Female Athlete Triad

June 26, 2012

First, I just have to share the best news ever with you.

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Our land lord came over and fixed our ac unit.  FINALLY!! I had had enough of this whole sleeping in desert like conditions.  Last night when I woke up and looked at our thermostat it said it was 87 degrees in the house.  That was the last straw.   It is fixed now and I get to stand with my face right in front of it all day long.  My quality of life has just gone up 65%.

Now I just have to convince Billy to move our bed out into the living room.

After my workout (pump and a short run) I had a banana nut Soyjoy bar and then lunch was with one of my bffs.  I am pretty sure we could talk for 32 hours straight without there ever being silence.

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I had the Subway roasted chicken breast sandwich (even though you can’t see the chicken, it was hiding) and it hit the spot!  Now time to break into the peanut butter cookies from last night that our friend sent home with us.

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This topic is something that I really don’t think is discussed enough among athletes and heck I have only written two posts along these lines (Running and Periods, Are You a Runner with Disordered Eating) and felt like today would be a great day to talk a little bit more about it.

I often get emails from women wondering how I was able to go from not having a period for over a year to being able to get pregnant so let’s talk about all this fun stuff.

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For me personally I think what happened was that I just wasn’t getting in enough calories for the amount of exercise that I was doing. Even if I go back to the beginning of my blog from 20 months ago I can clearly see that the bulk of my diet was from VEGETABLES (but that’s healthy?!?!) which was not allowing me to get enough calories.  Going through a bag of Costco broccoli in two days and 12 bags of skittles does not fuel high intensity training.  Even though I was eating A LOT of food, I still was not getting enough calories.

I truly thought that my exercise habits (10+ miles a day plus teaching spin classes) was what was going to get me my sub 3 marathon. I was so obsessed with my goal of PRing at the Boston Marathon that I fell into the Female Athlete Triad.  The loss of my period lead to getting 5 stress fractures in just one year.  PS I have sense had a bone scan done and my bone density is back in the normal range hallelujah.

Next year when I am shooting for that goal again I will go about my nutrition and exercise in a complete different way even if that means that I have to turn to counting calories to ensure getting enough for training.

Now of course there are many reasons for loss of a period other than because of the Female Athlete Triad and there are things like hormonal imbalances etc. that make it hard to get your period back but….

For me, I had to:

1.  Run less (easy to do when you get injured).

2.  Eat more.  I focused on eating a lot more FAT and calories every day.

The main goal was to increase my body fat percentage and once I did, my period returned.

If you are struggling with the Female Athlete Triad please seek help.  Do not put it off until after your next big race or think that it isn’t a big deal because it is and you need to get your body back to a healthy state.

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Ever had experience with this?  Ever had teammates/family/friends deal with the Female Athlete Triad?  What did you/they do to overcome it?

Have you ever cut out a certain food group or realized that you weren’t getting enough of a certain nutrient?

-I didn’t purposely cut them out but I was only focusing on carbs and proteins for a while and did not eat nearly enough fat….Eat egg yolks, I promise they won’t kill you:)

Who has had a stress fracture before?  WHERE?  What about a broken bone?

Have you ever had your body fat tested?  What did they use to test it?

JoJo June 26, 2012 at 3:15 pm

This is a great post!
I just learned about this in my nutrition class too, I also had a very irregular period for a while, I think it was due to exercising a lot and not consuming enough calories..
Now I try to think: healthy body + healthy mind = happy me! I try not to get too obsessive about exercise and food, etc. :)

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Janae June 26, 2012 at 3:19 pm

HEY YOU!! I want to take that nutrition class with you! I love your equation for a happy you…I could not agree more!

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Caitlin June 26, 2012 at 3:31 pm

Great article. I am even on the pill and every once in awhile, when I ramp up my training, I will skip a period. It’s always a reminder to me. It’s a totally different mentality us runners must have, since everyone is always talking about diet and weight loss. Food is fuel, not the enemy! Although it is a bit scary how often I need to eat when my miles pick up!

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Janae June 26, 2012 at 3:34 pm

It really is a warning sign for us when we skip our period that we need to really pay attention to our nutrition and training! You are right..it is FUEL:)
That is what I love about running blogs…it reminds me that everyone else eats a lot too when they are running high mileage and so I should too!

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Brandi June 26, 2012 at 3:33 pm

I agree that this isnt talked about enough! My track coach in high school really emphasized being small and thin and told me he would run me down until I was a “stick with boobs”. Not the best thing to hear from an adult that you trust!

I’m vegetarian so I dont eat meat but I try to make sure that I’m getting healthy fats and protein from real food!

I had a femoral stress fracture in my left leg and a tibial fracture in my right at the same time. That was not fun and definitely made me start paying more attention to how I was treating my body. I also broke my front teeth – does that count as a bone? :)

In a way, I’m appreciative of all of the injuries and issues I’ve had over the last couple of years. Sometimes you learn that you have to treat yourself well the hard way!

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Janae June 26, 2012 at 3:36 pm

BRANDI!!! Wow, I can’t believe your track coach in hs said that…SCARY. I think coaches really need to be educated in the warning signs of the triad! Why couldn’t we have had our stress fractures at the same time so we could have sat on the couch all day and eaten ice cream together. Yes..the teeth definitely count. I am just like you and thankful for the injuries because they opened my eyes for the first time.

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Morgan June 26, 2012 at 3:53 pm

Holy cow- I can’t believe your coach said that! My coach went crazy whenever anyone lost weight on our team and would hound us to make sure we were eating enough.

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Cara June 26, 2012 at 3:36 pm

I fell into this as a gymnast, and it ended my career. hadn’t had a period in well over a year, and I ended up with stress fractures in my back and wrist. now I am extra cautious with my running and eating, I never want to be forced to quit something I love again!

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Janae June 26, 2012 at 3:38 pm

WOW!! Cara, thank you so much for sharing this with me and I am truly so sorry about the injuries that you had. That is really scary that they ended your gymnastics career. Good for you to learn from it and pay extra attention to how you fuel your body now with your running!

