Health and Me

Ishita Roy

The Hidden Cost of Extreme Fitness On Women’s Bodies | Women's Day Special

"Women are NOT little men and therefore require a different training approach and inputs as well as more nervous system regulation," says Hyrox athlete Jade Skillen who said she lost her <span>period</span> for the first time in 16 years of training a high-level sport. As International Women's Day approaches, her words feel less like a personal reflection, but more like a warning to the women under rigorous training and how complexities are often missed when it comes to women's health.

Hyrox is an indoor <span>fitness</span> race that includes 8km of running with 8 functional workout stations. However, this requires rigorous training, including diets, often deficit in calories. Behind the sculpted physique lies a pain not many women talk about. <strong>Missed periods</strong>.

This is not just true in the case of athletes, but anyone under such rigorous training and much light was brought when journalist Jeon Da-hyeon's book <em>K-pop, Idols in Wonderland</em> gained attention and exposed that 8 out of 10 female trainees stop menstruating, attributing it to extreme calorie restriction and punishing training schedule.

While it is told to be "normal". The truth is, it is not.

<h2>When Training Switches Off Periods</h2>

From a medical standpoint, this isn’t mysterious. It’s biological.

Dr Surabhi Siddhartha, Consultant Obstetrician &amp; Gynecologist at Motherhood Hospital, explains that what many of these trainees experience is functional hypothalamic amenorrhea. “Menstruation is controlled by a delicate hormonal system involving the brain and ovaries,” she says. “When the body is under extreme physical stress, not getting enough calories, or facing emotional pressure, the brain senses that it is not a ‘safe’ time for reproduction.”

The hypothalamus reduces hormonal signals to the ovaries. Estrogen levels fall. Ovulation stops. Periods disappear. This is ovaries' way of survival mechanism.

“When rigorous exercise is combined with strict calorie restriction, the body enters an energy-deficient state,” Dr Siddhartha explains. “Amenorrhea is not just about missing periods. Long-term low estrogen can affect bone strength, fertility, mood and overall well-being.”

Doctor explains that this is your body's way of waving a red flag.

Elite-level training increases energy demand and severe dieting reduces energy supply. “The condition is usually reversible,” Dr Siddhartha says, “but it requires balanced nutrition, exercise moderation, stress management and medical guidance.”

The problem? In many high-performance cultures, whether K-pop or competitive sport, rest is seen as weakness. Thinness is rewarded.

For decades, missed periods in runners, gymnasts, or anyone under rigorous training were dismissed as routine.

Dr Pooja Chaudhary, Consultant in Obstetrics and Gynecology at Motherhood Hospital, is clear: “If menstruation stops for over three months or becomes irregular, especially with weight loss and fatigue, it should never be dismissed as ‘normal.’ It may signal a hormonal imbalance and needs evaluation.”

Missing three consecutive cycles is not a badge of athletic honor. It is a clinical concern. However, menstrual health continues to remains poorly integrated into training conversations.

“Menstrual health can often be neglected during training,” Dr Chaudhary notes. “Many coaches lack formal education on recognizing cycle disturbances.”

<h2>Exercise Is Helpful, But Excessive Of It Causes Disruption</h2>

How to know when to draw a line? While exercise is widely prescribed as first-line management for PCOS or polycystic ovary syndrome, cases show that training hard could worsen it. So, where do we draw the line? How do we reconcile advice that says “exercise more” with cases where rigorous training appears to disrupt hormones?

Recently, <a href="https://www.healthandme.com/fitness/can-too-much-running-worsen-pcos-gabby-logan-opens-up-about-athlete-daughters-diagnosis-article-153666340" data-type="tilCustomLink">Lois Logan</a>, daughter of broadcaster Gabby Logan was advised to avoid "extreme running" after her PCOS diagnosis. "Moderate, well-balanced exercise is beneficial for women with PCOS. But excessively high-intensity training without adequate nutrition or recovery can increase stress hormones and worsen irregular cycles," says Dr Chaudhary.

