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Active Expert: Nancy Clark RD CSSD

2 Posts tagged with the female_athlete_triad tag

If you are experiencing amenorrhea and are no longer getting regular menstrual periods, take note. This is abnormal and unhealthy!


Amenorrhea commonly happens in women who struggle to balance food and exercise. You are likely eating too few calories, as noted by feeling hungry all the time and thinking about food too much. You can achieve energy balance by exercising a little less (add a rest day) and by eating a little more (add a healthy snack or two).


Your goal is to consume about 15 calories per pound of body weight that you do not burn off with exercise. That means, if you weigh 100 pounds, you my need to eat ~1,500 calories to maintain your weight PLUS another 500 to 800 calories to replace the fuel you burned while training. That totals 2,000-2,300 calories for the entire day, a scary amount of food for some women.


The most important change required to resume menses includes matching your energy intake with your energy output, so you eat enough to support both exercise and normal body functions. Historically, doctors gave the birth control pill to women with amenorrhea; this forced menstrual bleeding. But taking the birth control pill is a “Band-Aid approach” and does not resolve the underlying problem. 


I highly recommend you get a nutrition check-up with a sports dietitian as well as a medical check-up with your doctor or gynecologist. To find a sports dietitian in your area, use the Academy of Nutrition and Dietetics referral networks at or


For more information:

                               Nancy Clark's Sports Nutrition Guidebook

2,402 Views 0 Comments Permalink Tags: nancy_clark, amenorrhea, female_athlete_triad, women_runners, no_monthly_period

NO! Skipped menstrual periods commonly mean you are restricting your food intake and have a significant calorie imbalance...


At the American College of Sports Medicine’s recent convention in Denver (June 2011), researchers reported that among 44 female high school (16 y.o.) cross-country runners--

• 39% restricted food, thinking being lighter would help them perform better.

• 42% reported missed or absent menstrual periods in the past year.


The amenorrheic runners were eight times more likely to believe missing multiple periods was a sign they were in better shape. These young women need to be educated about the medical problems associated with missed menstrual periods! Amenorrhea is a sign they are jeopardizing their health. They are losing bone density and at three to four times risk for stress fractures today, followed by early osteoporosis in the future, and potential difficulty getting pregnant when they decide they want to conceive a child.


To resume menses, amenorrheic women need to correct the energy deficit by eating a little more fuel and exercising a little less. The amenorrheic high school runners who drank a 360-calorie carbohydrate-protein supplement resumed menses, on average, in about 2.5 months (±2 months). The longer they had been amenorrheic, the more time they needed to resume menses.


• If you need help balancing food, exercise, and weight, consult with a sports dietitian.

--To find your local expert, use the referral network at

--For written information, read the chapter on "Dieting Gone Awry" in my Sports Nutrition Guidebook.


Be wise, eat well, and enjoy lifelong good health!


3,981 Views 1 Comments Permalink Tags: women, amenorrhea, menstrual_period, undereating, missed_menstrual_period, female_athlete_triad

Nancy Clark RD CSSD

Nancy Clark RD CSSD

Member since: Jul 8, 2007

Hi! I specialize in nutrition for exercise, and help active people figure out how to manage food, weight, exercise, energy and enjoyment of eating. Let me know if you have any questions!

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