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Sarah June 26, 2012 at 3:37 pm

Long time reader but first time posting! Great topic. I’ve been without my period for a year and a half. I’ve had a hard time accepting the act that the loss of my period is related to my diet and exercise routine. The doctors told me that I do not need to be under weight in order for my exercise and eating habits to affect my menstrual cycle.

This is such an important subject that more women need to be aware of!

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Janae June 26, 2012 at 3:41 pm

HEY SARAH! Thank you so much for commenting. It really is so easy to fall into denial about our exercise and eating habits. You know you can always email me if you need some moral support while you get this taken care of. PS I just checked out your blog and love it. How are you dealing with the lack of a froyo place where you moved to?

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Lindsey June 26, 2012 at 3:38 pm

Yup, sure have and still am. Its been quite the lifestyle change but I keep my end goal in sight and it seems easier (to have a baby!). I have gained about 5lbs now and had my body fat tested at the doctors with electrode type things and its all okay now. My guess is my body has not fully recovered and it might take a while still. I am hoping it goes back to normal sooner rather than later right now.

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Janae June 26, 2012 at 3:43 pm

Hey Lindsey! That was exactly the thing that motivated me to get healthy and get my period back…a baby! Way to go Lindsey and keep up the good work. It does take time but it is totally worth it!

PS from your last post…cloudy days REALLY REALLY effect my mood!

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Lindsey June 26, 2012 at 3:49 pm

Thanks Janae :)

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Nikki June 26, 2012 at 7:00 pm

You are going to love Cali, Janae! Sun shines like 350 days a year and I swear people seem happier.. It has definitely impacted my mood for the better since I moved here. Now if only you can figure out how to move your whole family here too. I am still trying ;-/

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Morgan June 26, 2012 at 3:38 pm

Great post Janae!

Yes, I have fallen into all the categories over the years since high school xc and track. I’ve had numerous stress fractures and am now taking it easy and eating a lot more fat like you said in hope for a return to normal. I was doing the same as you before- eating a ton of super healthy foods thinking thats what makes me run so fast.. but I wasn’t leaving any room for other foods.

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Janae June 26, 2012 at 3:44 pm

Thanks Morgan! Isn’t it crazy how even though we were eating loads of HEALTHY foods we still weren’t healthy…we need CALORIES too when we are training so hard. I am so happy that you are taking it easy and eating more fat. Please keep me updated.

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Abby @ Change of Pace June 26, 2012 at 3:47 pm

Yay for the AC!
I’m glad you talk about this so others can relate and realize they aren’t alone, or realize what they’re doing may not be healthy.
I think I eat pretty rounded, and although my body fat is fairly low I’ve never skipped a period. I do take certain vitamins, too. I wonder if they help me?

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Megan@ The Running Doc June 26, 2012 at 3:47 pm

As a former gymnast this was something that was pretty common, but NEVER talked about. It’s crazy because most of my teammates and myself would miss periods and have no idea why given that we were so young. It would have been so helpful to have someone sit us down to teach us about proper nutrition and exactly what our bodies need to function properly.

I had a stress fracture in my back when I was 13 from gymnastics. Not a fun time!

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shelly June 26, 2012 at 3:48 pm

Yep that happened to me. I had them being on the pill, but I’m not now and it only comes every other month. Very fustrating!!

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Kait June 26, 2012 at 3:52 pm

So good to see this being talked about!!!! Its something I’m dealing with now. As someone who has struggled with a full blown eating disorder I thought my newer habits were healthy and that my still missing period was simply due to exercise. WRONG! After having 2 femoral neck stress fractures (one in each leg–> tremendous fun, let me tell you)… It’s important to make sure that, as runners, we’re getting enough F-A-T and calories. I’ve never been afraid of fat, but I’ve realized by focusing my diet around foods like fruits, veggies and lean protein I was missing out — causing my “healthy” habits to HURT! Janae thanks for bringing this up!

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Katie @ Peace Love & Oats June 26, 2012 at 3:54 pm

This is definitely something I know I was getting close to last year, I’d never eat over 1400 calories and I exercised like a mad-woman! Definitely gained back some weight after that, which I’m sure my body was craving!

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Kelly June 26, 2012 at 4:01 pm

I’ve personally never experienced Female Athlete Triad but I know a few girls that have. I try really hard not to cut out a certain food group. But sometimes with all the things out there that tell you what you should and shouldn’t eat it can be hard not to test out the effects of eliminating something from your diet.

I had a stress fracture in my foot when I was running cross country in high school but thankfully no broken bones. I wore a boot for 6 weeks and it healed me right up!

I had my body fat test in college when I was in Kinesiology. We used the pinching method to test one another’s.

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HilJo June 26, 2012 at 4:02 pm

Yep, been there. In hs I lost a bunch of weight, ended up pretty underweight and lost my period for about a year and a half. I wasnt running enough to get a stress fracture at the time (20 miles a week for about 3 months of the year haha). It took me a LONG TIME to get my period once I started eating again (this is when my love affair with peanut butter began.) Then in college I ended up with a stress fracture on my fibula probably due to the fact that I was still barely in the healthy weight range…now I am finally in the 21 bmi range and doing WELL!! NO MORE INJURIES!

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ipek March 26, 2014 at 10:58 am

How long does it take to come back after u started to eat right? Im having the same problem and waiting for it to come back :(

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Megan @ Run Like a Grl June 26, 2012 at 4:04 pm

I’ve never had that happen but I’m glad you put that info out there, I didn’t really realize or think about that! I have had a stress fracture before in my tibia and had a stress reaction in my foot recently. I think I’m just cursed with weak bones, thanks mom and dad!

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Rachelle June 26, 2012 at 4:07 pm

First of all it was great to see you today!! You are always so happy and kind and I truly admire that about you. :)

Thanks for bringing up this topic. It really is something that so many people deal with but is rarely discussed or brought to light. Since I have a history of anorexia and went w/o menstration for 3 years in my early 20′s I have an incredibly hard time maintaining a period. I worked for 2 years to get mine back (with the help of meds) and have now lost it again with my increased training. ugh! It is hard because a lot of people train harder than me and don’t have problems but I just always will because of my history and I have to learn to work around it. It is very interesting how different everyones bodies are. Not fun but so incredibly real and important! Thanks Janae your the best. :):)

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Katie June 26, 2012 at 4:09 pm

Wow, the female triad situation scares me! I was always very intense with sports, mainly basketball & tennis, but I never missed a period. Our basketball coaches were really strict with “diet”, they made sure to have us all talk to a nutritionalist so we didn’t under eat and so we ate the correct type of foods. I feel extremely thankful for being taught that knowledge at such a young age!

