Dos and Donts For Women With Exercise-Induced Amenorrhea

Amenorrhea is the medical term for the absence of monthly menstrual periods. There are two types of amenorrhea— primary and secondary. Primary amenorrhea is when a girl doesn’t get her period by the time she is 15 years of age. Secondary amenorrhea is the absence of menstruation for three months or more by a woman who has had periods in the past. For the purpose of this blog, we will focus on exercise-induced amenorrhea, which falls under the category of secondary amenorrhea. 

The Dos And Donts Of Exercise-Induced Amenorrhea

Exercise-induced amenorrhea is a condition that occurs in female athletes due to environmental, nutritional, and metabolic stressors. The Journal of Clinical Endocrinology & Metabolism states that the reproductive system’s sensitivity to these stressors causes the suppression of menstruation in athletes. In many cases, women with exercise-induced amenorrhea are thought to have low body fat levels and nutritional deficiencies.

Exercise-Induced Amenorrhea Do’s

  1. Do Focus On Adequate Nutrition

Many women believe they have stopped menstruating specifically due to over-exercising or too little body fat. According to the Female and Male Athlete Triad, a group of women with similar exercise programs and low percent body fat will not all experience menstrual problems, and those that do usually have inadequate nutrition. When a body goes through famine-like conditions, it halts menstruation due to insufficient fuel to support a fetus. Ensure when you are eating, it is balanced with nutritious foods that contain necessary fats, carbohydrates, and proteins. 

  1. Do Toss The Scale

While stepping on the scale may feel like a necessity for women with disordered eating, it actually causes more harm than good. Instead of starving your body for a number on the scale, try eating intuitively. Eat when you’re hungry, and stop when you’re full. By doing this, your body will achieve a natural weight that matches your energy exertion and genetics. If tossing the scale altogether seems daunting and overwhelming, some women start by hiding the scale, so it is at least out of sight. 

  1. Do Understand The Long-Term Health Consequences

It is important to understand the long-term health consequences for those struggling with amenorrhea due to over-exercising and disordered eating. NEDA outlines a few possible results including:

  • The risk for heart failure rises as heart rate, and blood pressure levels sink lower.
  • Slowed-down digestion, known as gastroparesis, can lead to stomach pain, nausea, vomiting, blood sugar fluctuations, bacterial infections, and more.
  • Neurological implications affecting sleep, balance, and breathing.
  • Other consequences such as hair growth, dry skin, dehydration, hair loss, and anemia. 

Additionally, many women with amenorrhea also pose a risk for early onset osteoporosis, which is when the bones become less dense, weak, and brittle and are much more likely to fracture. 

Exercise-Induced Amenorrhea Dont’s

  1. Don’t Omit Certain Food Groups

Many women with amenorrhea due to disordered eating have “safe foods,” which are foods that are “safe” to eat. These foods don’t feel threatening to the overarching goal of weight loss. Eating outside of one’s “safe foods” can be anxiety-provoking and leave them feeling a loss of control. Try challenging the anxiety by not omitting certain food groups. This can also lead to a healthier relationship with food.   

  1. Don’t Skip Meals

Skipping meals is something that is often talked about when trying to lose weight. Women with exercise-induced amenorrhea should not be going too long without meals or intentionally doing without breakfast, lunch, or dinner. When you skip a meal, not only does your blood sugar drop, but you may experience anxiety, decreases in your energy, digestion irregularities, nutrient deficiencies, and even begin to lose touch with your hunger and fullness cues. Trust your body, listen to your body, be intuitive, and enjoy everything in moderation!

  1. Don’t Neglect Getting Help

When your behaviors start to get in the way of normal bodily functions, such as your menstrual cycle, but also affect your mental health, it is time to seek help. To contact the National Eating Disorder hotline, visit To find a sports dietitian in your area, use the American Dietetic Association’s referral networks: or

If you need more information about amenorrhea, or if you’re suffering from symptoms similar to amenorrhea, consult a provider at Raleigh OB/GYN. The physicians, nurses, and medical staff at our practice offer a comprehensive list of gynecological and obstetric services to help you better understand your menstruation. Visit our website to make an appointment, or call us at (919) 876-8225.