The Official Newsletter of
August 24, 2002

Exercise-induced Amenorrhea
 and Low Body-Fat

by Ron Brown, author of The Body Fat Guide 

"Ron Brown is a certified fitness trainer who doesn't have an inch of flab on his body. He'll tell you what you can do to become fit and trim too." 
Washington DC


"HOW can I lose muscle and replace it with body fat," a young woman recently asked me. I wondered why on earth anyone would want to do that!  She explained that she had a normal bodyweight, but, she had missed several consecutive periods. Since she was not pregnant and her blood tests showed no signs of health problems, she was concerned her low level of body fat was affecting her reproductive system. 

This woman referred to studies and literature in medical journals that made a direct correlation between a woman's falling body-fat level and the cessation of ovulation. Even athletic woman who are lean and otherwise healthy may get so lean that they stop ovulating.

Not wanting to pile on extra pounds of body fat to increase her bodyweight, the woman felt her only option was to increase her body fat percentage by replacing several pounds of lean bodyweight with body fat.

This woman's remarks raises some rather controversial 

issues about the relationships between amenorrhea, or the cessation of menses, ovulation, low body-fat levels, exercise and diet. Let's begin by examining the relationship between low body-fat levels, diet and health problems. 

The theory that osteoporosis, hormonal imbalances and other health problems are brought on by low body-fat levels is contradicted by examples of healthy people who eat normal balanced diets and have low levels of body fat. The real culprit in bringing on these unhealthy conditions appears to be the unbalanced and inadequate diets that many people follow. 

Nevertheless, it is often observed that as an otherwise healthy woman athlete trains and lowers her body fat level, even while eating a well-balanced nutritious diet, her periods stop. This has been described as exercise-induced amenorrhea. The assumption is that if a woman is not pregnant and ceases to have periods, she is not ovulating. However, this may not always be the case, especially in exercise-induced amenorrhea. 

Ovulation and Amenorrhea

Obviously, if a woman is not ovulating she can't have a period, but just because a woman doesn't have a period, it doesn't always mean she isn't ovulating! The theory that ovulation always ceases in cases of exercise-induced amenorrhea would be disproved if it can be demonstrated that woman athletes with this condition can still get pregnant. In fact, there is evidence that they do easily get pregnant. For this reason, exercise-induced amenorrhea is not recommended as a reliable means of birth control. 

How is it possible that ovulation can occur in a healthy female athlete who is not pregnant and who misses her period? One proposed explanation is that the extra blood that drains out of

the uterus following ovulation is reabsorbed back UP into a fit woman's general circulation. On the other hand, in a relatively unfit woman with poorer pelvic circulation, less pelvic muscle tone, and more pelvic weight from stored abdominal body fat, extra blood draining from the uterus following ovulation hemorrhages DOWN into the vaginal canal. Pathologists point out that hemorrhaging in any part of the body is never a sign of a healthy and normal physiological process.

Could it be that the ovulating fit woman with less vaginal blood flow associated with periods is actually healthier and more normal physiologically? If so, this would override any apparent need for a woman to raise her body fat level in order to stay healthy.

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