I’ve always wanted to do a body fat test…I never have. That’s definitely on the list of to do’s!

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Katrina June 26, 2012 at 4:10 pm

I just got over recovering from a stress fracture in my foot! It was from running too much mileage at once, and took months of recovery and healing to get back to where i used to be fitness-wise. More, calcium, calcium, calcium!!!The Female Athlete Triad seems to affected my friend who went through a stage of disordered eating habits and lost a ton of weight, but now she is on the right track. Today actually she was telling me about how she feels so much better eating more calories and the right food (which makes a big difference!!). I’m 15 and I haven’t gotten my period yet (because of running) but my doctor told me not to worry, it is common in young female endurance athletes.

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Ashley @ My Food 'N' Fitness Diaries June 26, 2012 at 4:12 pm

yep, been there!!! i had to cut out running for awhile and have since been adding a ton more fat and calories to my diet. my body LOVES me for it. thankfully my period returned a couple months ago. my biggest motivation? a little peanut!

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Michele @ nycrunningmama June 26, 2012 at 4:13 pm

Oh girl…it’s comforting, in a way, to know that other females struggled with similar issues I did. At various points in my running/army career, I skipped my periods. Sometimes for a month, sometimes for over a year. I was a vegetarian – and was definitely not getting the proper nutrients – especially when I was deployed. I have yet to open up about this on my blog, but I want to. I ate fruit for breakfast, bread w/ peanut butter for lunch, and a huge salad with fruit and veggies for dinner. I would then snack on tostitoes and pretzels at night to satisfy my hunger. In my mind I was getting everything I needed to. I thought that the loss of period was b/c of how hard I was pushing myself (b/c I was – averaging 60+ miles/week and working 15-18 hrs/day). I was super skinny and had no body fat. I thought it would make me faster.
Anyways, thanks for being so open about it. I love all the pregnancy pics – you look SO happy and healthy !!!!

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RunInBoise June 26, 2012 at 4:13 pm

Thanks for sharing this post. I have not had issues with my girl system, but I know other females that have. Making sure I eat enough and not working out every hour of the day isn’t a problem for me. I did have my body fat tested a couple of times. Once was with calipers and the other time with one of those hand held devices.

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Annette@FitnessPerks June 26, 2012 at 4:14 pm

Great post! You’re right, this is SUCH an important topic! When I was anorexic I suffered from all of the above…it was horrible. Now my bone density is back to normal, and I am so thankful for that (and my period!) This is something VERY real, so it’s important to talk about. Thank you for this!

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Brittany June 26, 2012 at 4:19 pm

Been there! Lost my period for only about 4-5 months but got a severe stress fracture in my heel (calcaneus). First orthopedic surgeon brushed off my symptoms and told me I could keep running – yikes! Got a second opinion and an MRI and was put on crutches and a boot. That doctor told me if I had kept running, I could have actually split my heel bone in half. I now say that you often know your own body and that something isn’t right – so if you don’t get answers, get a second opinion! My second orthopedist was awesome – asked me immediately if I’d been getting a period and worked with me all the way through, including a training schedule when I started running again. She was a woman and a runner – so she gets it!! First doctor’s question to me was “Why are you out running 9 miles at a time?” – like he’d never heard of distance running before – wait, isn’t he in sports medicine?? Crazy! Great post and I agree it’s not talked about enough.

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Rebecca June 26, 2012 at 4:20 pm

I feel lucky as this hasn’t been an issue for me, but I have heard of this happening to a lot of women who run higher mileage. In fact, I would be interested to hear how the elites handle this since they run upwards of 100 miles per week.
I had a tibial stress fracture a few years ago but it was only because I stubbornly thought that $35 shoes from Costco were fine to train in. Lesson learned…

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tessa June 26, 2012 at 4:29 pm

Love the post and the topic. I think its important for runners to have positive roll models to look up to. I think a lot of runners in HS and college think if they get thin they will run faster, plus many coaches emphasize that (luckly not mine, they were great!). And honestly it does work for a VERY LIMITED amount of time. But all those professional women runners who have been able to maintain a high level of fitness for years like Kara Goucher, Paula Radcliffe, and Deena Kastor and able to have heathy babies are great roll models and they all openly talk about eating a LOT of good food. Many young women don’t think about the impact that loosing a period can have on future fertility, until the time comes when they WANT to have a baby and can’t, or it takes a long time to regulate and be able to.

Fortunately I love butter, eggs, milk products and meat too much to ever really have any issues with losing a period or super low body fat ;) But its scary how many times I have seen this happen to fellow runners and friends. They have risked their future on very short term goals. Thanks for being honesty and open about the topic and congrats on the AC that is HUGE! You will sleep like a rock now ;)

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LauraMae June 26, 2012 at 5:09 pm

I love that you’re honest with us! Oh, and I totally wish we had air conditioning right now! I am seriously comtemplating moving to Alaska. =)

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Angie @ Pint of Goals June 26, 2012 at 5:09 pm

In high school I didn’t get my period for nine months: I was very active with ballet and cheerleading. I loved it then but now realize I wasn’t properly fueling my body. Thanks for posting about this – it seems like it’s a very common issue for women.

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Susan June 26, 2012 at 5:12 pm

I’m in an interesting place – I have had a very variable period, going without it for months. It had nothing to do with exercise, trust me, it started when I was large and continued on through when I lost the weight. I’m entering into my marathon training and I do have concerns about fueling/eating and overwork so I definitely will keep an eye out. Without the warning of unusual changes in period timing I could slip straight into a stress fracture or two.

