From No Period to Pregnancy

Tags: Athlete Story, FemaleRead time: 6mins

In a world where success is often measured by podium finishes and personal bests, there lies a hidden struggle that many athletes face in silence".

For me, it began nine years ago, when I first noticed the absence of my menstrual cycle. The sense that something "wasn't quite right" had been lingering within me for a while, but it took a disappointing performance at the Commonwealth Games to inspire some investigation. Until then, being a distance runner, I had learned to dismiss the subtle signs of RED-S that had been creeping in over recent months as mere occupational hazards. Illness and injury, a rail-thin appearance, resistance to rest days, and a penchant for salads with dressing on the side seemed simply par for the course in sport. Even when I voiced concerns about my fatigue to my doctor, the raised eyebrow and, “What do you expect when you run 80 miles a week?” remarks left me questioning whether my concerns were valid. After all, my basic blood tests had come back ‘normal’, except for extremely low iron levels, which were treated with regular infusions at the local chemo ward.

There’s certainly nothing like being hooked up to an IV drip, surrounded by others whose lives literally depend on it, to inspire you to take charge of your own health while you still have the chance."  

I began my quest for answers by honouring an inkling that it was time to come off the contraceptive pill. Like many others did back then (and unfortunately still do without proper guidance), I had relied on the pill to manipulate my "periods" around my training and racing schedule. Little did I know that these pills created an artificial withdrawal bleed, camouflaging the absence of a natural menstrual cycle.

Back then, I didn’t appreciate the importance of a natural menstrual cycle from either a health or performance perspective, but I nonetheless wondered whether it could be connected to my dwindling energy levels, atypical low moods, and constantly depleted iron stores. So, after waiting the customary three months for my cycle to re-establish (it didn’t), I saw an endocrinologist who reassured me that my missing periods were “normal for an athlete who trained as much as I did”. (If anyone says this to you or someone you know, please find another healthcare provider!).

I was advised to resume use of the pill in order to protect my bone density - another common and harmful misconception that has been repeatedly proven wrong by recent research studies. In fact, in addition to masking menstrual dysfunction, the contraceptive pill can even compound the negative effect on bone health. If I’d only known where to turn for the right support back then, I could have avoided covering up this key symptom of RED-S and delaying diagnosis for many years to follow.

When I finally found the medical advice I needed—zero periods, one stress fracture, and five years later—I started to understand the significance of my cycle.

My then-boyfriend, now husband, Rich (or ‘Saint Richard’, as he’s known by my mother) had been with me from the start of my decline into the RED-S spiral and supported me through my desperate search for answers as to what was wrong. I knew he wanted children someday and I once did too, but at the time, I couldn’t have felt any less maternal. I had started to research the impact of female hormones on emotional and motivational states, but I wasn’t finding much to reassure me that my own missing cycle could be suppressing my desire to have children. I did, however, want to give my mind and body the opportunity to make that decision when the time came, so my recovery journey was at least partly inspired by the potential to become pregnant one day. 

That day arrived 3 years later, while on holiday in Amsterdam before Christmas. For those wondering, our choice of contraception for the years preceding pregnancy had been the fertility awareness method (FAM). While recovering from RED-S, I took a deep dive into hormone health, learning and monitoring how my own hormones fluctuate throughout the cycle. Each month I gained a newfound respect for my body and awe over what each phase of the cycle could bring. By tracking things closely over time, it became easy to keep tabs on when ovulation occurred each month, and use that marker to identify my ‘fertile window’. Knowing when the likelihood of conception was the highest meant we could take precautions then, until we wanted to try for a baby. Meanwhile, with the help of healthy hormone levels, my interest in parenthood slowly grew. But despite having maintained monthly menstruation and ovulation for several years, I was still sceptical of my body’s ability to easily conceive. After suppressing my cycle for so long, it almost felt like something I didn’t deserve a right to, and I've since chatted with many other women who sadly feel this way. So, thinking it could take years, we were decidedly less cautious around my fertile window in November, but didn’t overthink it. When my period didn’t arrive a few weeks later on holiday, I was pretty gobsmacked. 

Reflections

Looking back, this ‘let’s just see what happens’ approach to pregnancy was perfect for me. As was often the case with my running, the goal I was chasing was achieved while in my most relaxed and happy state: no pressure, no preoccupation with results, and no stressing over timing. I’ll never forget sharing my positive test result with the man who had supported me through the highs and lows of RED-S recovery and retirement from competitive running, while blindly trusting (or hoping) that I would one day want to grow our family as much as he did. It was a moment made even more exciting by both of my sisters and my best friend being pregnant at the same time - with one sister announcing hers on the same day we took our test! So far, it’s been pretty incredible to share in my loved ones’ experiences and swap notes on my own musings and milestones - noticing that we are all so incredibly different, and never more so when it comes to growing a human being. I’ll save my experiences with pregnancy itself for another day, but in sum, it seems to share a good few parallels with gearing up for a race. It requires preparation, patience, and plenty of carbs - only this time, they’re helping me to grow a human being, which already feels more worthwhile than any race win or personal best.  

NB:

Hormonal contraceptives can be a great method of birth control for some, but it's essential to be aware that the “withdrawal bleed” is not a substitute for a natural, regular menstrual cycle. The fertility awareness method is also certainly not for everyone, especially those who want some certainty about not falling pregnant at any given time. This approach to birth control requires both effort and understanding from you and your partner, so as always, it’s well worth reading up on it before making any decisions. You can check out some great resources below.

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