🗓 28/10/2022 👤 Sanja Middeldorf, Tara Rezaie Farmand

Why don't I get my period?

Trigger warning: This text is about topics such as amenorrhea, sports addiction and eating disorders. If you feel triggered by these topics, please click away or read the article in the presence of someone you feel comfortable with. Be sure to seek psychological help or support from experts.

Why don't I get my period?

We all know these videos on social media: A day of an influencer is shown, with everything she eats, does and how much sport she does. It is often noticeable: The meals consist of small portions, there are hardly any snacks in between and the hours in the gym pile up. This quickly leads to a calorie deficit. What does this do to our bodies and why can we miss our periods? We talk to experts about this problem.

Periods stop, but the pregnancy test is negative

More and more often, young women come to the practice of gynecologist Dr. von Gruchalla. The reason is that they don't get their period. They suffer from amenorrhea. But is this a cause for concern? First of all, it is normal that the cycle can shift. This often happens due to stress or hormonal fluctuations, such as after stopping the pill. If menstruation continues to be absent after some time, this should be taken seriously. One of the reasons could be a high workout load or too large a calorie deficit.

What is amenorrhea?

Amenorrhea means that the monthly menstrual period does not occur, although the pregnancy test is negative and pregnancy can be ruled out. A distinction is made between primary and secondary amenorrhea. Primary amenorrhea is diagnosed when the period does not occur even after the age of 15. Secondary amenorrhea is when menstruation started in the past, but then stops for three months or more at a time.

What are the reasons for missed periods?

There are different reasons for secondary amenorrhea. This can occur, for example, after stopping the pill due to hormonal fluctuations. Stress, mental illness or malnutrition and competitive sports can also promote a lack of menstruation.

But why do we miss our periods when we eat too little and exercise too much? Dr. med. von Gruchalla explains the connection in a simplified way: If we eat too little, do too much sport and/or have too much stress, the body reacts in a very original way: Ovulation is saved because the woman would not be able to go through with a pregnancy. The body pulls the emergency brake and the period does not occur.

What are the long-term consequences of amenorrhea?

Osteoporosis, or bone loss, is an old people's disease - or so we think. But the long-term absence of menstruation affects our bone health and can therefore lead to early osteoporosis even in young women. Nutritionist Dr. Claudia Osterkamp-Baerens works with many athletes at the Olympic Training Center in Munich and observes the ever-growing problem.

What does our period have to do with our bones?

If we eat too little over a longer period of time and thus consume too few calories, our body fat percentage decreases. This is linked by hormonal chains to the estrogen level, which in turn is equally affected by the drop. Estrogen, along with other hormones, is responsible for maintaining our bone mass. If it is lacking, bone mass decreases - in young women sometimes before bone formation is even properly completed. The so-called peak bone mass (maximum bone mass) is not even reached. As a result, young female athletes sometimes suffer from this disease in their mid-twenties, which usually means the end of their career. Osteoporosis is "just" one of many health problems that can occur in connection with missed periods, along with impaired fertility and long-term disturbances in the menstrual cycle.

Why do so many women exercise excessively?

Why is it that so many young women eat too little and exercise in a way that does the opposite of what it is supposed to do: harm their health? According to the nutritionist, the low-carb trend is partly to blame. Social media and shifted beauty ideals further fuel this process. This is precisely the phenomenon she can observe in the nutrition diaries of the young women who come to her - carbohydrates are cut out as much as possible, snacks are omitted and the calorie deficit becomes ever greater. The gynecologist von Gruchalla also confirms that the psyche plays a pretty big role here. The borderline to slipping into orthorexia, the compulsion to eat healthily, is not always visible. So a high sports workload and a poor diet often go hand in hand and this can have a significant impact on our health.

What treatments for amenorrhea?

A long break from sports, a balanced diet, eating more and incorporating snacks back into daily life. This can help counteract the effects of the long calorie deficit. This can be quite difficult, but it is anything but impossible. That's why it's even more important to get support from experts and talk to your friends.

If you have found yourself in this text, please consider seeking professional help. If you want to know more about this topic, check out our report "Periods stop: Amenorrhea due to diet" .