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Megan D June 26, 2012 at 5:14 pm

Amazing post! And as you can see from all these comments, this IS something that needs to be talked about so we can all look at ourselves a little closer and possibly be willing to admit there could be a problem. I have told you before about losing my period and over exercising and NEVER eating fat. I was borderline underweight…it’s not like I LOOKED anorexic, so I thought I was fine. I had roomates that ran more and ate less and had a period, so I told myself I was ok. Even though because of my behavior I triggered my hypothyroidism that I will now deal with for the rest of my life. Weird how different bodies react differently to training and what not. Any who, my weight has gone up and down so much I feel like this is something I constantly battle. Finding the ‘balance’ in it all. Just today I was talking with my neighbor who is very thin and she said she wants to lose more weight so she can be faster. As my husband says often, ‘it sucks being a girl’. ;)

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Lilly June 26, 2012 at 5:16 pm

Janae, you are seriously the best! I am so glad you are writing posts like this. It seems like this type of thing is so super common but not talked about nearly enough. If it was brought up more, then maybe more girls/women could avoid injuries or doing harm to their bodies if they only knew more. I have had a femoral neck stress fracture that put me on crutches for 13 weeks… now I am working super hard to increase my bone density, get everything working properly again, and hopefully avoid serious injuries like that. You are such a role model and a great example that you can really learn from past experiences, injuries, etc. and make something good come from it and get healthy. Now you have your little peanut on the way, and you are going to be a fantastic mom! I remember reading you had femoral stress fractures, but you had 5 total stress fractures? Ahhh, I am so glad you are writing about these things, this is why your blog is the best… seriously, my favorite :) Enjoy your air conditioning!!!

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Becky Przy June 26, 2012 at 5:28 pm

Great post! I don’t think this gets talked about enough….Been there, still there, but working hard to correct it! I have researched the cr*p out of it…I think I am in line w/the research that points to not eating enough to fuel intense exercise.

Sooo true about eating fats! I cut those out (not intentionally) but its easy for me to forget to put p.b. on bread or only eat vegis and fruits.

I had a stress fx in my pelvis. I have had my body fat % taken, it was ‘athletic’ they did the caliber pinch test (so fun, haha).

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Shanna June 26, 2012 at 5:45 pm

This definitely defines my senior year of college (a couple years ago). I came back from studying abroad in Italy for 6+ months (awesome,but CARB CENTRAL!) and when I got back, all I did was exercise and eat tons of veggies, yogurt, and fruit. I wasn’t dieting – I truly missed these foods and having access to a gym on a normal basis. I lost a ton of weight without really trying and then stopped getting my period as well. Now I have a healthy diet and exercise the right amount for my body. I’m recovering from 2 stress fractures now and this is my 3rd week of being able to run after being out for 3+ months, so I’m taking the time to slowly get back to it while balance my food intake. I’m learning how much exercise and food are right for my body – not what it says in runners world/online, etc, and it’s actually quite fun! I had my bodyfat taken last week for a health test at work and it’s on the “athletic” low end, but I think I’m naturally that way. Great post!

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Erin @ The Grass Skirt June 26, 2012 at 5:47 pm

Whenever you have Subway, you make me want it! Yesterday the woman at the counter called me out as the pregnant lady whose husband always comes in to fulfill her Subway sandwich cravings. LOL. Glad you have AC now! :)

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cait June 26, 2012 at 5:48 pm

Janae…hugs to you for this post.Like many of you
posters,been there,done that.I am older and wiser now.I have always been pretty small and light but marathon training plus what I called “healthy” eating(like you,lots of gummy candy and veggies) were enough to make me ammenhorreic.It took a while to catch up with me but sure enough I suffered a stress fracture too.I got my act together in a big way,overhauled my diet and my training,and I am sooo glad I did.
The way I see it now,I need to eat a LOT to fuel my training,and my workouts are soooo much better now.
Another thing that really made me want to change my bad habits was my beautiful daughter-I didn’t want her to think I was any kind of role model for healthy living.
I know you are going to be a fabulous mom and role model to your baby girl:)

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Kristen @ notsodomesticated June 26, 2012 at 5:55 pm

Thanks for sharing about this. :) When I was a sophomore in college, I didn’t get my period for about 6 months. I was working out too much and not feeding my body properly. But I am happy to say that I haven’t had an issue with that in about 9 or 10 years. I eat PLENTY these days, and yet I actually weigh a little less than I did back then! I can’t stress enough to women how important it is to fuel your body properly. You don’t need to eat 1200 calories a day to be at a healthy weight! Eat more! Your body will thank you!

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Sara June 26, 2012 at 6:04 pm

Good stuff! As a dietitian working w ED and as an athlete w a long hx of gymnastics and now endurance sports, I’ve seen all sides of this issue and it IS important and it’s STILL not talked about enough or at the right times and places. Coaches/parents/teachers really need to know more about the warning signs and how to help someone that might be struggling. If it’s caught early enough, it seems like it often stems from a misunderstanding of being healthy and how to eat well for whatever sport they are doing.. But if it goes on too long, it can become an obsession and become full blown ED, which is so hard to overcome and treat.. But obviously can with the right guidance And if the will to change is there. Anyway, kind of a tangent, but good post and good to get folks thinking about this stuff

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Hayley @ Running Down the Runway June 26, 2012 at 6:04 pm

Thank you THANK YOU for such a great post! This was super helpful, and this is something I’ve been dealing with for about 2 years now (since I really started amping up my running) It definitely is a scary thing, and a complete pain in the you know what to deal with. I agree- when you are running its easy to fall into way-to-healthy eating habits, even though our diets require waaaaay more calories than most! I have never had a stress fracture and can’t even imagine what I would do if i did- so that is why I’m doing everything to fix this!

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Jaeme + Randy June 26, 2012 at 6:17 pm

There are some blogs that I can’t read anymore because I do not like the message they send about cutting out certain foods for females. Food is not the enemy and it makes me really sad to know what some people do to their bodies. Hearing about athletic people that limit carbs makes me espeically crazy. Not only does your body need it as fuel, that is the sugar your brain uses. It is not healthy if it is not balanced, and it is not balanced if you are cutting things out and not replacing them.

Great post and great attitude about how you want to start training differently after baby! You are a great example.

