Hypothalamic Amenorrhea - Losing a Period as a Weightlifter

This article gets a bit personal, and I’ve been sitting on releasing this one for several months now because of how close it cuts to my heart.

But, I realize the best thing that I CAN do in order to inform everyone else and to bring light to such a big issue is to post about this. I’m not looking for sympathy. I’m not looking for a bunch of sorry messages and posts about, “oh, I’m so concerned for you honey!” because I already know, and I’m working hard to reverse the damage done.

I feel that the topic of lost periods isn’t really bounced around much in the world of weightlifting or CrossFit, yet we see this medical symptom all the time in other high intensity sports where there’s huge pressure to maintain lower body weight for performance, such as running, triathlons, gymnastics, and many other endurance activities.

Hypothalamic Amenorrhea (HA) is a loss of a menstrual cycle due to hormones not behaving the way they should – specifically the ones that are linked to the part of your brain (the hypothalamus) responsible for general survival and regulation of reproductive cycles. Usually most women experiencing this have very low level of hormones (progesterone, estrogen). HA  often a “diagnosis of exclusion” meaning you have to rule out all possible other issues (PCOS, hypothyroidism etc) to be able to conclude that this is the issue. Please see links and other resources listed at the bottom of this post for more information.

Most of the stereotypical women we hear about who experience HA are huge endurance freaks, are underweight, constantly doing TONS of cardio, severely low in body fat (< 19%), and under a BMI of 22.

BUT, I’m a weightlifter – I have a BMI of 23-24 (I currently weigh 54-55kg on a daily basis at under 5’0″) and seriously am approaching the “overweight” category.

I only have 4 training sessions a week of just lifting – no crazy intensive hours of “cardio” or what have you. My BONES are even strong because I freakin’ LIFT WEIGHTS (even got a Dexa scan to prove this, because women experiencing the female athlete triad are generally more prone to lower bone density due to lower estrogen levels from low body fat%)

Yet, I still don’t have a period?

Listen, ladies, it CAN happen to you unfortunately. Here I am, as a moderately competitive national-level athlete coming out of the woodwork to share my experiences and warning to many of you. This is my story dealing with this inner battle between wanting to be competitive in weightlifting, but also wanting to be healthy, and deciding which of the two I value more in my life. As a disclaimer, note, I am not a medical professional by any means, and I HAVE made visits to my primary care doctor and gynecologist to do some testing necessary to reaffirm what’s the real cause or culprit of my problem – I’ll touch on my experiences with this in a future article.

Those Inspirational Strong Bodies – Are They As Healthy As We Thought They Were?

Now, this is probably because I have lived and trained in the world of crossfit and weightlifting now for several years. My entire facebook feed, instagram feed, community I surround myself with and social groups are all obsessed with crossfit and lifting. Every day I keep seeing photo after photo of top regional and games athletes, world-class weightlifters, and even just friends or clients I train and members at my own gym doing amazing things with their bodies because it’s simply what shows up on my feed based on who all my friends are and who my community is. (Yes there’s a lot of baby pictures and Tasty videos and dog videos as well, but you get what I mean.)

“Strong is Beautiful.”

It’s about what you can do and not necessarily how you look, right?

Problem is, I’ve been striving to achieve what I thought was “my ideal body”now for my whole life. I’ve always thought that having this body composition would make me happy and give me much more joy and satisfaction in my life. People give me praise all the time for how lean and strong I look, and all of the things that I can do and all the weight I can lift with my body. This body is and has been my identity now for several years.

Being Too Lean vs Where I am Today - Developing Secondary Amenorrhea as a Weightlifter

 

But now that I’ve achieved this body, I’ve come to realize that it’s actually not as healthy as I perceived it to be…nor what the media or a lot of people I surround myself with perceive it to be.

Sometimes the body that we *think* we would like to have and that will make us happy (and that we constantly see a lot of athletes have) is NOT a true healthy body.

In fact for women, I’ve shifted to the mindset that a truly beautiful and healthy body is a fertile body.

I would honestly love to know how many weightlifters, crossfit athletes who are supposedly ripped, less than 18% body fat actually HAVE their periods or who have developed secondary amenorrhea. I NEVER hear any high level athletes discussing or talking about it out in the open. Because of this, many of us who love to weightlift, who love to crossfit or engage in this type of training (even not at a competitive level) start to lose our periods and think that “it’s not fair!” “why is this happening to me?” when supposedly other females out there who seem to be training much harder, who have much leaner bodies haven’t said a word or still have their periods.

Is it really not fair?

The Dark Side of Being Too Lean – Reasons Why I Think I Developed Hypothalamic Amenorrhea

I don’t have a period right now.

This is not. a. good. thing. Doesn’t matter whether I’m a competitive athlete or not, or “whether I’m not as lean than they are”…this is serious business.

My story of how I developed HA will undoubtedly be much different from yours or anyone else’s.  I can’t say that the answer to solve this issue will be the same for you, me, or everyone, because we all have our own unique individual circumstances, bodies, hormones, and lives. Mine never came back after I got off of birth control. Many others find they lose theirs through means of restricted eating, cutting weight, exercising too much, or other related variables.

But here are a few of the possibly culprits and reason why I think mine never came back to me and how I developed hypothalamic amenorrhea:

 

1. I probably developed HA because my Body Fat % is too low despite having a regular “BMI”

It’s kind of disheartening and upsetting to me that even at the weight I currently am for my height that I still fell victim to developing a loss of a period.

