I’ve had a very hard time figuring out where to start with this. It’s complicated, and yet so simple. It’s downright embarrassing and highly personal, but I’m sharing it anyway. Why? Because maybe, just maybe, there’s some girl out there sitting in the same frustrated, lonely, confused place I was in, and maybe, just maybe, my story can help her.
*Takes deep breath* Let’s rip the taboo Band-Aid off right away.
Hi, my name is Steph, I am 22 years old, and I have not regularly menstruated in over two and a half years. My period has been completely absent for the past year and a half.
Sure, it has been great to not have to buy tampons, or suffer through cramps, and many people will say there is no medical need for a woman to menstruate. However, while the simple act of menstruating may not be necessary for a functioning female body, the lack of menstruation (in the absence of pregnancy) is indicative of something going wrong that should be addressed. You know that expression “hit the wall?” Yeah, well, what I did to my body felt a little more like I stubbed my toe on the wall, hopped around a bit until I lost my balance, fell down a few flights of stairs, stood up at the bottom, tried to convince myself I was fine, took one step and then immediately face-planted…into the same damn wall. I have a feeling that this type of burn out happens to a lot of women, and I don’t think enough people are talking about it.
So let’s talk about it.
I’m going to start by saying what exactly my problem is. In short, I have a hormonal imbalance. Hypothalamic Amenorrhea. The Female Athlete Triad. Relative Energy Deficiency in Sport. I don’t really like labels. There are a lot of different words for the basic fact that I totally jacked up my body’s chemical messenger system by putting my body under extreme stress for a prolonged period of time that resulted in physical symptoms. As you may have learned in your middle school sex ed class, hormones make the world go ‘round. Your body operates based on the signals from these chemical messengers, and they dominate everything from mood, to skin, to menstruation, to energy, and beyond. They intermingle and auto-regulate with incredible flexibility and precision comparable to an expert tightrope walker. Stress has a huge hand in how well the hormonal axis is able to continue functioning. It’s like the wind for the tightrope walker – a little bit of wind and she can adjust her balance and carry on, but with a gust big enough, she stands no chance and topples right over.
So with that very basic rundown of the pathophysiological reason for my lack of period, let me tell a little bit more of my story. During my teenage years, I was not a runner. I played lacrosse for a few months out of the year, but that was it. My period was regular and I felt great (well, aside from the normal agonizingly awkward high school experiences). I started running a few times a week after my second year of college as a way to get exercise and relieve stress. After about a year, I signed up for my first half marathon, and that’s when things started to head south. I wanted to prove to myself and others that if you work hard enough your body can do anything you set your mind to. With the thought of training for a race in the back of my mind, I began paying attention to what I ate. I thought that I should eat as “clean” as possible in order to enhance my athletic performance. I began tracking what I ate. I counted calories. I started cutting out foods that I deemed “bad.” I ate the way I saw other runners on social media eating because I figured if it worked for them, it should work for me too. I hesitate to say that I had an eating disorder because I was never diagnosed and I never sought help, but I know that what I was doing was not healthy. Around this time, I also stopped taking my oral contraceptive due to insurance coverage issues. After that, my period was gone for good.
At the time, I was not concerned at all. I’m in pharmacy school, so I knew that after discontinuing birth control it could take some time for my cycle to regulate itself. So I continued to increase my mileage, get stricter with my diet, take on more life responsibilities, give up sleep, and pick up more hours at work, all the while trying to maintain some shred of a social life and mental health. Even as I started to show other symptoms of burnout, I ran the half, had a blast, and decided that I wanted to run a full marathon the next year.
Before I started training for my marathon, I went to my OB/GYN to talk about how I had not had a period in a year. She never asked about my diet or exercise habits, but she noted that my acne was pretty terrible, so she tested some of my hormones, and slapped a diagnosis on me: polycystic ovarian syndrome. First line recommended treatment? Diet and exercise. I was running and cross training most days of the week, I ate my veggies, I wasn’t sure what more I could do. But still, at the time I thought diet modification was my best bet to rebalance my hormones. I did research, I read that PCOS put me at greater risk for insulin resistance and diabetes, I found many accounts of women claiming that cutting back on carbohydrates helped their PCOS, so I tried that.
Now let me list out some of my main stressors at this point for you:
I was training for a marathon (that’s lots of miles a week, and exercise is a stressor).
I was intentionally cutting back on carbs (an important fuel source for literally everyone, not just athletes).
School was incredibly difficult (getting your doctorate in six years is not easy, shocker).
I was working three jobs (college and life are expensive).
I was not sleeping or eating enough (because I simply did not have the time).
Various other day-to-day life stressors (such as a fight with my mom or a friend).
Negative self-talk (I still felt that I was not working hard enough).
Any of that sound familiar? I know I’m not the only one with a fully loaded plate. It was a recipe for disaster. My symptoms got worse. A few months later, further testing would show that I likely did not actually have PCOS, so I was back to square one with the question: what is wrong with me?
Stay tuned for part 2 coming soon!