No Periods, No Babies?

Q: I am a competitive runner in my mid-twenties and I haven't gotten my period in several years. Is this an effective method of birth control? Am I at risk of getting pregnant?

C.S.
Santa Cruz, California

A: The condition you are referring to is called exercise-associated amenorrhea. It is a diagnosis of exclusion, so other causes, including pregnancy, must be ruled out before it can be made.

Many factors have been linked to the onset of exercise-associated amenorrhea. Women need a certain amount of calories, protein and body fat to maintain menstruation. Factors such as stress, weight loss, training intensity, history of irregular periods and a late menarche may make a woman more prone to stop ovulating.

The body stops ovulating and menstruating almost as a protective factor to guard against pregnancy during a time of physiological stress. Women more likely to develop amenorrhea are those who are young (under 25), have a late menarche, have never had children, are vegetarians, have weight loss associated with training and train intensely.

You need to be aware that exercise-associated amenorrhea is a very unreliable form of birth control. It is so unreliable that it shouldn't even be considered as a method. Any woman who develops this condition and is sexually active should continue to faithfully use a conventional method of birth control.

You cannot accurately predict when the next egg will be released into the Fallopian tubes, and thus you can get pregnant without having a period. This happened to Ingrid Kristiansen, the world record holder in the 5,000 meters, 10,000 meters and marathon.

She was well into her fourth month before she discovered she was pregnant. It worked out fine for her, but this may add serious complications for a woman who isn't ready to have a child.

However, is exercise-associated menorrhea a sign of peak conditioning?

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