Female Health: Periods, PBs and Extra Pounds

Neady83

This article popped up on my FB feed earlier and I thought it was an interesting read.

I think this this has been touched on in some logs and other threads here but maybe it deserves a thread of it's own.

Weight, periods and the effects of contraceptives on bone health is probably something we don't talk about enough.

Back in my late teens, I had issues with being underweight and my whole body shutting down though thankfully I didn't have an eating disorder, it was a chain of events that conspired to cause a few issues for a few years. Getting into mountain climbing and running has had a very positive impact on my overall health in that I'm much more educated about food and my body.

It seems that this girl has had a good outcome by being open with what sounds like a very open and knowledgable coach.

Annie get your Run

That’s a great article. Although not in the same league, developing Graves’ disease was almost certainly a result of over training / trying to achieve goals greater than my capabilities. A big part of that was a considerable weight loss which is reversing itself now (and as a separate issue dealing with emotions around that) and all the effects that brings on your body . I will admit to being delighted with the weight loss and it’s (Ill) affects but understand it wasn’t real or healthy.

She was very lucky to have a coach that understood and is prepared to tailor her training based on her health issues and goals - no matter what level you’re at having help like that is key to recovery and future gains.

RacoonQueen

I don't think disordered eating and problems caused by low weight is a female athlete only problem. But for hormonal reasons...side effects for us can be a lot more extreme. Aside from that, the whole periods and hormone thing is unique to us...can be a huge blocker for women improving their performance if they're incapable of training properly / much / at all for a week of ever month. The boys don't know how lucky they are.

OOnegative

http://www.bbc.com/sport/tennis/30926244

Remember reading this in relation to Jessica Judd and how her period affected her times so much.

TFBubendorfer

There's an even more drastic case. Have a look at the story of Bobby Clay (she's mentioned in the original article). She ran at a very high level (she was 1500 meters European junior champion in 2015) but at the age of 20 still never had a period. It got so bad she developed osteoporosis and her bones got so brittle she broke a foot while swimming :eek: and a stress fracture simply by sitting down too hard on a chair :eek::eek::eek:

This should be required reading for all young athletes, especially girls

http://www.athleticsweekly.com/performance/bobby-clay-my-osteoporosis-nightmare-70422

Annie get your Run

OOnegative wrote: »

http://www.bbc.com/sport/tennis/30926244

Remember reading this in relation to Jessica Judd and how her period affected her times so much.

Jesus that's mental, getting injections to stop periods, going on the pill etc etc purely to get the best performance possible but the worst part is male doctors giving female junior athletes medications to postpone a period, that's quite shocking.

RacoonQueen

Annie get your Run wrote: »

Jesus that's mental, getting injections to stop periods, going on the pill etc etc purely to get the best performance possible but the worst part is male doctors giving female junior athletes medications to postpone a period, that's quite shocking.

It's bizarre to me what doctors do for athletes thinking of some of the questionable TUE's out there. Surely going against their vow to y'know help people?

Keeks

RacoonQueen wrote: »

It's bizarre to me what doctors do for athletes thinking of some of the questionable TUE's out there. Surely going against their vow to y'know help people?

Its not just Athletes.....they do questionable things for ordinary people too....

HelenAnne

I've read a lot of articles on this topic on social media etc recently. It's scary to think that so much of your bone strength is laid down before your mid-twenties - exactly the time of life you're NOT thinking about the future etc!!

I was also really surprised to hear female runners could become ammenorrheic at relatively high / normal weights / bmi-s; I'd known about the female athlete triad for years but imagined it only affected elite athletes training very hard and with very low body weight, but (& I can't remember which episode this was!) there was a discussion on Marathon Talk recently and it seemed to suggest that it was very individual - some runners were losing their periods if their body fat went below about 20-21%, whereas others were perfectly healthy at 15% body fat. So it's worth keeping an eye on energy levels / periods etc even if you wouldn't consider yourself high risk. Also, I heard another interesting interview on 'Running on Om' podcast last year, where Lauren Fleshman was answering a query from a runner who was finding it hard to get pregnant - the runner asking the question was a recreational runner, not an elite, and wouldn't have considered herself underweight, but the advice was still to cut back on training / eat different foods / refuel after training etc etc.
Sorry, that's all very vague because I haven't included links (I THINK the Marathon Talk one was ep 408 with Liz Yelling), but to make my rambling point shorter: as well as young, elite, very light runners being affected by RED in running, it's something all women probably need to bear in mind if they're exercising and trying to conceive, and all runners probably need to pay attention to their diets / bone healthy etc. (For those of us who already eat enough, but are getting on a bit - me - a bit of strength work to preserve the bones we have probably wouldn't go astray either!)

