For female athletes and fitness enthusiasts, training hard is a sure route to peak performance and a healthy, athletic physique. Until it is not. For women, overexercising, particularly when accompanied by restricted nutrition, can lead to a decrease in hormone production and a disruption in your monthly cycle. Decreased production of estrogen can also lead to osteoporosis and set you up for potential injury that can take you out of the game.
The Menstrual Cycle
Your menstrual cycle begins with the onset of bleeding. As the month progresses, four hormones regulate a sequence of changes that occur throughout the cycle. Follicle-stimulating hormone, or FSH, stimulates follicles in the beginning of the cycle that cause the egg to mature. The egg and the follicle become ripe and ready to be fertilized at mid-cycle, about 14 days after the onset of bleeding. Around this time, you experience a spike in estrogen, followed soon thereafter by a spike in leutinizing hormone, or LH, and more FSH. Estrogen and progesterone work together to prepare the uterine lining for a fertilized egg. If a fertilized egg does not implant, estrogen and progesterone levels drop, and the uterus sheds its lining, marking the onset of a new cycle.
Estrogen and Amenorrhea
Intense exercise can lead to altered hormone levels, including a drop in estrogen production, which in turn can lead to oligomenorrhea, meaning irregular menstrual cycles, or amenorrhea, a complete cessation of menstruation. When menstruation stops, ovulation is disrupted. Sports coach Brian Mac notes that intense training is not the only factor involved in amenorrhea. Mac points to stress from trying to juggle training, competition, family and school or work, and to too-low body fat that inhibits estrogen production as contributing co-factors.
Female Athlete Triad
Female athlete triad is a cluster of symptoms and behaviors that begins with overtraining and disordered eating, leading to a drop in hormone production, amenorrhea, and eventually, osteoporosis. According to the NCAA, estrogen is necessary for the building and maintenance of healthy bone. In amenorrheic athletic women, low levels of estrogen can lead to rapid loss of calcium from the bones. A female athlete can lose up to five percent of her bone mass per year. Loss of bone can make an athlete more vulnerable to stress fractures and more prone to injury.
The Role of Nutrition
For women who train hard, nutrition plays an important role. According to the NCAA's "Coaches Handbook for Managing the Female Athlete Triad," disordered eating does not necessarily mean a full-blown clinical disorder like anorexia or bulimia. Disordered eating can simply mean consuming too few calories and other nutrients to offset the amount of energy expended during exercise. Athletic women striving for a thin physique or low body weight are at risk for disordered eating, leading to a disruption in the monthly cycle.
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