now. I've got about 8 hours/week, with some of that being core work right now, it will climb some as race season approaches, but not up 20 hours.

[Wahine]

but still, 20 hours a week? are you a pro? I've got CAT1 and CAT2 male clients who don't train 20 hours a week. that's an awful lot of saddle time.

That was me that said I train 20 hours a week in my base period. What I should have added was that that's my Ironman training schedule and includes all three disciplines. Sorry for creating any confusion.

[velogirl]

you triathletes are crazy! oh yeah, I'll be focusing on triathlon next season. did I really admit to that? right now I'm just running and riding and lifting and it's definitely sucking the hours out of me. I have no idea how I'll fit swimming in there come December.

oooppps! didn't mean to drift.

[HappyAnika]

Your body apparently can't absorb calcium without the hormones (estrogen I believe) present in a regular menstrual cycle.

So this is a bit of a drift from topic, and I'm sorry if it's a stupid question (I know very little about biology/physiology) . . . What about the new birth control pills where you only have 1 period a year? Does this pose problems with calcium absorption? Or do the hormones in the pills keep everything reasonably balanced?

[AuntieK]

Just a thought, but is stress an issue in your life right now?

The way I understand it, ovulation can be put off by stress. If ovulation is delayed, your period will be, too.

But, I'm not a Dr. either. I would also suggest seeing a Dr. if you're concerned.

Sorry, HappyA, I have no answer for you. I tried that route once, but it didn't work for me. Just set my cycle into continuous bleed -- opposite of what I was looking for!

[Wahine]

So this is a bit of a drift from topic, and I'm sorry if it's a stupid question (I know very little about biology/physiology) . . . What about the new birth control pills where you only have 1 period a year? Does this pose problems with calcium absorption? Or do the hormones in the pills keep everything reasonably balanced?

The body requires naturally occuring steriods (progesterone and estrogen in women and testosterone in men, although women produce testosterone as well but at a much lower level), to maintain bone mass. This is related to the bodies ability to assimilate minerals and calcium into bone. BC pills work by providing a continuous levels of pro. and est. that mimics pregnancy and subsequently ovulation. So I would assume that these new generation BC pills would still allow for normal absorption of nutrients into bone. I don't know that for sure but it's good in theory. In fact, I believe that some anorexic women are placed on BC pills to try to prevent bone loss as their bodies are no longer producing the required hormones.

Men also get bone density problems if they do not have enough testosterone in their system. The first treatment in these cases is testosterone replacement therapy.

[michelem]

In fact, I believe that some anorexic women are placed on BC pills to try to prevent bone loss as their bodies are no longer producing the required hormones.

"Estrogen Supplements Do Not Appear To Prevent Bone Loss In Anorexics"

BOSTON, MA -- November 21, 2000 -- More than 90 percent of young women with anorexia nervosa were found to have significant bone loss in a study conducted at Massachusetts General Hospital (MGH). The report, appearing in the November 21 issue of Annals of Internal Medicine, also found that taking estrogen did not seem to reduce the risk of bone loss. "While it is well known that bone loss is a significant problem for women with anorexia, this study shows how extensive the problem is and characterizes factors that predict bone loss," says Steven Grinspoon, MD, the paper's lead author, who is on the staff of the MGH Neuroendocrine Unit. "It also shows that regaining and maintaining a healthy weight is key to preventing or reducing bone loss." David Herzog, MD, director of the MGH Eating Disorders Clinic and a study co-author, adds, "Anorexia and its associated bone loss are very serious medical problems that present difficult challenges to both patients and the clinicians who care for them. We hope one result of this study will be to help motivate women with anorexia to get the treatment they need." Patients with anorexia nervosa - an extreme loss of weight associated with seriously restricting food intake, an unrealistic fear of weight gain and a distorted body image - are at risk for a number of serious, even life-threatening health problems. A loss of menstrual periods, associated with disruption of normal levels of estrogen and other hormones, is a hallmark of anorexia in women. Loss of bone mass, sometimes leading to fractures, is a significant complication in most women with anorexia, but it was not previously known whether that bone loss resulted primarily from the estrogen deficiency or from overall malnutrition. The study enrolled 130 women in their mid-20s with anorexia nervosa, most of whom did not have normal menstrual periods. Some participants had resumed periods while taking supplemental estrogen, primarily in the form of birth control pills. Participants all were living in their communities, not hospitalized for treatment of their illness. The research team gathered detailed histories and measurements on the participants - including menstrual history, estrogen use history, fracture history and frame size - before conducting bone density measurements of the spine and hip. The results showed that 92 percent of study participants had significant bone loss (osteopenia) in at least one of the sites measured, and 38 percent of participants had bone loss serious enough to meet World Health Organization criteria for osteoporosis. Broken down by site of measurement, more than 50 percent of the women had osteopenia at the spine and almost 25 percent had osteoporosis; and 47 percent had osteopenia measured at the hip with 16 percent having osteoporosis. Of numerous other variables recorded, weight was the most powerful predictor of bone loss at all sites, with those women who weighed the least showing the most serious bone loss. Menstrual history also correlated with spinal bone density, suggesting that estrogen deficiency plays a greater relative role in spinal bone loss than in loss at other sites. Current estrogen use was reported in 23 percent of participants and previous estrogen use reported in 58 percent of participants. However, estrogen use had no effect on bone density at any of the sites measured. Use of calcium or Vitamin D supplements similarly had no effect. Anne Klibanski, MD, director of the MGH Neuroendocrine Unit and the study's principal investigator, says, "Some of these young women are experiencing bone loss comparable to that of women many decades older, despite estrogen therapy. Given this severity and the prevalence of bone loss, the importance of screening all women with anorexia for osteoporosis cannot be over-emphasized. Other studies have shown that some degree of bone loss in anorexia may be permanent, so it will be critical to develop new therapies to prevent and treat bone loss in these women."

____________________________________________

Adolesc Med. 2003 Feb;14(1):97-108.
Osteopenia and osteoporosis in anorexia nervosa.
Golden NH.
Eating Disorders Center, Division of Adolescent Medicine, Schneider Children's Hospital, New Hyde Park, New York, USA.

Osteopenia is a frequent and severe complication of anorexia nervosa. Once established, it is difficult to treat and is only partially reversible. Osteoporosis is a preventable disease, and intervention should begin during childhood and adolescence. Optimizing peak bone mass accrual during adolescence is essential, and an episode of anorexia nervosa during adolescence interferes with that process. In anorexia nervosa, results with hormone replacement therapy have been disappointing. Calcium and vitamin D supplementation should be prescribed where necessary. Excessive exercise should be avoided and moderate weight-bearing exercise encouraged. Until more effective treatment regimens become available, the mainstay of treatment remains weight gain, nutritional rehabilitation, and spontaneous resumption of menses.

________________________________________

[Jolt]

According to the info in "The Complete Book of Running for Women", current theory is that amenorrhea occurs when you're not eating enough to meet your body's caloric needs. So it could be a simple fix, but it's still a good idea to get checked out.

[Wahine]

Thanks Michelem for the research info. I hadn't seen anything to support or dispute the use of BC for preventing bone loss. I only knew that it is being used by MDs in some places. Interesting information.

[paytash]

ehirsch83- Are you presently taking thyroid replacement pills? Have you had your levels checked recently ( you mentioned no insurance...)? There are so many reasons for missing periods that may or may not be related to training. With your health history you really need to see a dr . I don't know what a physicians' visit costs , but you are investing so much time and effort into your health via exercise that I think the financial cost of a drs visit is worth it.
Keep us posted.........