Homeweight lossMenstrual Irregularities & Amenorrhea In Female Athletes Reducing Body Fat

Menstrual Irregularities & Amenorrhea In Female Athletes Reducing Body Fat

Menstrual Irregularities & Amenorrhea In Female Athletes Reducing Body Fat


In response to several requests, in 2007  I started writing an article on menstrual irregularities and amenorrhea in women who were able to achieve a high degree of muscularity and muscle definition by significantly reducing their body fat. At the time it was my experience working with female athletes that problems with their menstrual cycles were often an issue, and that there wasn’t that much in the way of literature that addressed the issues they were facing. There is sadly, mountains of male centric information with regards to getting into shape but even the magazines designed for women don’t always address certain topics. Perhaps it is a matter of certain health issues being almost taboo in our culture, but nonetheless, they do need to be addressed. I started this article relying on my own experience training women and getting them into contest level shape, and my experience with traditional Eastern medicine, however the more I wrote, the more I realized that my observations were still very limited, even though I trained a good number of women over the years. One of the problems with studies or observations of any kind is what is known as sampling error- which occurs when the number of subjects used to observe any particular effect or attribute is too small to represent a consistent aspect of the entire population. Think about getting some of your friends together and asking them all if they ever get headaches. If you have 10 friends and they all work in really high stress jobs and four of them say that they regularly get headaches, it would be erroneous to extrapolate that data to say that 40% of the population regularly gets headaches- the number is simply too small to represent the numerous variables of the general population. That being said, in my quest for a bit more universality, I put out a call to female physique competitors, fitness models and athletes to write in and share their experiences before I made any generalizations. It took two years to get over 50 detailed responses from mostly natural athletes and their coaches and the information collected was invaluable. Without their input I would not have been able to write this piece (which I finished originally in 2009) and I dedicate this updated version  to each and every athlete and coach who was kind enough to share their experiences and I hope that it helps give some insight into the menstrual changes that can occur for female athletes.




Many women will have irregular or absent periods when subjecting themselves to the conventional methods of body fat reduction; usually high intensity resistance training coupled with extensive aerobic exercise and severely calorically restricted diets. Many competing in drug tested contest also employ over the counter fat burners, while many competing in non-tested events resort to prescription only thyroid medications, clenbuterol, anabolic steroids and diuretics. Whether using drugs or not many find themselves with irregular if not completely absent periods while training and dieting for their event. Lack of menstrual cycle is called amenorrhea.


About Amenorrhea In Female Athletes And Non Athletes

Menstrual cycle and hormone levels in females
Menstrual cycles and the monthly occurrence of ovulation is arrested with amenorrhea.

Amenorrhea is a menstrual condition characterized by absent menstrual periods for more than three monthly menstrual cycles. Amenorrhea may be classified as primary or secondary.
Primary amenorrhea – from the beginning and usually lifelong; menstruation never begins at puberty.
Secondary amenorrhea – due to some physical cause and usually of later onset; a condition in which menstrual periods which were at one time normal and regular become increasing abnormal and irregular or absent.
Human reproductive functions are exceptionally complex- and require a perfect synchronization of neurological and hormonal functions in order for the monthly menstrual cycle to occur.[ 1] An evolutionary failsafe of sorts designed to ensure that pregnancy does not occur under ideal circumstances. The hypothalamus is a gland responsible for regulating ovarian function and certain stressors affecting it can negatively affect the function of the ovary and induce amenorrhea. [2] Stressors can cause a lack of balance between eating patterns, overall energy consumption, physical and psychological stress. Stress induced amenorrhea is usually called hypothalamic amenorrhea and affect a consistent percentage of women, regardless of age.
(For the purposes of this article we will deal only with hypothalamic amenorrhea and all references to amenorrhea will refer only to this type.) While cessation of menses during pregnancy and lactation is normal, within the context of females striving for lower body fat it may be brought on by what the body sees as a form of malnutrition, or possible endocrine dysfunction brought on by the use of drugs. Most would argue that having low body fat levels are also a primary cause of amenorrhea, but as we will see- there wasn’t much solid evidence to support this common conclusion.

