Bowl of yoghurt berries and granola

Why calcium is one of the key nutrients you need if you’re exercising with amenorrhea

Posted by for Nutrition

If you have irregular or absent periods (amenorrhea), here’s why it’s especially important to take extra care of your bone health 

Just to clarify upfront, increasing your calcium intake won’t fix irregular or absent periods.

There are many reasons why your menstrual cycle could be playing up, from PCOS (Polycystic Ovary Syndrome) to thyroid problems to RED-S (Relative Energy Deficiency in Sport). Whatever the reason, even if you don’t quite know what it is yet, it’s always important to pay attention to missing periods. 

“It’s best to think of a regular menstrual cycle as an indicator of good health,” says Alex Parren, nutritionist & personal trainer for Sundried. “If you have irregular or absent periods (amenorrhea), something is wrong and you should prioritise rectifying it as soon as possible.”

Secondary amenorrhea is when you have missed three or more cycles, and studies suggest it affects 30% of women who exercise regularly. Functional hypothalamic amenorrhea (FHA) is one of the most common causes of secondary amenorrhea, responsible for 20-35% of cases. 

In a nutshell, FHA means your hypothalamic–pituitary-ovarian axis isn’t firing properly, and is not producing the necessary sex hormones needed for your menstrual cycle. 

Typically, this is caused by stress, weight loss and/or excessive physical exercise. So the best way to fire it back up again and restore your periods is to restore normal hormonal balance by increasing your caloric intake, having a rest and reducing the stress going on in your body.

In case you didn’t know, low levels of sex hormones like oestrogen and progesterone don’t just effect menstruation. Holly Dunn, clinical nutritionist and Hypothalamic Amenorrhea specialist, tells Stylist that low levels of both of these hormones, alongside other potential factors, such as low body weight and higher than average levels of stress, “together can adversely affect the micro-architecture of bone tissue leading to a reduction in bone mineral density (BMD) and eventually osteoporosis.”  

Why calcium is so important

Calcium is a key mineral that helps to provide the structural elements of bone density, which is a measure of bone strength. It also plays a vital role in many physiological functions throughout the body, such as maintaining muscle, cardiovascular and nervous tissue function. Rebecca Williams, nutrition manager at Huel, tells Stylist that when oestrogen levels are low, calcium is leeched from the bones in order to maintain normal levels of circulating calcium in the blood. 

“In turn,” she says, “women with amenorrhea may be at a higher risk of developing osteopenia (bone loss before osteoporosis) or osteoporosis (other-wise known as brittle bone disease) at an early age.”

How to get more calcium into your diet

According to NHS guidelines, “adults aged 19 to 64 need 700mg of calcium a day.” To put that into perspective, one serving of milk or yoghurt roughly provides 300mg of calcium. 

Chances are, you might already be getting enough calcium in your diet. However if you’re currently trying to regain your period, you may need to increase your daily intake.

woman eating spinach
Calcium: leafy greens like spinach and kale are also a great source of calcium.

Holly Dunn recommends including it every time you eat. “Those who are at risk of bone complications as a result of missing periods, low body weight, disordered eating or a family history of osteoporosis should look to incorporate at least one portion of calcium rich foods at each meal or snack.”

Don’t worry if you’re dairy-free, because there’s more to calcium than milk, cheese and yoghurt. “Some of the richest natural sources of calcium in foods include dark leafy green vegetables like kale and spinach,” Dunn tells Stylist, “as well as oily fish like tinned sardines (with their bones), sesame seeds and tahini, edamame beans and tofu. Fortified plant-based milks and cereals can also act as good sources of calcium.”

“Calcium supplements may also be helpful in certain individuals although, based on the literature, there are currently both potential advantages and disadvantages of calcium supplementation for human health. It’s always best to seek advice from your GP, dietician or a registered nutritionist.”

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