Rachel, a fitness instructor’s story

A personal story from Rachel, a fitness instructor from Penn State University

Being a late bloomer during adolescence, I wasn’t initially concerned when I entered high school without having experienced my first menstrual period. At the age of 16 I had my first period followed my second about 12 months later. When I continued to have missed periods, I decided to consult my physician. She explained that judging by my body weight and height I appeared to have a healthy BMI. However, based on my highly active lifestyle and the irregularity in my menstrual cycle even at the age of 17, she suggested that I begin taking oral contraceptives in order to “get my body on the right track”. By this time I was a freshman in college, training to become a fitness instructor, and attending fitness classes most days of the week. After about a year of being on oral contraceptives, I decided to discontinue my usage. My period was regular for 2 or 3 months after I stopped taking the pill but soon after I became irregular again.

I continued to exercise frequently and at relatively high intensities and my periods remained irregular. As a Kinesiology major, I became aware of the Female Athlete Triad through several of my required courses. Although I displayed some symptoms, I always ate when I was hungry and I tried to maintain a healthy diet to compensate for the energy that I expended during exercise. When I began teaching fitness classes, I actually gained several pounds and have managed to maintain a healthy weight throughout my college career. Although I knew that my menstrual irregularities were not normal, I did not know of any other actions that I could take to improve my condition. In addition to fitness classes, I decided to take up running.

During the Spring of 2011 I decided to participate in a study where I completed a DXA scan measuring my bone density at the hip and the spine. My BMD Z-scores at my hip and spine were 0.6 and 0.4, respectively. These results were favorable to me as my bone health is very important to me especially given my background knowledge in the area of women’s health, exercise, and bone.

In the summer of 2011, at the age of 21, I began training for a marathon. In addition to teaching muscle conditioning and aerobics classes, I went for 6 mile runs usually 3 times during the week. By the end of the summer I began having foot pain and when I returned to school in August, an MRI showed a stress fracture in my 2nd metatarsal. My orthopedist suggested that in addition to staying off of my foot, I should take vitamin D and calcium supplements and eat a sufficient amount of calories to replace the energy that I expend during exercise. I struggled with recovery during the whole semester and took up swimming and weight lifting to replace running and high intensity aerobics. After about 2 months of decreased exercise, my period became somewhat regular. I resumed my normal fitness aerobics activity in January 2012 but have not picked up running yet. Since October I have had a menstrual period for 6 consecutive months although they have been at somewhat irregular intervals.

As a fitness instructor, I am a health and exercise role model for other students and fitness enthusiasts. Yet, even though I exercise routinely but not excessively, eat a healthy and sufficient diet, and maintain normal BMI and BMD values, I still struggle with several major factors associated with the Female Athlete Triad. I’ve been frustrated by the fact that I seem to do everything right and follow the recommendations of my physicians, but my body continues to display signs of a significant problem. I think that the Female Athlete Triad Coalition plays a very important role in promoting awareness and encouraging education, research, and treatment for athletes like myself. Personally, I would like to see more research done on the signs, causes, and interventions for the Female Athlete Triad.

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