Menstruation is the process of changes in the endometrium, regulated by hormones from the hypothalamus, anterior pituitary gland and the ovary, and is very much a natural female monthly phenomenon. Birth control pills are often used by the general population as a way delaying, reducing or in some instances avoiding menses altogether. Athletes employ them as well so as to not interfere with performance during key competitions, and the same applies to several physique competitors wishing to ensure that they do not experience the painful cramping and increased water retention that can affect their physical appearance onstage.


Reported Female Athlete Experiences With Amenorrhea and Menstrual Irregularities:

reported cases of amenorrhea in women

That being said, here is a synopsis of the patterns, trends and experiences among those that I have worked with as well as those that shared their experiences.

  • Most of the women who engaged in what they described as a severely restrictive diet, to reduce their fat levels did not menstruate for a month or more, with one third of respondents reporting clinically defined amenorrhea.
  • Of those who experienced menstrual irregularities, all of them engaged in extensive exercise routines, with weight training and aerobic exercises for a group average of one and a half hours five times a week. (A smaller number trained more often, with one respondent reportedly training every day of the week for three hours to prepare for a contest).
  • Almost all surveyed reported using over the counter fat burning supplements of some kind, however doses were not given. What was interesting is that all but one female who admitted using illegal drugs to increase their rate of body fat loss, experienced menstrual irregularities that continued well after their contests. One unfortunately reportedly that she had not resumed her menstrual flow and was seeking medical intervention as a result.
  • Another unexpected and interesting occurrence was the account of one woman who experienced minor abnormalities while preparing for a contest, but stopped menstruating completely after gaining a total of 15 lbs over the course of two weeks after her contest. A result of binge eating after ending her rigorous pre-contest diet.
  • Of those who did not suffer from any menstrual cessation while significantly reducing their body fat levels and increasing their muscle mass, all of the women who I worked reported a decrease in the intensity of their menses- less cramping, reduced blood flow and shorter periods overall. Which many saw as a positive occurrence.
  • Of those who did not engage in calorie restricted, crash type diets, only one reported a full cessation, (she skipped one period immediately before the contest).
  • Of those who did not severely restrict their fat intake during their diets, only one reported any cessation.
  • Of those who trained an average of three to four times a week for less than an hour and without aerobic exercise, only two out of twelve reported temporary menstrual irregularities.



Some conclusions and thoughts:


From the information presented to me there are some observations that we can make- although I will preface any conclusions with the fact that this was not a scientifically conducted study and that there very well may be individuals whose personal experiences contradict what is published here, and I invite anyone with different experiences to share with me as well). However, there are some patterns that emerge that I would think are significant and worthy of consideration. Here are the conclusions:


Extreme Dietary Changes & Not Low Body Fat Levels As A Possible Cause of Menstrual Irregularities


In general, almost all the women who drastically reduced their energy intake while increasing their energy output through almost daily bouts of aerobic exercise experienced major menstrual irregularities. The ones who did extreme (one hour or more 5 times a week) amounts of aerobic exercise in addition to weight training were also the ones who restricted their calories the most and so it is difficult to know whether the restrictions alone brought on menstrual irregularities or if the high volume of aerobic exercise caused it- or if it was the combination of both. Without a control group doing only high volume aerobics and one doing only low calorie dieting it is hard to tell, but it is nonetheless useful to know that the combination seems to be associated (from this data) with amenorrhea. Menstrual cessation occurs early on for many of these women with the high volume cardio/low calorie regime, long before we can assume they attained their sought after low body fat levels. From this alone we can infer that low body fat may not be the reason for their menstrual irregularities. A study of long distance runners published in 1983 offers some insight into our finding, as two groups of runners with relatively equal body fat levels, fitness levels, age, training experience and aerobic exercise volumes. One group experienced irregular menstrual cycles while the other group with the same body fat percentages and training volumes did not.[3] The conclusion was that low body fat alone cannot be considered a universal cause of athletic amenorrhea and that more research was needed to understand the causes. As insightful as the study was- it was limited in that it did not record caloric intake among individuals or the rate of change of calorie intake- which we see here may be a contributing factor.


Stress And Over Training As A Causative Factor For Athletic Amenorrhea


Overtraining may be a cause of amenorrhea
Overtraining may be a cause of amenorrhea and menstrual irregularities.


