Bone Health for Women The Skeletal Risk of Overtraining
January 02, 2018
Submitted by Elizabeth Madlem, APN, The Bone Health Clinic at Millennium Pain Center
Are you exercising too much? Eating too little? Have your menstrual periods stopped or become irregular? If so, you may be putting yourself at high risk for several serious problems that could affect your health, your ability to remain active, and your risk for injuries. You also may be putting yourself at risk for developing osteoporosis, a disease in which bone density is decreased, leaving your bones very vulnerable to breaking.
Why is missing a period such a big deal?
Some athletes see amenorrhea (the absence of menstrual periods) as a sign of successful training. Others see it as a great answer to a monthly inconvenience. Some young women accept it blindly, not stopping to think of the consequences. Missing your periods is often a sign of decreased estrogen levels. Lower estrogen levels can lead to osteoporosis, a disease in which your bones become brittle and more likely to break.
Usually, bones don’t become brittle and break until women are much older. Some young women, especially those who exercise so much that their periods stop, develop brittle bones, and may start to have fractures at a very early age. Some 20-year-old female athletes have been said to have the bones of an 80-year-old woman. Even if bones don’t break when you’re young, low estrogen levels during the peak years of bone-building, the preteen and teen years, can affect bone density for the rest of your life. Studies show that bone growth lost during these years may never be regained.
Broken bones don’t just hurt — they can cause lasting physical malformations. Have you noticed that some older women and men have stooped postures? This is not a normal sign of aging. Fractures from osteoporosis have left their spines permanently altered.
Overtraining can cause other problems besides missed periods. If you don’t take in enough calcium and vitamin D (among other nutrients), bone loss may result. This may lead to decreased athletic performance, decreased ability to exercise or train at desired levels of intensity or duration, and increased risk of injury.
Who is at risk for these problems?
Girls and women who engage in rigorous exercise regimens or who try to lose weight by restricting their eating too much are at risk for these health problems. They may include serious athletes, women who spend considerable time and energy working out, and those who believe "you can never be too thin."
“I was training really hard — all the time. Finally, my parents made me quit the cross-country team… I was eating almost nothing, training with a stress fracture… I trained even when my body ached. I thought the pain, the headaches, and the missed menstrual periods were normal. I thought that was how a ‘champion’ was supposed to feel and train. I was proud of myself for being so thin and disciplined, and losing all the ‘baby fat’ I had carried throughout junior high school. My friends all said, ‘Gosh, you have lost so much weight!’ But I wasn’t in control. After my parents made me quit the team and took me to get help, I realized that my training regimen was not normal or healthy. I realized that I was hurting myself, and that I did not have to be obsessive about my weight, eating habits, and exercise in order to be attractive. I still exercise now, and I watch what I eat, but I am much more relaxed, healthier (my doctor says!), and happier. I have more energy — and more fun. I don’t have to set any records anymore, and I am a champion anyway!”
— An athlete who recovered from problems associated with overtraining and missed periods.
Here are some signs that you or someone you know may be at risk for bone loss, fracture, and other health problems
- missed or irregular menstrual periods
- extreme or “unhealthy-looking” thinness
- extreme or rapid weight loss
- behaviors that reflect frequent dieting, such as eating very little, not eating in front of others, trips to the bathroom following meals, preoccupation with thinness or weight, focus on low-calorie and diet foods, possible increase in the consumption of water and other no and low-calorie foods and beverages, possible increase in gum chewing, limiting diet to one food group, or eliminating a food group
- frequent intense bouts of exercise (e.g., taking an aerobics class, then running five miles, then swimming for an hour, followed by weight-lifting)
- an “I can’t miss a day of exercise/practice” attitude
- exercising despite illness, inclement weather, injury, and other conditions that might lead someone else to take the day off
- an unusual amount of self-criticism or self-dissatisfaction
- indications of significant psychological or physical stress, including depression, anxiety or nervousness, inability to concentrate, low levels of self-esteem, feeling cold all the time
If you recognize some of these signs in yourself, the best thing you can do is to realize that you need some help. See your doctor, who can guide you in working towards a healthier balance of food and exercise, which will improve your overall health, including protecting loss of bone. If you recognize some of these signs in a friend or teammate, be supportive and sensitive. She probably won’t appreciate a lecture about how she should be taking better care of herself. Maybe you could share a copy of this article with her or suggest that she talk to her parents, a trainer, coach, or a doctor.
Brittle bones may not sound as scary as a fatal or rare disease. The fact is that osteoporosis can lead to fractures. It can cause disability. Imagine having so many spine fractures that you’ve lost inches in height and walk bent over. Imagine looking down at the ground everywhere you go because you can’t straighten your back. Imagine not being able to find clothes that fit you. Imagine having difficulty breathing and eating because your lungs and stomach are compressed into a smaller space. Imagine having difficulty walking, let alone exercising, because of pain and misshapen bones. Osteoporosis isn’t just an "older person’s" disease, and it’s never too early to be aware of your bone health.
For more information on osteoporosis, you may contact The Bone Health Clinic at Millennium Pain Center, 309-662-4321. They have a new location at 2406 East Empire St. in Bloomington, next to Orthopedic & Sports Enhancement Center. Elizabeth Madlem is a certified bone health consultant. The clinic provides screening, diagnosis and a comprehensive treatment plan for people who have or are at risk of developing osteoporosis.
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