The doctor explains that while in such cases, it may feel like your body is betraying you, the issue is not exercise, but in imbalance, especially when paired with calorie restriction and insufficient recovery. PCOS thrives in hormonal chaos. Extreme endurance training can sometimes fuel that chaos instead of calming it.

This is where individualized care matters. The doctor explains that blanket advice to “exercise more” ignores the fact that intensity, fuel and rest must be calibrated carefully, especially in women whose endocrine systems are already vulnerable.

<h2>We Asked Experts Some Tough Questions</h2>

Not just the feeling of being betrayed, but also the question of why just women? Men train just as intensely, yet we rarely hear about reproductive shutdowns. To this, Dr Rashmi Niphadkar, Pune-based, Fertility Specialist at Nova IVF Fertility explains that the difference lies in biological design.

“In women, the reproductive system is sensitive to energy availability,” she says. “When the body feels under stress, it switches into survival mode and reduces signals to the ovaries.” Men, she explains, can experience drops in testosterone and sperm quality under extreme stress, but they do not have a visible monthly reproductive cycle like menstruation.

“The signs are subtler and less immediately visible compared to menstrual changes in women,” she says.

<h2>Does That Mean Women Are Biologically More Vulnerable?</h2>

Dr Sandeep Talwar, a Delhi-based Fertility Specialist from Nova IVF Fertility says, "The female reproductive system is closely linked to energy balance and overall health. When a woman experiences intense training, calorie restriction or chronic stress, the brain reduces signals to the ovaries. It is a protective response.”

However, the protective response could come at a cost when prolonged over months or years. This cost could be bone density loss, fertility challenges and emotional strain.

“Missing three consecutive cycles should never be ignored,” Dr Talwar emphasizes. “Periods are a vital health marker, not an inconvenience.”

<h2>Is There A Safe Way To Train At Elite Level?</h2>

The answer is yes, but not without awareness and with adequate personalization. “Intense athletic training is possible without sacrificing reproductive health,” Dr Talwar says. “But it requires balance, proactive medical guidance and not pushing the body beyond its biological limits.”

<ul><li>Matching calorie intake to energy expenditure</li><li>Including healthy fats and proteins to support hormone production</li><li>Scheduling rest days deliberately</li><li>Tracking menstrual cycles consistently</li><li>Seeking medical advice early</li></ul>

It also means coaches, gynecologists, nutritionists and sports physicians working together.