It is known that when the body is not properly nourished, as a preventative measure against a pregnancy that cannot be supported, menses will stop as a protective measure as both bringing a baby to term and lactation requires a significant amount of energy reserves. We also know from several studies that extreme stress brought on by exercise can cause cessations in menstrual flow. [4] In either case, I think it wise that many women reconsider their dietary habits, as many of the conventional calorie and macronutrient reduction methods used may very well be a cause of malnutrition.  Also of note is the extreme amount of time exercising both with weights and cardiovascular type exercise, (to the point where one might begin to suspect exercise addiction.) In one respondent that was not at all a competitive athlete, but who had a similar exercise regime, she found that her periods would become erratic and eventually cease when she kept up her daily marathon sessions of hours of weight lifting followed by at least an hour and a half of aerobic exercise.


Overtraining As A Causative Factor:


Overtraining thus, can be figured in as a contributing factor in bringing about menstrual irregularities and cessation as only two out of twelve women who did not employ cardio as a part of their contest preparation suffered any changes in menstrual cycle. Of those two who did report changes one female athlete also trained six days a week and the overall finding was that the more often individuals trained, the greater the likelihood of some form of irregularities . This is underlined by the reports of those that did not have any menstrual abnormalities while reducing their body fat levels, which leads to a rethinking of the commonly accepted notion that menstrual cessation is an inevitable result of a woman significantly reducing her overall body fat.


Rate of Change In Body Fat As A Possible Cause Of Menstrual Irregularities


From my own experience working with female athletes and from the data collected, how long it takes to achieve muscle definition and reduce body fat levels appeared to be a common factor among those who reported no major irregularities. All but one woman weight training, who took five or more months to reduce their body fat reported any serious changes in menstrual cycles. Those dieting for 12 weeks or less had the highest incidence of amenorrhea and irregularities- except for those who lost only 8-10 lbs to get into onstage contest shape. One explanation being that those who lose weight gradually seem to be less likely to have menstrual irregularities as in the end almost all those reporting were in shape enough to win or place at local to regional level figure and bodybuilding contests. See also my article, Ultra Low Body Fat Is Not Healthy.


Fat Loss Without Menstrual Irregularities Or Amenorrhea In Female Athletes Is Possible:


Losing body fat too quickly can cause amenorrhea
It is possible for females to lose body fat, even to very low levels without experiencing menstrual problems if they don’t overtrain, lose fat too quickly or do too much cardio.

To summarize, it is indeed possible for a woman to get into shape without any menstrual irregularities as having a low body fat percentage does not necessarily bring about problems with menstruation. However, it does require more time, and a more consistent and balanced approach that is a far cry from the usual protocols employed for contest preparation. It is my hope that there is more solid research done with women trying to reduce body fat levels to competitive levels as to date there isn’t much of anything addressing this population. Hopefully this article at least opens a dialogue about the need for more female issues being addressed and researched in the field of health and fitness. Again, my thanks to everyone who took the time to share what were very personal experiences and I hope that the article is useful for future female athletes and their trainers.

Related Articles:

Should Women Lift Weights Like Men

How Long Does It Take To Get Muscle Definition

Body Fat Percentage Comparisons For Men and Women

5th Avenue Gym circa 2009- 5 years out from my last show.

As you can see, trophies and competitions were NEVER the driving force behind why I train the way I train and why I eat the way I eat.

It's always been my passion to see how far I could go as a natural athlete and perhaps even more so, to show what can be accomplished without using drugs.

And 5th Avenue Gym was the perfect place to do it.

I really miss that gym.

It was a place where legends came to train and while it wasn't pretty, it had everything we needed to do the work we needed to do.

And boy did we work!!!

5th Avenue for life as they say!!!

Hope you are still training hard and as always, Excelsior!!! #naturallyintense

And thanks @pit_bulls_67 for snapping the shot!!!!

#naturalbodybuilder #naturalbodybuilding #throwback #fifthavenuegym #5thavenuegym #drugfreebodybuilding #naturalbodybuildinglifestyle #gym #gymlife #gymmotivation #naturalbodybuildingmotivation #bodybuilding #bodybuildinggym

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Why Are Pull Ups So Hard For Some But Not For Others?

Pull ups are an exercise people love to hate!