HelenAnne

Annie get your Run wrote: »

... A big part of that was a considerable weight loss which is reversing itself now (and as a separate issue dealing with emotions around that) and all the effects that brings on your body .

I know what you mean! No matter how sensible we think we are, I think we are a bit conditioned to think lighter is better, whether that's for running, or just to conform to what's considered attractive ... I lost quite a lot of weight immediately after I had surgery last year - about ten pounds in a couple of weeks. Even though I was actually a bit worried by it, and I knew it was from loss of appetite, and probably muscle loss as well, and i certainly couldn't have run anywhere at the time, I still had to give myself a talking to not to be disappointed when the numbers on the scale started creeping back up to normal

diego_b

Related to the above, Tina Muir was on the Kinetic Revolution podcast recently with an show/interview/q&a recorded from a few months back where she had stopped running. One item she mentioned was that she hadn't had a period for 9 years and was taking a break from running for a bit to try get back to normal.
It's a very good interview in general but seeing the post above just caught my eye to mention it here.

She's just had a new baby in the last few weeks

She also has a huge blog post on her taking a break here:
https://tinamuir.com/stop-running/

HelenAnne

I was just thinking about this thread and I remembered when TFGR posted on her blog about body composition testing and she said they’d said to her that fat for women should be 12-15%. Does that mean ‘essential fat for women should be 12-15%’ or overall body fat for fit women? Based on what all the blogs above etc are saying 12-15 sounds v low doesn’t it?
Just wondering what runners would consider a normal, healthy level for active women?

annapr

HelenAnne wrote: »

I was just thinking about this thread and I remembered when TFGR posted on her blog about body composition testing and she said they’d said to her that fat for women should be 12-15%. Does that mean ‘essential fat for women should be 12-15%’ or overall body fat for fit women? Based on what all the blogs above etc are saying 12-15 sounds v low doesn’t it?
Just wondering what runners would consider a normal, healthy level for active women?

Healthy body fat % for normal women is up to 30%... there's a wide range of 'healthy', but over 30% is usually considered above it, varies by age, etc..

For athletes, the %'s are obviously lower but some scales suggest ESSENTIAL fat for women is 10-13%. And yes, I would think 15% is very low for most women, even regular runners (not talking about Olympians who are pushing their bodies to extremes as those articles above show).

TFBubendorfer

HelenAnne wrote: »

I was just thinking about this thread and I remembered when TFGR posted on her blog about body composition testing and she said they’d said to her that fat for women should be 12-15%. Does that mean ‘essential fat for women should be 12-15%’ or overall body fat for fit women? Based on what all the blogs above etc are saying 12-15 sounds v low doesn’t it?
Just wondering what runners would consider a normal, healthy level for active women?

12% body fat for women is a critical threshold, anything below that is actually unsafe and dangerous.

Even 15% is very low. A woman with 20% body fat would still be very lean and that would be a typical value for an (amateur) athlete, so I have serious doubts about those numbers. Anybody recommending numbers like 12-15 is grossly irresponsible.

HelenAnne

TFBubendorfer wrote: »

12% body fat for women is a critical threshold, anything below that is actually unsafe and dangerous.

Even 15% is very low. A woman with 20% body fat would still be very lean and that would be a typical value for an (amateur) athlete, so I have serious doubts about those numbers. Anybody recommending numbers like 12-15 is grossly irresponsible.

