I feel that my situation was pretty typical of what a number of female athletes go through. I was prescribed Ortho Tri Cyclen* when I was 17 because I hadn’t had a period for more than two years. Not wanting to put anything artificial in my body and being scared about the hormones, I didn’t actually start taking the pills until I sustained a stress fracture in my foot during my freshman cross-country season at college.
After the fracture, a doctor convinced me that it occurred because my bone density was low. He said my bones were suffering because I didn’t have periods. This was the case because the absence of menses meant that my body didn’t have enough estrogen… and estrogen was the key to calcium being absorbed by my bones. He told me that my estrogen was low because I ran so much. And he said all this could be corrected by taking the birth control pill because it would supply my body with artificial estrogen that would keep my bones strong.
The Female Athlete Triad- of disordered eating, amenorrhea, and osteoporosis- was a relatively new buzzword ten years ago and doctors, trainers, and coaches were quick to jump to the conclusion that the birth control pill was the easiest, quickest-fix band-aid solution to the most bothersome part of it. I wish that I could say that as a community, sports medicine has made tremendous progress – that doctors, coaches, and trainers know a great deal more about how to address these situations with their athletes, but I don’t really believe it’s much better. Birth control pills are more than ever being prescribed to young athletes (and non-athletes alike) as a quick-fix solution to problems that require a much deeper and more comprehensive look at the whole system.
When I look back at my own situation, I realize that the Doctor made a lot of assumptions in his hypothesis. First, he assumed that my stress fracture was due to having low bone density, though he never measured the density of my bones. In reality it was my training that changed significantly – I had gone from running maybe 40 miles per week on dirt roads in high school in Colorado to running 70+ miles per week in college mostly on pavement.
The other reality about my situation was that running or body fat percentage wasn’t the cause of my amenorrhea. I was always a very active teenager and a “late bloomer.” I played 3-4 varsity level sports during high school. I only had a couple “regular periods” when I was 15 years old and they ceased when I left to be an exchange student in southern Brazil. In Brazil I wasn’t allowed outside of the house alone. It was, by far, the most sedentary I have ever been at any time in my life. And like all exchange students, I gained a few pounds. And yet this is the time in my life when my periods stopped. When I returned from Brazil, I embarked on a 30-day wilderness education course backpacking across Colorado’s San Juan Range. But still my cycle didn’t return.
Over the years I stopped taking birth control twice for several months at time to see if my period would return on its own. Each time I noticed a marked improvement in my mood and digestion, but each time a friend or doctor encouraged me to go back on the pill because I needed it for my bones. I remained on a mono-phasal birth control pill until the age of 25. At that point, my digestive problems and allergies were so bad that I wanted to try anything to alleviate the situation. I read as much as I could find on the subject, scheduled a bone density scan that came back on the low side of normal, and quit the pill for good. It was a liberating feeling!
Eventually, about 7 months later, my cycle returned naturally for the first time in over 10 years. For the first year or two it was not consistent- some months it wouldn’t come, some months it would only last a day. However, the overall trend was one of progress.
Acupuncture has been the single most helpful tool for me in finding hormonal balance and regulating my periods. I highly recommend it!