It’s not like I cut way down to a 48kg class (like many women at my height choose to for competition) – in fact, I had to accept that the 53kg class was where I was meant to be to retain my sanity (and not feel like I was restricting and cutting my food all the time for the amount of lifting I was doing), but also for general feminine health.

Turns out, my body weight is still not heavy enough. Or rather…my body fat percent is too low.

After recently doing a bod pod test and finding out that I sit at around 17% when I’m near competing for weightlifting…I realized my body fat is too low for general female health reproduction.

Apparently, ovulating and conceiving a healthy and happy child is nature’s way of expressing that your body is in a hormonally balanced and healthy state. When a female does not ovulate, it means that she is probably too stressed or not in a state that she can grow a happy baby. Note though, that we might feel mentally stable and happy on the surface (lifting & smashing PRs in the gym and all the things!) – but it’s our primal senses (AKA the hypothalamus) which drives our very basic functions and needs and actually decides if we are “stressed”. If you want to read more about this, the book No Period Now What is a fantastic read.

Although I am considered almost overweight, unfortunately stress of being a competitive weightlifter, meeting training requirements, watching my food intake like a hawk, alongside a general obsession of “having an attractive body” has led me to develop HA and maintain it for the past few years.

2. I probably developed HA because I have a history of having a very strong “dieting” mindset of monitoring food

Although on the outside I seem so proud and happy of the body composition I have achieved and I strive to eat “healthy”, my inner mind is screaming at me for undergoing such “restriction” for an extended amount of time. Truth is, I can’t lie to myself and I can’t cover it up. I thought for the past several years that my new healthy ways – my strive to maintain a diet focused on mainly whole, nutrient-dense & unprocessed “paleo” foods – was much better for me than my former overweight high school / college self. Turns out, I’m partially wrong. The past few years I have been:

  • Saying “no” to certain foods because I felt they would make me too bloated or gain weight when I was trying to maintain a weight class (i.e. NO GLUTEN which is true, I do get a little puffy with bread)
  • Watching my macros & weighing my protein intake – I’ve always striven to hit numbers when it comes to food, and really ignored my body’s natural hunger signals because I didn’t trust them because I would literally eat ALL THE THINGS if I listened to when my body wanted to eat and what it wanted to eat all the time. A whole avocado instead of 50 grams? I could down that easily! Because I didn’t trust myself, I fled to hard numbers and science to make sure I was eating AS MUCH as I could to still maintain my weight class. Zone, Renaissance Periodization, you name it.

And well, it comes to no surprise that it was when I started having this very restrictive mindset about food a few years ago that any sign of a period disappeared.  So, even when I did stop being on any birth control in hopes of getting a period back – even after 1.5 years it still has not returned.

BUT WAIT, how can you say that?! I’m eating healthy, wholesome, non-processed foods. Most of y’all know me – I really don’t drink, have pizza, pasta, donuts, fast food, or anything like that often at all.  What gives? Shouldn’t my health be even better?!?

Well, this is just one possible culprit – not saying it’s the only one, but there could be many factors at play here.

3. My HA probably resulted from a slow, unnoticeable shift towards more physical stress due to wanting to PR and be better at everything.

It’s tough to say that there was one big major event that caused everything. In fact, there are a LOT of little factors that all individually have contributed and built up into one larger problem over time. Every last little piece needs to be accounted for:

  • diet & nutrition
  • body composition
  • training volume & frequency
  • hormone level changes
  • having been on birth control for extended periods of time
  • stress of life & work
  • stress of moving across the country
  • weight fluctuations with training & cutting for meets
  • stress of competition
  • mindset <======== this one should not be overlooked that easily.

As much as I wish it was just ONE big thing I could change in my life, working to get my period back means working on improvement and tackling ALL of these areas in my life. That means shifting my mindset away from one that I’ve had for the last several years of what a REAL healthy female body should be like.


Where I am now and what I’m working for:

I’m a bit stubborn, honestly.

I love lifting, and I love competing. I know for certain if I decide to give up my life of lifting for an extended amount of time and just gain back a bunch of body fat, stop working out all together that my body will result back to the fertile self it used to be several years ago. But I’m too stubborn to give up just yet.

I cross my fingers that there is some hope that by having a huge shift in mindset from “being as lean as possible” to “be as absolutely plump, fat, and nourished as possible while still being able to compete as I can in the 53kg class” that I may get it back soon.

That’s right, you heard me….”fat”. And I’m OK with that. As in, I’m done trying to work to maintain some “6-pack” anymore. I’ve accepted my body needs some more curves, bumps, and jiggle. But as much as possible while still lifting as a 53kg… (which by all means isn’t a low body weight for my height, it’s just that I have so much darn muscle mass!!).

I currently have been working with Working Against Gravity to monitor my macros and find the right caloric needs for me that allow me to stay around the weight class that I need choose to be at while minimizing any amount or feeling of restriction. Again, I’ve gotten done plenty of blood work and tests…I don’t have any other abnormal medical issues (such as PCOS) or thyroid issues per what my doctor/OBGyn say so far, though possible second opinions might be needed if things don’t change over time.

I hope that one day, many other top-level strength-focused athletes whom have these “inspirational bodies” that we wish we had can come out and confess whether they also deal with amenorrhea or not – that the many (or few) of us who do don’t feel alone anymore, or that something is “wrong with us” when really it’s a much larger issue that it appears to be.


I invite many of your comments and questions you have about my experience below and I’ll respond to them as truthfully and as honestly as I can.

 

Some Resources:

National Institute of Child Health & Human Development – Secondary Amenorrhea

Paleo for Women: Hypothalamic Amenorrhea

Book: No Period, Now What? (a really good read for those of you experiencing HA…warning, very emotional)