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Steph June 26, 2012 at 6:30 pm

Ug, had a stress fracture. Fortunately it wasn’t related to this problem. It was shin splints that developed into a stress fracture in my shin bone. Totally sucks

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Madison @ Pilates Makes You Happy June 26, 2012 at 6:50 pm

Oh man. I’m totally dealing with this right now! And it’s been almost a year with no period! But gaining weight is so hard mentally! Especially when we are all such health and fitness buffs. It feels like the whole world is trying to loose weight…gaining weight is such an anomaly. Although, I know that if I don’t stop the consequences could be worse!
Thanks for sharing this!

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Nikki June 26, 2012 at 6:55 pm

I have not had personal experience with this, but commend you for posting it. Your blog inspires so many people and this is a very important message. Amen to egg yolks!

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Tyffany June 26, 2012 at 6:57 pm

I haven’t had my period for months now, it’s always been sporadic though.. It’s been hard trying to find the “perfect” weight for my body. I’m not really sure if it’s a number either on the scale or the planets aligning and my body deciding that it is now healthy and ready to menstrate. It’s important to keep your doctor involved though and make sure that he’s not only aware but active in your life. In my case there are other things involved making it hard such as ovarian polycistic fibrosis. If I had assumed that the problem was all determined on my weight and running when really it is a group of issues…
I had my body fat measured by a trainer with the pinch test method. BUT there is a body scan that can be done and it’s more accurate.

Good luck girlie:)

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lindsay June 26, 2012 at 6:57 pm

yes yes and yes! run less, eat more, and STRESS LESS!

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Colleen June 26, 2012 at 7:32 pm

I have dealt with this for many years. I was a gymnast prior to becoming a runner and ended up with a stress fracture in my back after losing my period. Still trying to get it back…

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Laura Duquette June 26, 2012 at 7:48 pm

I’ve often wondered if I fall into Female Athlete Triad. I haven’t had my period in over 2 years. My Dr says it’s because of my birth control (which I got on to help regulate me)

For a long time I cut out meat in my diet. I had to recently bring it back in because I realized my reason for not eating it was disordered.

I’ve had a stress fracture before… in my kneecap. I still ran on it for months refusing to believe anything was wrong. I’m always getting injured tho. The most recent is my hip which they thought was a stress fracture but now have told me is hip tendonitis.

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Claire @ Let's Go On A Living Spree June 26, 2012 at 7:50 pm

I definitely have a form of disordered eating. I’ll admit it. It’s not that I don’t eat enough…it’s that I have a binge eating issue at night. I just continue to eat, eat, eat after dinner. The thing is…I FEEL hungry. Yes, to a certain extent I think it is stress relief, but I am ACTUALLY hungry! “So eat more during the day!” (aka front load your calories) you say. But I’ve tried that and I still get ravenous at night. I don’t really gain weight from it and I actually enjoy the nonstop snacking at night but I know it’s not normal. I asked my doctor and she said I’m probably just running/exercising so much that I am hungrier. But it only happens at night…so hmmm

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Kristin June 26, 2012 at 8:10 pm

Oh my gosh Claire I feel like you just wrote my story. I do this, too, but it really bothers me. It almost feels out of control.

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Kristin June 26, 2012 at 7:57 pm

Hi Janae!! Thank you for such a great post. The honest discussion that it evoked is so important. Will you tell me a little bit about how you emotionally dealt with the increase in body fat? Did you go though a period of sadness/guilt/decreased self-esteem etc? Thanks you, again…I admire you so much :)

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Courtney LeDuc June 26, 2012 at 8:07 pm

Yep I had some major eating issues stemming from college track and field and no period for a long time, which resulted in a MIS-diagnosis for PCOS (which ironically usually occurs in overweight people and I weighed a whopping 98 pounds, had 9% body fat and looked like a little boy) and fertility treatments to get pregnant. Low and behold, I gained weight, had a healthy pregnancy, my period came back magically all on its own when I had enough meat on my bones and the second time around my husband and I got pregnant in about 5 seconds au natural! ;) Amazing what your body can do when you treat it right ! ;)

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Susanna June 26, 2012 at 8:24 pm

I am a collegiate distance runner and I have gone through the same thing. I was (am) eating SO MUCH healthy food, but still wasn’t getting enough calories. It wasn’t on purpose; I thought that eating healthy like that was helping me! Anyway, now I’m trying to figure out to eat for my training and gain back some weight so that I can maintain my performance (I almost got to stress fracture point). It’s really hard to figure out how to do that though without just packing down milkshakes. It’s lucky peanut butter is one of my favorite foods, though :)

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Elizabeth June 26, 2012 at 8:55 pm

Thank you so much for this post!!

I have actually gone through this three times. (currently dealing with it).
I have really bad stomach issues to the point that I can’t even touch/look at/ be with in 5 miles of dairy, and fruit after dinner is a big no no, I have to really watch my intake of nuts, and I am vegetarian. (I should probably not be vegetarian but I feel like my running is so much better with out meat). Anyways, so that basically leaves me eating a lot of vegetables and meat substitutes, some nuts and eggs.
So I have to eat this way but I still have this issue of the disordered eating (I have had an eating disorder sense my senior year of high school and I just graduated college). It is all very complicated.

I have had a bone scan, which they said my bones were strong from so much running. I have also had the body fat test of just pinching different areas, but my numbers were not told to me.
Thank you so much for sharing and getting the word out about this!

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Samantha June 26, 2012 at 9:00 pm

Ugh, this topic is unfortunately relevant to me… I’m so impressed you got your fertility back, btw, and congrats on the kid! So excited for you.

But yeah, me… well, I haven’t had a period in almost two years. Early this year, in March, I got my body fat analyzed with BIA, not super-accurate but tends to OVERestimate, and the thing spit out 12.6%. Too low? I’ve since gained about 5 lbs and gotten up to maybe 15%, which feels really uncomfortable, to be honest. But no period. I do eat enough food, so I think it must be inadequate dietary fat, so I’m going to work on that next, even though it’s hard for me to digest [doctors tells me I shouldn't eat too much at once b/c I have gastritis, so I'll need to space it out throughout the day].

I’m not even a high-mileage runner, which is frustrating! Over 40 miles is a GOOD week.

