An increasing number of women are losing their monthly periods because they are following a social media trend for restrictive diets and excessive exercise, experts say.
Charity heads and nutritionists have raised the alarm about the increase in hypothalamic amenorrhea, a condition where the body enters survival mode because it is under-fuelled, causing menstruation to stop. It is a reversible disorder caused by stress related to weight loss, excessive exercise and trauma.
Martha Williams, a clinical advice coordinator at the leading eating disorder charity Beat, said the condition was becoming more widespread, and was often seen in people who were not underweight and did not have a low body-mass index.
“There are not exact statistics on this issue but the majority of people we see have lost their periods and some of these women are not seriously underweight. Some are a healthy weight but have restrictive eating,” Williams said.
Women often consulted their family doctor when their period stopped, but Williams said many GPs did not have the right training to spot the underlying cause, and prescribed the contraceptive pill to restart menstruation.
Williams said the pressure of lockdown was difficult for a lot of people, and the message from the government promoting an hour of exercise a day was not helpful for everyone. “The emphasis on this message was likely quite damaging for someone struggling to regulate their exercise levels.”
She added that social media could be a “problem”, because women shared edited photos of their bodies, creating unrealistic expectations of how people should look. Williams said fitness influencers would also tell their followers what they ate in a day, including how many calories, which did not help those with eating disorders.
Women have been raising awareness on Instagram about the implications of overexercise and so-called clean eating – a restrictive diet concept where a person avoids refined and processed foods.
Chloe Hodgkinson helps girls with disordered eating, amenorrhea and periods, based on her own experiences. When she stopped taking the contraceptive pill her period did not return, and doctors said it was normal for menstruation to be delayed. Although Hodgkinson felt it was related to the fact she was undereating, because her body mass index was not low doctors did not take her seriously. She went to a dietician who told her she had low oestrogen, after which she changed the way she approached exercise and eating, and her periods resumed.
“I have clients who have worked with a dietician or nutritionist or doctor and I help them get back into training after losing their cycle and help keep them accountable to their period journey,” she said.
Hodgkinson gets more than 20 messages a day, “with girls simply wanting answers because they can’t get them anywhere else.
“They can relate to me, they see old me in them now and see that I’ve come out the other side … They need to support to see that life is better this side,” she said.
Renee McGregor, an eating disorder dietitian, said in the past 12 months she had had 1,000 hours of contact time with clients and 95% of them had had hypothalamic amenorrhea. “It’s a big problem, bigger than people appreciate, particularly because for so long it has been – not that it should be – accepted that when women do lots of exercise they lose their period.”
She said the problem was often misdiagnosed, with women being turned away from GP surgeries and told their period had not resumed because their body was getting used to coming off the pill. “I had someone last week who was told by a gynaecologist that because they do not want children right now it’s not a problem. But not menstruating has a wider impact on physical and mental health,” she said.