Q I train two hours a day preparing for a marathon, and my period has been gone for five months. Is exercise the cause?
A High-intensity exercise and low body fat suppress GnRH secretion in the hypothalamus, stopping menstruation. This is part of the female athlete triad (amenorrhea, osteoporosis, energy deficiency), and adjusting training volume and improving nutrition must come first.
Detailed Answer
Excessive exercise leads to an energy deficit, which suppresses GnRH secretion in the hypothalamus, lowers LH and FSH, and results in anovulation and amenorrhea. This is the core pathway of the Female Athlete Triad (energy deficiency, amenorrhea, osteoporosis). Reducing training volume and increasing total daily energy intake sufficiently is the first step toward recovering menstruation.
Korean Medicine Clinic Perspective
In Korean medicine, this situation is viewed as a state of Qi and Blood Deficiency (giheo-hyeolheo), in which far less is being replenished than is being expended. Slightly reducing training volume while taking formulas that tonify Qi and Blood allows the body to begin redirecting energy back to the uterus. In addition, acupuncture to release the muscular tension built up from high-intensity exercise helps restore autonomic nervous balance.
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