When I was describing my problem to a doctor eight years ago, even I could admit I sounded insane. I’d spent the best part of a year visiting healthcare professional after healthcare professional, chasing around answers and achieving nothing other than galloping neurosis. I was willing to work with anyone and do anything it took to fix my problem, but no one could even offer a diagnosis, let alone advice on how to help.
My well-practised appointment pitch went a little like this:
Until recently, I had been a ‘normal’ athlete with tonnes of energy and enthusiasm. After starting university life in Birmingham (UK), I had taken up a scholarship opportunity in America, finally managing to handle high training volumes, achieve my ‘race weight’, and live like the professional runner I wanted to become. From a simple training and conditioning perspective, nothing seemed suspect; I was simply a devoted athlete, chasing her goals like everyone else. Yet over the recent months, a mysterious health condition characterised by a set of seemingly unconnected symptoms had started seeping into every aspect of my life.
It had started subtly at first, with the odd cold that took too long to shift; unusually low moods muddled in with homesickness; a growing preoccupation with food disguised as dedication to my sport; and an inconsistent and unfamiliar form of fatigue. It made no sense to me at the time. In the absence of any other abnormal test results, iron deficiency seemed enough to justify the exhaustion, but its inconsistency remained puzzling.
On days when I was too tired to train, I grew disproportionately anxious about eating for fear of gaining weight.
I had worked so hard to achieve my 'athletic aesthetic' that I couldn’t bear to watch it slip away.
When I could run, I felt so weak that I’d push harder—fueled by mounting pressure to perform and the absurd notion that this could all be driven by a lack of fitness. With every visit to the doctor came an increased sense of helplessness, and with every set of ‘normal’ test results came increased confusion. Since I was taking the Contraceptive Pill, didn’t identify with an eating disorder, and wasn’t experiencing any bone stress injuries (yet), the Female Athlete Triad was never mentioned. So, despite knowing full well that something just wasn’t right and that this ‘something’ could be serious, I pushed on, continuing to sail miserably under the RED-S radar for a few frustrating years to follow.
Fast forward a few years, and I was finally starting to make sense of my experience. For years, I’d been a living, breathing, just-about-running, example of the condition, yet neither I nor anyone else I'd ever worked with had ever even heard of it. Quite the contrary, I’d been repeatedly reassured by doctors that it was normal for ‘someone like me’ not to have periods after coming off the Pill. Who was I to question the experts? So, like a terrifying number of others ‘like me’, I simply stood by to watch my athletic dreams slip away.
When an internet search eventually led me to the information I had needed years earlier, it was via other athletes stories just like mine. Despite the fact that RED-S was a relatively new term (only introduced by the International Olympic Committee in 2014), it appeared the problem was one of indeterminate magnitude within the exercising population. As I trawled through page after page of other people describing MY condition in words that could’ve easily been my own, it started to hit me that I wasn’t going insane or facing some sort of rare medical phenomenon after all, but a relatively straightforward one shared by countless others of all ages, genders, and participation levels all over the world.
In the end, all it had taken was hearing others describe the shattering yet subtle symptoms I was facing in order to line up the pieces of my own RED-S puzzle. I'd spent years dismissing many of them in ignorance or denial, unable to believe that a competitive athlete like me could seriously be suffering from an energy-related issue; that someone who still ate three meals a day could be experiencing an eating disorder; that this extreme fatigue wasn't all in my head; that the Pill wasn't a suitable replacement for a period; or that my missing natural period was a critical indicator of my condition.
Sadly, I am all too aware of how many others are now where I was back then. I now know how easily this can occur in anyone at any time.
I've seen what happens when it’s overlooked and how dangerous it is to dismiss the early warning signs. I also understand how tricky it can be to open up about this issue. At the time, it felt so isolating, and afterwards, it was something I just wanted to forget. Talking about it felt hard in a way I was unfamiliar with; I couldn't imagine anyone could understand what I had gone through emotionally or how I could begin to justify experiencing this much personal trauma over losing something so trivial as sport.
Eventually, I came to see that problems like RED-S thrive on isolation and the longer we keep quiet about them, the longer these issues fly under the radar. I feel privileged to now be in a position to provide this resource, sharing the advice and experience of athletes, experts, and researchers who are pushing for change. If you're keen to help, we'd love to hear from you.
Feel free to reach out, here.