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Bean June 26, 2012 at 9:01 pm

I broke a bone in my foot in H.S. and had a stress fracture in my left leg. No fun. I had some eating issues in H.S. with eating too little and then I went the other way in college with eating too much. Now I am trying to balance it out. Eat healthy but have some room for fun:).

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Cari June 26, 2012 at 9:16 pm

goodness you are super woman for living in that hot house!!! omg and pregnant too? i have respect for you!

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Janae June 26, 2012 at 9:35 pm

Thanks:) I am currently in heaven as I am sitting in my living room and it is almost TOO cold right now!

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Elle June 26, 2012 at 9:20 pm

Good on you for talking about this! I actually found running when I was in recovery from anorexia. My therapist recommended cardio to improve mood, and I absolutely fell in love. Originally, I thought running was keeping me in recovery (and it was), but I began eating a high carb diet with little protein and almost no fat. I thought I was doing the ‘healthy runner’ thing but, in hindsight, it was excessive. Thankfully my mom was onto it and got me back on the right track, but it is definitely a slippery slope for athletes.

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Janae June 26, 2012 at 10:41 pm

That is so neat that running helped you in your recovery from anorexia and you fell in love with the sport. I am so thankful your mom recognized what was going on and helped you out! Keep in touch with how you are doing!

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Elizabeth June 26, 2012 at 9:30 pm

Oh girl–why do you talk about what I need to hear? You must REALLY want me to show up in Utah. STRUGGLE in the middle of! Right here. Its so bizarre the eating thing. How can I not get ahold of this? I had my body fat tested. Im embarrassed at how low it was. I didn’t even tell my husband. I need to grab a clue and CHOSE THE RIGHT thing to do to care of myself, my health and my family. my injury list is getting too long. and I love my children too much. e

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Janae June 26, 2012 at 10:40 pm

I do want you to show up in Utah. I am so so sorry that you are struggling with this right now. PLEASE PLEASE PLEASE get help and take care of yourself. You know you could email me and talk about this anytime you want!

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Rachel June 26, 2012 at 9:51 pm

Wow, five stress fractures?! You poor thing! :( I just got off crutches after two months from a pelvic stress fracture (pubic ramus). Not a fun bone to fracture since even sitting puts stress on it! I still am not allowed to run, or exercise, I’m going crazy! It was a combo of vitamin D and osteopenia

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Janae June 26, 2012 at 10:39 pm

OUCH!! Rachel, that sounds awful!!! I can’t even imagine. Please keep me updated with how your recovery is going. I will be thinking about you!

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mel August 15, 2012 at 10:00 pm

Hi Rachel.

I hear your pain. I was diagnosed with an inferior pubic ramus stress fracture back in November. It’s now the middle of August and I still haven’t been able to run. It’s been such a long recovery, and I blame my poor eating and low bone density. I would love to hear how you are doing. I’m really glad I found this blog and this discussion on female athlete triad. Since my injury, I have been devoting more time to eating right and weight training. I never want to go back to my old ways again. I had no idea how much I was beating up my body.

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Ashley G June 26, 2012 at 10:25 pm

Did you really have 5 stress fractures last year?!! I knew about the femoral neck and the tibias, but what else?!

I had the tibial stress fracture, and honestly, you are a big part of what helped me get through it. The couple emails you sent me and reading about your struggles/triumph over them was so inspiring and comforting to me. Now, lets not have anymore of those injuries ok? :)

I had my body fat tested a few times in high school. I was kind of obsessed with having low body fat then, so it’s amazing that I got through 4 years of tennis and track without major injury. But now I’m old and I find something new to bellyache about every week :)

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Janae June 26, 2012 at 10:38 pm

I had 3 in my tibias and one in each femora! Thank you so much for your sweet words and I totally remember our emails back and forth! Yes, NO more injuries for us. I need an update on your blog so I can stalk how you are doing:) Have a great night!

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Erin June 26, 2012 at 11:02 pm

Ahhh – I am still trying to get over my latest round of stress fractures!! I have had so many and I am definitely not suffering from the female athlete triad (very healthy weight and no missed periods ever!). My sports medicine doc is trying to find a problem they could at least try to solve and so far there is nothing that he can figure out. It is so frustrating.

But, great job covering a really important topic, Janae!!! You are an amazing inspiration and I’m sure this will help so many girls out there!

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Khushboo June 26, 2012 at 11:35 pm

Great post, J and thanks for sharing! I haven’t gotten my period for a while and I sometimes wonder if it’s because I’m not eating enough but like you, I feel like I am eating A LOT (granted a good chunk of that is veggies)! For a long time I followed a low-fat diet and while it did help me lose weight, it didn’t do much for my cravings. My diet is full of healthy fats now and I feel better both internally and externally so contrary to popular belief, fat is not the enemy…nor does it make you fat!

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Erin June 27, 2012 at 4:42 am

Another great post! First of all, congrats on the new AC you must have been dying.

Second, could you do a post on how you dealt with the mental part of increasing body fat? That is what I struggle with the most.

You are hardcore for mentally suriving 5 stress fractures! I have had two, one in each tibia. Lots of scares thanks to lower bone density.

running also helped save me from my ed, some days wanting to be able ot run was the only thing helping me try to hit my meal plan. Ironically, once I started taking care of myself my marathon time improved dramatically!

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Kristin June 27, 2012 at 7:36 am

Erin, the mental part is what I struggle with the most, too! I would love to hear how Janae was able to find peace and happiness with more body fat. Gosh, that sounds pathetic but it really is hard!

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Janae June 27, 2012 at 11:06 am

HEY GORGEOUS GIRLS!! I am going to do a post about this today! Thanks for the great ideas and keep in touch with me on how you are doing pretty please with sugar on top!

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Marissa June 27, 2012 at 1:27 pm

I am REALLY looking forward to this post! I’m sidelined from running right now due to injuries and my Dr. thinks I need to increase my body fat to be healthier overall and heal faster, but I’m having a very very difficult time accepting this. I feel like a silly girl, but I don’t want to gain weight!

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Erin June 27, 2012 at 2:37 pm

yay look forward to reading it!! Have a great day in your AC

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Chris June 27, 2012 at 5:39 am

I’m shocked at how many women this has effected :( I always thought this was something that only elite athletes experienced. We really do need to talk about this more. Thanks Janae for starting the conversation.

