Continuing the important conversation about female athlete health, Anna Boniface openly discusses her own amenorrhea and asks if personality is a contributing factor to the absence of periods?
I never imagined my life would hang on something that most females dread each month. I’ve reverted back to my 15-year-old self, waiting with anticipation for something to happen.
A period – puberty is bad enough the first time around and I’m doing it all over again!
I was late hitting puberty. I wasn’t running apart from doing some school cross country. I started my period on the first day of year 11 (funnily enough, this was also the first of wearing a skirt to school).
That following winter I joined Reading AC and ran my first cross country season.
Running regular, periods irregular
I spent my post GCSE summer teaching sailing and intermittently running. I had lost some weight from the hard work in the holidays and my energy balance was starting to seesaw.
My training volume was unremarkable, running a few times a week. My nutritional intake wasn’t adequate and I remember not coping well with the pressure of A-Levels.
My running had started to improve. I proudly represented Berkshire for the first (and last) time at the English Schools Cross Country Championships in 2008, finishing 144th.
This is when my periods first stopped and I was dragged to my GP by my mum. I was reassured that my amenorrhea wasn’t a problem.
The return of the cycle
During my last year at school and throughout my gap year, I was injured. I became unfit and my physical activity was next to nothing.
My periods came back, but it was short-lived.
The summer before I started university, I did Camp America teaching sailing and lifeguarding. I started running again during my three months in Massachusetts.
It was a very isolating environment and difficult to escape the “camp bubble”. I suffered a lot from culture shock and going for a run gave me some respite. I wasn’t eating well and being very physically active, I lost a lot of weight.
Since that summer in 2010, I haven’t had a period. I don’t count the three artificially induced by the contraceptive pill. Even with the synthetic hormones, they still eventually stopped.
There’s a common trend with my amenorrhea:
1) I was running/training regularly.
2) I wasn’t eating enough.
3) I had a busy lifestyle balancing work, training, socialising and health – read my athletics weekly article “the balancing act”.
4) I was stressed.
Can your personality affect your periods?
I am your classic high stress, type A personality. That’s just who I am.
Particularly over the last few years, my life has been a constant balancing act. Juggling training, my physio career and socialising, there’s little time for relaxation and recovery.
A high achieving stressed person in an energy deficit. It’s no wonder my body doesn’t perceive that it is “safe enough” to reproduce.
It’s fascinating how potentially my personality traits are contributing to my amenorrhea. They are typical athlete traits. Arguably this is another reason why RED-S is such a common problem.
This is a concept based on the hypothalamic–pituitary–adrenal axis and high levels of the stress hormone, cortisol.
Do relaxed runners maintain menstruation?
Perhaps it’s the laid-back athlete that can maintain their period whilst still training hard?
These athletes are disciplined in their recovery. They can move on from a bad training session with ease and they aren’t compulsive about training.
They are more relaxed about their diet. They can switch off, watch Netflix on the sofa all day with no guilt.
The question is can I be that athlete?
Despite hormone replacement therapy increasing my oestrogen levels, I still haven’t had a period.
I’m told they can take a while to return, but its clear from my latest bloods – I am still doing too much.
As my fracture has essentially healed, I’ve talked myself into a false sense of security that I can train near normality. My “cycle commute” to the gym escalated into cycling everywhere. Although not effortful, it was still too much physical stress alongside my rehab and cross-training.
I’ve realised how impatient I am. I’m itching to get back racing. I’m desperate to be as fit as possible for when I can run. I keep reminding myself that harsh reality is, if I return to running now, I will break.
I never anticipated how much I would need to cut back to allow my hormones to recover. Six months in, the rest and scaling back is still incredibly challenging.
I am a compulsive and obsessive person, particularly about training. I’m sure other runners can empathise. Not training feels like a massive void in my day. I feel like I’m losing my identity as an athlete.
The next steps
I’m monitoring my hormones closely with regular testing with Medichecks. I’ve cut back training, I am focusing on nutrition and finding methods of relaxation.
Current training involves (max 15 hours a week)
Alter G 30 minutes at 75% 2-3 x a week
Spin classes x 2 a week
Aqua jogging sessions x 2 a week
Rehab (plyos and S&C) x 2 -3 a week
Long bike ride x 1 a week
Weekly rest day
For periods to be a real deal, I need to fully embrace this process and jump in with two feet, rather than just dip my toe in the water.
Anna Boniface is part of the ‘class of 2018’ and this year will share her running journey every month. You can read Anna’s previous posts here and further information about the ‘class of 2018’ can be found here.