Amenorrhea is the absence of a menstrual cycle or period; the most common reason for amenorrhea to occur is pregnancy. There are two types of amenorrhea; primary and secondary.
Primary amenorrhea is diagnosed when a girl has not started her periods before the age of 16. It may be due to an underlying genetic or anatomical problem e.g. polycystic ovary syndrome (PCOS).
Girls who are very active in their younger years may be more prone to primary amenorrhea.
Secondary amenorrhea is defined as not having a period/menstrual cycle for three cycles in a row or 90 days by someone who has had periods in the past. This is the most common type of amenorrhea. There is a high prevalence in females that are active, and there are a few reasons why it may occur:
-Exercise/fuelling balance – Energy availability
Doing a lot of exercise, especially if it is high intensity, puts a lot of stress on your body and requires a lot of energy to recover from and keep on going. If you don’t fuel this correctly, then menstruation could come to a halt.
Whilst doctors and scientists used to think that it was the overall energy balance in one day that was the most important factor in causing this type of amenorrhea (i.e. energy in vs. energy out over one day), new research suggests that the distribution of energy may actually be more important. Therefore, long periods of being in a negative energy balance during the day should be avoided.
-Stress, sleep, lifestyle
Extreme psychological stress, sleep deprivation (including shift work), long periods of travelling across time-zones, and rapid weight gain or loss can also cause secondary amenorrhea. Basically, if your body thinks that it wouldn’t be able to have a baby, or there could be a risk to the baby’s growth in vitro, then it won’t continue to menstruate.
Other reasons for secondary amenorrhea:
It should be remembered that pregnancy, use of certain medications (including some hormonal contraceptives) and gynaecological conditions can cause secondary amenorrhea.
What to do?
If any of these apply to you, or to someone you know, then the best thing to do is to seek professional medical advice. It is important that you speak to someone that you feel comfortable with and who understands the position you are coming from, and who you can work with closely to, hopefully, get a regular menstrual cycle.
Fuelling correctly is also incredibly important from a health and performance perspective as an exercising female. Make sure you plan your meals and snacks ahead and avoid long periods of being in a negative energy balance (burning more calories than you’re taking in) during the day.This is even more vital if you are going through a tough training period.