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Jennie June 27, 2012 at 5:40 am

Hi! Happy AC day! I love your sharing is caring for the comments! Cute! And I care! Um I never have problems eating enough fat!! (I live 45 seconds away from BK and their amazing onion rings! Blast!) Guess what?!?! I ran a mile at 8:43 and then went onto finish a 5K! Yippee! Have an awesome day!!

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Kari @ Running Ricig June 27, 2012 at 5:50 am

87 degrees in your house is ridiculous! Glad you’re cooling down now!

I didn’t have my period for a while, but I’m not sure what it was from. I haven’t changed my diet and I probably exercise more now when I have it again. Part of it may have been that I was lifting a lot more back then and now I’m just running.

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Lizzy June 27, 2012 at 6:34 am

great post janae! i feel like the female triad is something that is so easy to fall into – it’s good to talk about it and keep awareness up! i’ve broken 3 bones – ouch. ps- i had the worst run EVER last night, but your blog has helped me to not beat myself up about it and focus on the next one. thanks for doing what you do!

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Leah June 27, 2012 at 6:53 am

I really, really appreciate that you acknowledge these problems because not enough female athletes talk about it! I think I may have commented on one of your other posts about the subject, but when I was swimming in college, we had regular body fat tests. Our head coach made it seem really important to have low body fat (even though in swimming, fat= flotation!!). My sophomore year, I got really obsessive about getting to and maintaining a low level, lost my period, and was tired and miserable. I’ve been measured with calipers and with that other electrical thing (?)…I never thought I looked super thin but at my lowest I hit somewhere in the 9-10% range. After quitting swimming and spending a semester abroad I gained some weight and my periods came back. Some days it’s still really hard to get used to being heavier than I used to be, and trying on my old clothes that don’t fit anymore, BUT I have much more energy now than I used to and I was able to run my first marathon this spring! If I had tried to train for a marathon before, I probably would be out with a stress fracture right now.

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Carolyn June 27, 2012 at 7:16 am

Oh stress fractures…after three weeks in a boot for a fibular stress fracture, I am now out of the boot but still have to stay off/”baby” my ankle for another two weeks. For everyone who’s had a stress fracture, any tips/hints on anything I can do to make sure this heals right? As I understand, there’s nothing I can do to speed up the process of healing – is that true? But I must admit I’m starting to go a little stir-crazy, any exercise you would recommend that doesn’t flare up the ankle? I really want to get back to running as soon as possible, but do realize that this needs to heal up fully first! Makes me realize how much I love running :)

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Janae June 27, 2012 at 10:56 am

I am so so sorry that you are struggling with a fibular stress fracture right now. That is just awful. Honestly the only thing you can do to make it heal faster is to rest it. I also really upped my calcium intake to help make my bones stronger too. Have they said that you could swim? That is what I did when I couldn’t run and it helped me a lot to still get some endorphins and not go crazy. Hoping you have a speedy speedy recovery!

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Yolie @ Practising Wellness June 27, 2012 at 9:06 am

I had this problem when I had an eating disorder and exercised heaps…but now my bone density is back up too, and I’ve had my periods for several years <3 :) Plus I am about a gazillion pounds heavier, lol! ;) It makes me sad when people ignore this problem as it is a very real health risk – not good to get no periods, no matter how convenient it might be, lol! I am really passionate about educating people about that, and how having too low body fat is very bad for you…Health is the goal, and vibrancy, wellness, vivacity, and joy! Skinny, no. Strong and healthy, yes! <3 Well done you for making that wonderful commitment to your health! And now you have the gift of a healthy body and a wonderful baby! xyx

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Blakely @ The Husky Life June 27, 2012 at 9:23 am

I had a severe stress fracture in my right tibia last year. I was in pain for about 4 months before I went to the doctor… something I can’t believe now! An entire month with no exercise AT ALL and two total months without running (sad face) made me realize that I had to shape up. Now I am conscious about cues from my body and concentrate way more on nutrition than I did in the past.

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Meghan @ After the Ivy League June 27, 2012 at 9:30 am

I think recently I’ve been focusing too much on proteins and healthy fats, and not enough on carbs! My body responded with some serious carb cravings, so I’m trying to add more to the mix (although being GF makes it a little more difficult).

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Kay June 27, 2012 at 1:22 pm

Great post! It’s always important for all of us to be aware of what we are consuming!

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Sarah June 27, 2012 at 1:38 pm

GREAT post!! While I haven’t had issues with my period, I HAVE had a stress fracture (around the same time you were dealing with your tibial fractures) and most likely disordered eating habits. I had an under water fat test and the results placed me in the fit/athletic range with the recommendation to gain weight and eat more protein. I’ve managed to gain a few pounds, which is annoying on my petite 5’3″ frame, but I’ve noticed a HUGE different in my running. I’m so much faster and feel so much better in general. This is big when so many runners hold the mantra that “skinny/light = faster”. I still HATE to see those extra pounds when I weigh myself, but I know it’s only making me a better athlete. Thanks so much for your blog. You’ve really helped me become a better runner! It’s nice to know there are others like me out there! :)

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Bridie June 27, 2012 at 2:25 pm

What a great post! I struggled with an eating disorder in high school. I can’t believe I haven’t thought to pull this info out and share with the moms of the girls on the youth track team I coach. This post was an important reminder, I forwarded it on to some of our moms as an FYI and something to watch for as the girls get older. I think it’s important to note that undereating may not be a result of an intentional eating disorder per se – but lack of understanding just how much fuel one needs.

My 7 yr old had not been at the dr’s office in some time, I had noticed since track season started he was looking a lot leaner (and he’s thin to begin with). We went in for an ear infection, and when they got his measurements, he was two inches taller and 3 lbs lighter than 8 months ago! And this kid eats a LOT of food – but we eat really healthy and mostly vegetarian, so a big plate of food in our house doesn’t equal nearly as many calories as (sadly) the typical American plate contains. It really can happen very unintentionally, by just not realizing what your caloric needs are.