They love to hate it because in my experience, most untrained men or women can't do one pull up and those who train can often struggle to do 6 or 10.


Because pull ups are hard!

And yet people like myself can easily do as many as 20-25!

So what's the reason for this discrepancy?

Is there some secret that allows me and others to do pullups so easily?

There isn't, and in this video I go over exactly why I can do as many as I can and why it can be so much harder for others.

I also go over my #1 pull up variant that ANYONE can do, even if you can't do one pull up.

And yet it can build strength and muscle size in some cases even more so than regular pull ups!

So click the link in my bio to see the full video on YouTube or go to my channel by looking up naturallyintense!

Thanks in advance for watching and as always, Excelsior!!! #naturallyintense

#pullups #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #backworkout #pullupworkout #naturalbodybuildingtips #backtraining #highintensitytrainingtips #hometraining #trainingtips #bodybuildingtips

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Maximize Biceps Growth With High Intensity Arm Blaster Hammer Curls!

50lb Dumbbells For 20 reps!

The Arm Blaster is a fantastic piece of equipment for a home gym or any gym!

It doesn't take up much space and allows you to add variety to your biceps training.

It locks your elbows in place, thus increasing training intensity, and by doing a hammer curl, you can use more weight (thus increasing intensity even more) and target your brachialis muscles which help add density to your biceps!

This was my last set and I couldn't go any heavier as I am still nursing a wrist injury, but the 50lbers were more than enough to do the job!

Try them out next time you train arms and let me know how it goes!!!

Still training, hope you are too and as always, Excelsior!!! #naturallyintense

#hometraining #homeworkout #homeworkout #nuobell #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #armworkout #bicepsworkout #naturalbodybuildingtips #biceps #armtraining #bicepsworkout #highintensitytrainingtips #drugfreebodybuilding#powertec #armblaster #hammercurls

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Injury-Proof Your Training: The Power of Workout Variation!

One of the main reasons why I can still train heavy and intensely at 49 after 35 years of nonstop training without any training related overuse injuries is the fact that I vary EVERY workout!

Overuse injuries come from doing the same movements over and over and by always changing your routine, you radically lessen the likelihood of chronic injury.

Squats, deadlifts, barbell curls and bench presses are great exercises, but if you do them all the time, you do increase the odds of getting injured.

And as a natural athlete, it bears mentioning that it takes years to realize your full potential, and so it's crucial to have a training program that is sustainable, and one that will allow you to train injury free for as long as I have or longer!

Thanks so much for tuning in and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuildingtips #naturalbodybuilder #naturalbodybuildingvideos #injuryprevention #fitover40 #workout #gymlife #workouttips #trainingmotivation #naturalbodybuildingmotivation #drugfreebodybuilding #highintensitytraining #injuryfreetraining #longevity

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High Intensity Training Leg Extensions To Failure!
And as always, Excelsior!!! #naturallyintense

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117 16

This Is What 35 Years of Natural Bodybuilding Looks Like!

So as you know, As you may know I recently turned 49 and every year I do a photoshoot to show my progression.

In the hopes of showing that you can not only maintain a level of excellence as the years go by, but that you can do it without steroids, TRT, drugs or even pre-workouts and protein shakes!

(I’ve never had a pre-workout or energy drink and haven’t had a protein shake in decades!)

You don't need it as all it does make you forget tht excellence doesn’t require anything outside of yourself.

You already have all the tools you need!

Not a huge fan of taking photos of myself, (I much prefer being behind the camera) but I humbly try to be one example of just how much you can achieve with proper training and an uncompromisingly proper diet!

So here I am again at 49 and I am looking forward to seeing what you accomplish over the years as well!!! Thanks so much for tuning in and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuilder #naturalbodybuildingvideo #naturalbodybuildingmotivation #naturalbodybuildingtips #highintensitytraining #drugfreebodybuilding #nodrugs #fitover40 #fitoverforty

366 36

High Intensity Arm Training- 50lb Concentration Curls!

There are two basic types of exercises, compound movements like barbell curls and isolation movements like concentration curls.

If you want above average arm development, you have to go hard on all exercises.

Isolation movements included, especially if you are drug free as we don't have the privilege of maximum growth from anything less than putting in some seriously hard work!