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"Women are NOT little men and therefore require a different training approach and inputs as well as more nervous system regulation," says Hyrox athlete Jade Skillen who said she lost her period for the first time in 16 years of training a high-level sport. As International Women's Day approaches, her words feel less like a personal reflection, but more like a warning to the women under rigorous training and how complexities are often missed when it comes to women's health.Hyrox is an indoor fitness race that includes 8km of running with 8 functional workout stations. However, this requires rigorous training, including diets, often deficit in calories. Behind the sculpted physique lies a pain not many women talk about. Missed periods.  This is not just true in the case of athletes, but anyone under such rigorous training and much light was brought when journalist Jeon Da-hyeon's book K-pop, Idols in Wonderland gained attention and exposed that 8 out of 10 female trainees stop menstruating, attributing it to extreme calorie restriction and punishing training schedule.While it is told to be "normal". The truth is, it is not.When Training Switches Off PeriodsFrom a medical standpoint, this isn’t mysterious. It’s biological.Dr Surabhi Siddhartha, Consultant Obstetrician & Gynecologist at Motherhood Hospital, explains that what many of these trainees experience is functional hypothalamic amenorrhea. “Menstruation is controlled by a delicate hormonal system involving the brain and ovaries,” she says. “When the body is under extreme physical stress, not getting enough calories, or facing emotional pressure, the brain senses that it is not a ‘safe’ time for reproduction.”The hypothalamus reduces hormonal signals to the ovaries. Estrogen levels fall. Ovulation stops. Periods disappear. This is ovaries' way of survival mechanism.“When rigorous exercise is combined with strict calorie restriction, the body enters an energy-deficient state,” Dr Siddhartha explains. “Amenorrhea is not just about missing periods. Long-term low estrogen can affect bone strength, fertility, mood and overall well-being.”Doctor explains that this is your body's way of waving a red flag.Elite-level training increases energy demand and severe dieting reduces energy supply. “The condition is usually reversible,” Dr Siddhartha says, “but it requires balanced nutrition, exercise moderation, stress management and medical guidance.”The problem? In many high-performance cultures, whether K-pop or competitive sport, rest is seen as weakness. Thinness is rewarded.Missed Periods Are "Not Normal"For decades, missed periods in runners, gymnasts, or anyone under rigorous training were dismissed as routine.Dr Pooja Chaudhary, Consultant in Obstetrics and Gynecology at Motherhood Hospital, is clear: “If menstruation stops for over three months or becomes irregular, especially with weight loss and fatigue, it should never be dismissed as ‘normal.’ It may signal a hormonal imbalance and needs evaluation.”Missing three consecutive cycles is not a badge of athletic honor. It is a clinical concern. However, menstrual health continues to remains poorly integrated into training conversations.“Menstrual health can often be neglected during training,” Dr Chaudhary notes. “Many coaches lack formal education on recognizing cycle disturbances.”Exercise Is Helpful, But Excessive Of It Causes DisruptionHow to know when to draw a line? While exercise is widely prescribed as first-line management for PCOS or polycystic ovary syndrome, cases show that training hard could worsen it. So, where do we draw the line? How do we reconcile advice that says “exercise more” with cases where rigorous training appears to disrupt hormones?  Recently, Lois Logan, daughter of broadcaster Gabby Logan was advised to avoid "extreme running" after her PCOS diagnosis. "Moderate, well-balanced exercise is beneficial for women with PCOS. But excessively high-intensity training without adequate nutrition or recovery can increase stress hormones and worsen irregular cycles," says Dr Chaudhary.The doctor explains that while in such cases, it may feel like your body is betraying you, the issue is not exercise, but in imbalance, especially when paired with calorie restriction and insufficient recovery. PCOS thrives in hormonal chaos. Extreme endurance training can sometimes fuel that chaos instead of calming it.This is where individualized care matters. The doctor explains that blanket advice to “exercise more” ignores the fact that intensity, fuel and rest must be calibrated carefully, especially in women whose endocrine systems are already vulnerable.We Asked Experts Some Tough QuestionsNot just the feeling of being betrayed, but also the question of why just women? Men train just as intensely, yet we rarely hear about reproductive shutdowns. To this, Dr Rashmi Niphadkar, Pune-based, Fertility Specialist at Nova IVF Fertility explains that the difference lies in biological design.“In women, the reproductive system is sensitive to energy availability,” she says. “When the body feels under stress, it switches into survival mode and reduces signals to the ovaries.” Men, she explains, can experience drops in testosterone and sperm quality under extreme stress, but they do not have a visible monthly reproductive cycle like menstruation.“The signs are subtler and less immediately visible compared to menstrual changes in women,” she says.Does That Mean Women Are Biologically More Vulnerable?Dr Sandeep Talwar, a Delhi-based Fertility Specialist from Nova IVF Fertility says, "The female reproductive system is closely linked to energy balance and overall health. When a woman experiences intense training, calorie restriction or chronic stress, the brain reduces signals to the ovaries. It is a protective response.”However, the protective response could come at a cost when prolonged over months or years. This cost could be bone density loss, fertility challenges and emotional strain.“Missing three consecutive cycles should never be ignored,” Dr Talwar emphasizes. “Periods are a vital health marker, not an inconvenience.”Is There A Safe Way To Train At Elite Level?The answer is yes, but not without awareness and with adequate personalization. “Intense athletic training is possible without sacrificing reproductive health,” Dr Talwar says. “But it requires balance, proactive medical guidance and not pushing the body beyond its biological limits.”That means:Matching calorie intake to energy expenditureIncluding healthy fats and proteins to support hormone productionScheduling rest days deliberatelyTracking menstrual cycles consistentlySeeking medical advice earlyIt also means coaches, gynecologists, nutritionists and sports physicians working together.