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karla June 28, 2012 at 5:26 am

great post as always! I have never had a stress fracture, thank goodness! I get my periods regularly but….that doesn’t = healthy. I always heard that you know you’re at a healthy weight when you have your period…not always true! my hubby and I have been trying to have a baby, but found out I am not ovulating. You can have a period and not ovulate. My doc says I need to gain some more weight (which scares me bc I already feel too big) and that when I do I will ovulate. soooo scary to me. But, I just wanted to put that out there… undereating, overtraining, or not being at YOUR (not what media tells you) healthy weight matters and you may not know the damage you are doing.

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Suzanne June 28, 2012 at 7:38 am

It is so tough to avoid falling into the trap of “a meaner, leaner you” or “the runner’s DIET.” The word diet is so evil. Everything in moderation, right? I don’t totally practice that. I try to pack as much fruit and vegetables into me as possible. But I am realizing that egg yolks are OK. Roast beef sandwiches (ok, I only had a half of one last night) are OK.

I have never skipped a period, but my husband and I are having trouble getting pregnant despite all tests being completely normal. Being active is a huge part of my life, but if my goal is to have a little peanut soon, I may have to make some changes to the way I go about it!

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Christy Morton June 28, 2012 at 10:20 am

Thank you so much for writing this post. I think there is a huge lack of education and discussion about female athlete triad. I feel that for the most part people aren’t even aware about this; I know I wasn’t before I dealt with it myself.

I had really increased my running and training last summer. I was running several half marathons that summer/fall and was doing the long runs with a friend training for their first full. While I wasn’t restricting my food, I never considered that I should increase my food intake to properly fuel my body for the additional exercise. Also, similar to you I wasn’t getting the right mix of carbs, proteins, fats needed. During this time I lost my period. I never thought that it could have been connected to my running or eating. Then the week before I ran RNR St. Louis in October I started having some pain in my hamstring. I babied it that week, ran St. Louis and after was in more pain in my hamstring and now groin muscle areas. I had RNR San Antonio two weeks later, so I eased up a little but figured I could run through the pain. After all I would have a break from races coming up. While running San Antonio I was hurting pretty bad, at mile 8 my leg almost gave out. Finishing those last 5.1 miles was excruciating. After I returned home I went to the doctor and found out that I had four stress fractures in my pelvis. Then with further testing they discovered that I had osteopenia, which was not normal for a then 25 yr old. That’s when my doctor talked to me about female athlete triad, and the puzzle pieces fell into place. The triad, along with other minor things, had caused the fractures, osteopenia, and loss of my period.

After a long, agonizing break from running my fractures are healed, my period is back and I am working on building back up my bone density. I just started training for my first full marathon (Chicago!) and am going about it in a much smarter, healthier way. So, thanks again for the post, hopefully there will be an increase in education and awareness about the triad. Maybe even a Runners World article. ; )

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Arrienne June 28, 2012 at 12:01 pm

Love this post!! Thank you for discussing this topic on your blog. It totally makes complete sense. A big help:)

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Leonor @FoodFaithFitness June 28, 2012 at 2:39 pm

Thanks for posting this. We need to be aware of things like this and take care of our bodies.

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Kailey January 5, 2013 at 12:29 pm

Do you know how much you increased your intake by? Right now I eat about 2100 – 2200 calories a day but I haven’t had a period in almost 5 years. I am seeing an RD again to see if my nutrition is matching up with my expenditure…I just want to be regular again without birth control!

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Jen May 25, 2013 at 3:33 pm

Hi! Thanks so much for writing this post. I am just now learning about the Female Athlete Triad. I haven’t had my period since January, and up until then I had a pretty regular period every month since I was 16 (I am now 28). I have never taken birth control. But I recently became a personal trainer, and I coach bootcamps as well as do my own workouts and yoga(so for several hours every day). The only symptom I am really showing is the lack of period, I haven’t had any stress fractures (yet)…and I do have *some* “disordered” eating I guess (I eat paleo…but I eat plenty of protein, carbs and fats…I keep a very close eye on my macro nutrients)…and I’ve been eating a good 2300 calories a day (and feeling terrible about it…I try to get to 1600 which is my RMR…for fat loss purposes) and I can’t do it because I’m so damn starving all the time from all of the activity! I had my body fat tested in a hydrostatic tank…it was 16.7 which isn’t THAT low…

Sorry for the all over the place explanation!

What I’m getting at is…how long did it take you to get your period back? Do you think I should be worried? I would actually like to decrease my body fat a little more, but it seems like it may be dangerous. And sometime in the next 5 years I may want to get pregnant, and I don’t know if that’s possible doing what I’m doing. But it’s hard because it’s my career, and I am surrounded by it daily. Thanks in advance for your input. I am just glad I found a place where I could talk to some other ladies who have gone through the same thing.

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Brooke June 26, 2013 at 6:00 am

You are just an inspiration to me. I’m having trouble with this at the moment and would love to chat about it …
My email is bm4williams@students.latrobe.edu.au

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Erin Duffy September 1, 2013 at 12:53 pm

This post was very inspirational to me as well! I am thrilled that you were able to get pregnant (gives me hope!)

I am 25, 5’0 and about 90 pounds. I run 7 miles about 6 days/ week and strength train about 30 min/ day. I have had ammenorrhea for about 10 years and have been off and on several birth control pills to induce a period. Recently, the desire to get pregnant in the next couple of years has made me more aware of my nutrition. I take pre-natal vitamin supplements daily but how much protein should I be shooting for per day?

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Callie January 15, 2014 at 6:37 pm

I want to know how the Olympic long distance runners change their running routines so that they can get pregnant. If you don’t have a period for a long time because you’re running a lot and have low body fat, if you want to get a period for a while so you can get pregnant, can you just put on weight for that period of time and then return to your normal training regiment after the baby?

I’m a 22 year old runner and have been running competitively since age 14, high school, college, and no post-collegiate competitively in the marathon. I’ve never had a normal cycle and have had to take birth control since age 17 (when I first got my period) to regulate my cycle and prevent bone loss. I’ve only had 2 stress fractures ever, but I am concerned that this might hinder my ability to get pregnant sometime in the future…

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Morgan November 7, 2014 at 11:47 am

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