Thanks! That’s what I thought - it was just a bit unclear - she said (& it was a video blog so that must be why I misunderstood) that a certain level of essential fat was necessary. Then in a new sentence said they’d recommend 12-15%. That must have meant 12-15% essential fat was recommended.
I was just wondering, because a lot of the articles quoted earlier in the thread seemed to say it’s quite a fine line between being lean but healthy and going into RED and I thought 12 % sounded v lean (even for an Olympian or elite - plus I think elite athletes are at their leanest for competition etc, even they don’t maintain those levels year-round.
Btw I was only asking generally because of the topics covered on this thread, I’m nowhere near those dangerous levels myself, nor am I aiming for them!
Thanks for the responses

hillsiderunner

Neady83 wrote: »

Weight, periods and the effects of contraceptives on bone health is probably something we don't talk about enough.

In the other direction, too much bleeding can also damage bone health by running down the iron reserves. You can't win :rolleyes:. In-situ contraception may improve things by reducing the blood lost each month without messing with hormones.

Apart from all of that we are losing bone mass from our thirties onwards, and running doesn't help (*sob*). I bought a copy of this last autumn though I'm not finished it yet:
https://www.goodreads.com/book/show/9097291-the-endurance-paradox
There is some good stuff in there but it asks a lot in terms of eating-the-right-stuff and weight training etc.

Never further from an eating-issue on this side of the screen but I've had a few of these bone injuries regardless.

rainbow kirby

No bone injuries here in nearly 10 years of running - any of mine have been either soft tissue or ligaments. I'm quite chunky by running standards though!

No issues of the lady kind due to running either, and only stopped running 4 weeks before my second son arrived.

Neady83

hillsiderunner wrote: »

In the other direction, too much bleeding can also damage bone health by running down the iron reserves. You can't win :rolleyes:. In-situ contraception may improve things by reducing the blood lost each month without messing with hormones.

Apart from all of that we are losing bone mass from our thirties onwards, and running doesn't help (*sob*). I bought a copy of this last autumn though I'm not finished it yet:
https://www.goodreads.com/book/show/9097291-the-endurance-paradox
There is some good stuff in there but it asks a lot in terms of eating-the-right-stuff and weight training etc.

Never further from an eating-issue on this side of the screen but I've had a few of these bone injuries regardless.

Likewise, I've been lucky enough not to suffer any bone injuries. I take an over the counter calcium supplement every day because the doc recommend it due to the contraceptive that I'm on. Reduces blood loss but increases the chances of osteo - you can't win

That's an interesting book - there's a copy winging it's way to me now, thanks for the recommendation.

Actually, speaking of iron levels and supplements. I've given up trying to get enough iron into me through my diet, it's never enough and I can feel the fatigue creeping in all too frequently so I've been taking glafer iron tablets with folic acid and a glass or orange juice every day but for the last month I've been taking Feroglobin slow release tablets and I'm not falling asleep in seminars and lectures anymore I'd highly recommend them to anyone taking iron - much easier on the tummy too.

hillsiderunner

Neady83 wrote: »

Feroglobin slow release tablets and I'm not falling asleep in seminars and lectures anymore I'd highly recommend them to anyone taking iron - much easier on the tummy too.

I was on ferrous fumerate last winter and it worked to bring the iron levels up quite fast. Taking nothing right now as the mirena should have fixed everything, but I'll admit I was supposed to go back to get the ferritin checked before Christmas and forgot all about it.

Also have no idea how you'd get the RDA of iron in a modern diet looking at the statistics ...

The book doesn't have lots about the female angle - seems male runners also weaken their bones with increased mileage - but is good on what we all should be doing to improve bone strength.

Annie get your Run

I’ve tried taking iron a few times over the years but it seems to have a negative affect on me (them again so have multi vits) I was assured on more than one occasion that levels were fine although I understand that ferritin (?) levels are not checked in normal bloods. I doubt my diet is any better than anyone else’s although I do eat quite an amount of broccoli!

rainbow kirby

When I've had low iron in the past I found Ferrograd C good - the vitamin C helps absorption and they are extended release so less hard on the stomach. Difficult to find here though, which is annoying because I could do with them now tbh.

Kellygirl

There’s a fairly new iron tablet out called Active Iron. I’ve just finished a 3 month course of it and it’s the only iron supplement I’ve ever tolerated. Others have made me collapse and all sorts including Ferrograd C.

HelenAnne

Annie get your Run wrote: »

I’ve tried taking iron a few times over the years but it seems to have a negative affect on me (them again so have multi vits) I was assured on more than one occasion that levels were fine although I understand that ferritin (?) levels are not checked in normal bloods. I doubt my diet is any better than anyone else’s although I do eat quite an amount of broccoli!