You have to go to that dark place where you can barely get the weight to move and do whatever it takes to get it up!

And then somehow find it in you to do it again!!!

You can't intellectualize it, you just have to do it and believe!!!

This was my third and last set and so I went all out!

My wrist is still a bit off so not going ultra heavy (by my standards) but
this was a hard set!

I haven't done concentration curls in a while, so I am really sore right now as I type this out two days after the workout!

Bear in mind that I always try to change it up and no one exercise is done every time I train.

Never training to maintain, always working hard to gain!!!

Still training and I hope you are too!!!

Thanks for tuning in and as always, Excelsior!!! #naturallyintense

#hometraining #homeworkout #homeworkout #roguerack #nuobell #highintensitytraining #naturalbodybuilder #naturalbodybuilding #fitover40 #naturalbodybuildingvideos #armworkout #bicepsworkout #naturalbodybuildingtips #biceps #armtraining #bicepsworkout #highintensitytrainingtips #drugfreebodybuilding

157 16

Unlock Your Natural Potential By Varying Your Workouts!
For the past 32 years I have always done a different workout every time I trained.

I have never followed a set program of exercises and the only unifying aspect of my workouts is the blistering intensity!

I train three times a week with a protocol I call Naturally Intense High Intensity Training, and what distinguishes it from other forms of high intensity training is the constant variety.

Muscles grow in response to overload and UNACCUSTOMED stimulation.

Remember when you first started training how effective everything seemed to be, but over time that progress slowly ground to a halt.

You change your routine and see some progress, but the gains in size and strength inevitably fall off over time if you don't make a change.

Now what if you never left that "beginner gains" stage and were always training with different exercises and radically different ways of doing the exercises every single time?

You would be where I am, not having experienced a plateau over the past 32 years and be able to really start unlocking your natural potential!

How does it all work, and how would you measure progression? Watch the full video on YouTube by clicking on my bio link, or going to my YouTube channel (Naturally Intense) and see for yourself!

I really think it can help make a difference in your overall progress, and best of all, it helps you avoid injuries so you can keep training hard for years on end! Thanks in advance for watching and as always, Excelsior!!! #naturallyintense

#naturalbodybuilding #naturalbodybuildingtips #naturalbodybuilder #naturalbodybuildingvideos #workout #workouttips #fitover40 #gymlife #workoutmotivation #trainingmotivation #naturalbodybuildingmotivation #drugfreebodybuilding #highintensitytraining #highintensitytrainingtips #HIT

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Featured everywhere from the Wall Street Journal to network TV, Kevin Richardson is the international fitness consultant for UNICEF, natural bodybuilding champion, creator of Naturally Intense High Intensity Training and one of the best personal trainers in New York City. Learn more about his award winning personal training NYC services here!



References For Menstrual Irregularities & Amenorrhea In Female Athletes Reducing Body Fat:

  1. Marshall L.A. Clinical evaluation of amenorrhea in active and athletic women. Clin. Sports Med 1994
  2. Meczekalski B., Podfigurna-Stopa A., Warenik-Szymankiewicz A., Genazzani A.R. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol. Endocrinol. 2008
  3. Sanborn CF, Albrecht BH, Wagner WW Jr. Athletic amenorrhea: lack of association with body fat. Med Sci Sports Exerc. 1987
  4. Genazzani AD. Neuroendocrine aspects of amenorrhea related to stress.Pediatr Endocrinol Rev. 2005


Kevin Richardson
Kevin Richardsonhttps://www.naturallyintense.net
Featured everywhere from the Wall Street Journal to CBS News, celebrity Personal Trainer NYC and with over 2.6 million readers of his blog, Kevin Richardson is the creator of Naturally Intense High Intensity Training, one of the top lifetime drug free bodybuilders of his time, the first International Fitness & Nutrition Consultant for UNICEF, 2020 and 8 Time Winner of the Best of Manhattan Awards for Personal Training and a world recognized authority on high intensity training. Kevin has helped thousands, from celebrities to CEO's over the past 30 years achieve their fitness goals with his 10 minute high-intensity workouts done just three times a week in conjunction with his holistic nutrition approach. You can learn more about about his diet and training services at www.naturallyintense.net

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