MULTISPORT
Can ’ t run … keep swimming . Leigh pondering finding a new balance in her sporting activities uncommon for women who do a lot of high-intensity exercise , to lose their periods . However , I was also told that given my level of activity , that it was “ not a concern for someone my age .” I did not know this at the time , but this bit of medical information ( or misinformation ) led me to having the issues I am experiencing today .
The Female Athlete Triad
Now I have what is known as the Female Athlete Triad , a combination of three conditions : 1 . menstrual dysfunction / amenorrhea , 2 . low bone density / osteoporosis , and 3 . low energy levels with or without an eating disorder . I had a major sense of humour failure when I found out about all of this , so I am going to put all jokes aside , for now , and delve into the science of the conditions , as I feel it is important for young female athletes to be aware of the long-term implications .
gymnast from the age of eight , so my idea of what is normal has always been a little ‘ different .’ By the time I was 11 years old , I was training six to seven hours a day , six days a week . I trained through injury , because “ No pain , no gain ... no guts , no glory .” So , as a child , I had ingrained within myself the idea that I am indestructible and invincible . As a result , my biggest challenge now has been coming to terms with the reality that my body is vulnerable and fragile instead .
Hiking remains an option , even if ultra trail running is out
Necessary Overshare . Period .
This next part of the story is pretty personal , however I feel it is necessary to share , in the hope that other female athletes do not end up in the same position that I did ...
In the hope that he would pay a little more serious attention to my injury , I told the orthopod that I have a history of amenorrhea ( the absence of menstruation ). I highlighted that during my extensive internet searches , I had learnt that there is a strong relationship between amenorrhea and low bone mineral density ( BMD ) in young female athletes . Apparently , it never came up in medical school , though , and it appears I left him with more useful medical information than he could give me , but I did need him to scribble something on a piece of paper in order for me to get my skeleton scanned . And the bone scan confirmed it … a femoral shaft stress fracture .
At this point , my faith in doctors had sunk very low . Before I continue , I need to rewind to a series of visits to doctors about four years ago . I first went to a general practitioner ( GP ), concerned that I had not had my period in a while . The obvious first question was , “ Could you be pregnant ?” Being single at the time , I answered with 117 % confidence , “ No !” To emphasise the inconceivability , I suggested that unless it happened via wind pollination , it was not biologically possible for me to be pregnant . I received no follow-up questions . No useful diagnosis , either . Instead , I was put on ‘ the pill .’
I did not like the pill , as my body and emotions did weird things . Well , weirder than what is normal for a weirdo like me . I was on it for three months and my period came back , so I thought everything was fine , and since I did not need any kind of birth control , due to my stagnant sex life at the time ( by choice , I must add ), I did not want to put unnecessary hormones into my body . So , I thanked ‘ the pill ’ for rebooting my reproductive equipment and I cancelled my prescription subscription . As I did so , ‘ shark week ’ once again came to an end . Bollocks !
I visited another GP , who took blood tests that suggested my hormone levels were normal . Yet another doctor did an ultrasound to confirm that all my ‘ lady bits ’ were where they were meant to be , and doing what they were meant to be doing . The doctors found no physical issue to explain why I was not having my period . Instead , I was told that it is not
If you look at the diagram below , you ’ ll see that the Female Athlete Triad exists on a spectrum . The red and green triangles represent unhealthy and healthy athletes respectively . The black lines represent the spectrums of each of the three components , between the two extremes . The green triangle represents an athlete with a good balance between energy intake and expenditure . She therefore has a normal menstruation cycle , and her bone mineral density ( BMD ) is above average for her age . The red triangle represents an athlete with an imbalance between her energy intake and expenditure . This could be as a result of restrictive dieting and / or clinical eating disorders , or obsessive / excessive exercise . These women often develop functional hypothalamic amenorrhea , and as a result , hormones that promote the formation of bone , such as oestrogen , are supressed , and these athletes will likely develop osteopenia ( low BMD ) and ultimately , osteoporosis ( severely low BMD ).
If doctors had made me aware of this when I investigated my amenorrhea concern years ago , I could have avoided fulfilling all components of the ‘ Triad .’ My fractures were as a result of low BMD , as a bone density scan confirmed that I have Osteopenia in my femurs and lumbar spine .
Ironically , I now view both my femoral fractures as ‘ blessings in disguise .’ Two femoral fractures in six months raised my suspicions of an underlying issue , especially since one would expect muscles , ligaments and tendons to tear or snap before bones start cracking . I need to emphasise that this is not an attack on any doctors , as it is impossible for them to know everything . However , it is up to you to listen when your body is trying to tell you that something is wrong .
Now What , Granny Bones ?
A lifetime of obsessive and excessive exercise coupled with incorrect medical advice ( and a very headstrong , stubborn personality ) has led me here . I was an elite artistic
I also have to accept that ultra trail running is likely a thing of the past for me , but perspective prevails , I still have my legs , and six weeks after fracture # 2 , I was already up and running again … just slower , and shorter distances . The diagnosis is shitty , but a shitty diagnosis is better than no diagnosis . Now that I know what the problem is – and the consequences thereof , should no intervention occur – I can do something about it .
As for the recovery , most of it is DIY . I am now taking Biogen ’ s CALMAG Max tablets daily and Adult Ragged-Tooth Shark Multivitamins approved by my veterinarian . Calcium is the most important mineral for bone formation . I therefore eat wheels of cheese and barrels of yoghurt . I am grateful to my gastro-intestinal tract for its ability to digest lactose , and I am further grateful to my dogs for their tolerance of the violent winds that follow ! Vitamin D is important for the absorption of calcium , so sunshine is now a medical requirement , and a useful excuse to spend more time in my preferred mountain and ocean habitats . Naartjies and oranges are consumed in excess , and my fearlessness of needles allows me to inject myself with Vitamin B when I ’ m feeling flat .
My diet is pretty good for the most part , but I ’ m just giving my body some nutritional and supplemental assistance , in the hope that I can improve my BMD . The minor dietary changes , lower exercise load and an inability to exercise portion control at meal
The female athlete triad
44 ISSUE 135 NOVEMBER 2020 / www . modernathlete . co . za