I think everyone must just process the vitamins / minerals etc in food differently. I've been vegetarian for decades, and I look kind of pasty and anaemic, so doctors etc always think my iron will be low, and it never is - I'm bursting with iron, apparently. And like you, I don't take any special pains with my diet.

Runners do seem to get more anaemic, or at least I hear my running friends talking about it more, but I don't know if that's RED, or footstrike anaemia, or if it's just that as runners we're more tuned in to how we feel / our energy levels, so a runner might go and get checked out for drop in energy levels that might pass a more sedentary person by?

I know someone (who does run now, but wasn't running when this happened), who put her tiredness down to winter and minding a toddler for ages, until a blood test picked up very low B12 and she instantly felt better when that was replenished. But probably someone in marathon training would have noticed the dip in energy levels sooner as they're expending more energy?

Anyway, just came on to boast about my high iron levels

Neady83

Stuck episode 200 of Fitter Radio on yesterday to keep me entertained during my run. Weirdly enough, it starts with Bevan and Mikki discussing sound engineer Chris getting her period a few days before an ultra and discussing how it is fantastic timing as she will have more testosterone, feel stronger and be more carb tolerant for the race so will be able to hit it hard. Great to hear them discussing it.

They only touch on the period thing but as an aside, it's a great episode as they discuss the merits of the timing of workouts - so much to learn

Baby75

I am glad I opened this to read I've been feeling a little tired lately and wondered if it was my thyroid but could well be Iron or the very early mornings one to think about anyway

HelenAnne

Came across this article on Fast Running. I thought it was really good, especially the bit about needing to change the criteria for diagnosing eating disorders:

https://www.fastrunning.com/training/health/female-athlete-health-conversation-is-only-the-start/12720

(Not suggesting any posters here have eating disorders, or that you can tell by looking at light runners that they have disordered eating, just that for those who do get into a downward spiral of offsetting all calories with exercise / equating thinness with running gains etc, early intervention, before they get to dangerously low weights, could help).

(I know running / exercise can really help with body image as you concentrate on what your body can do rather than what it looks like, but for some people who are perfectionists or people at risk of disordered eating, I think it can sometimes normalise or legitimise or mask disordered or restrictive eating).

The Black Oil

TFBubendorfer wrote: »

There's an even more drastic case. Have a look at the story of Bobby Clay (she's mentioned in the original article). She ran at a very high level (she was 1500 meters European junior champion in 2015) but at the age of 20 still never had a period. It got so bad she developed osteoporosis and her bones got so brittle she broke a foot while swimming :eek: and a stress fracture simply by sitting down too hard on a chair :eek::eek::eek:

This should be required reading for all young athletes, especially girls

http://www.athleticsweekly.com/performance/bobby-clay-my-osteoporosis-nightmare-70422

Falls very much under the female athlete triad alright - the other component being energy availability issues. This has been addressed quite extensively in the literature, though there's still a way to go (getting the word out there, included - coaches and athletes) and generally the research has focused on those at the elite end.

https://www.acog.org/-/media/Committee-Opinions/Committee-on-Adolescent-Health-Care/co702.pdf

https://bjsm.bmj.com/content/48/4/289

https://bjsm.bmj.com/content/52/11/687

https://link.springer.com/article/10.1007/s40279-017-0790-3

RacoonQueen wrote: »

The boys don't know how lucky they are.

Possibly yes and no on that. Without wishing to start a gender war, there's plenty of that on the 'net, more is coming down the track re the experiences of elite males.

https://link.springer.com/article/10.1007/s40279-015-0411-y

https://nickykeayfitness.com/studies/

I've read a lot about this and can only imagine how disheartening (for men and women) it is to be injured, under-perform, not start and in some cases not have the underlying causes addressed.

The Black Oil

Researchers looking for participants re athletes and PMS.

https://docs.google.com/forms/d/e/1FAIpQLSehv5_jPqanxxhSQTdJfDxrlcuMvvu99ji4oanxyf49mqVOjg/viewform

https://twitter.com/Kelly64kg/status/1133654838611456000