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I think they're missing the point

Posted Aug 24 2008 1:51pm 1 Comment
One of the major criteria for diagnosing anorexia is amenorrhea - the absence of menstruation in women post-puberty but before menopause. The value of this criteria aside, amenorrhea is certainly an indicator that something is not quite right with your body. And that something usually has to do with an inadequate amount of fat on your body. Fat signals an appropriate energy reserve. Since menstruation takes energy (which is why you eat more right before your period), your body isn't going to waste it on something non-essential in the short term. Besides , thinks your body, she'll never be able to maintain a pregnancy with these energy reserves . So no period. Period.

Many female athletes report menstrual abnormalities, to the point where absent periods are just sort of thought to come with the territory. While researchers have known for a long time that too much exercise + too little food = loss of periods, the precise workings haven't been pinned down. Until now.

The culprit? Abnormalities in ghrelin levels. In research presented at the annual meeting of the Endocrine Society , age-matched high school female athletes who were not menstruating had higher ghrelin levels than those who continued to menstruate.

A press release titled " Hormone disorder may contribute to lack of menstruation in teenage athletes " said that:

The researchers studied 21 teenage athletes with amenorrhea , 19 normally menstruating athletes and 18 nonathletic girls. The body mass index, a measure of body fat, was lower in the amenorrheic girls than in the other two groups, but overall these athletes were not underweight. All girls were more than 85 percent of the ideal body weight for their ages. The amenorrheic group reported similar levels of physical activity as the normally menstruating group, and both groups of athletes reported more physical activity than the non-athletic group...

"These findings suggest that hormonal disorders may explain why amenorrhea occurs in some but not all adolescent athletes," Misra said. "In addition, ghrelin may be an important link between an energy deficit state and the hormones that regulate menstrual function."

I know that research presented at meetings tends to be much more preliminary, but all I could think while reading this was: didn't they think to check body fat levels? BMI is not the be-all and end-all of weight status. My periods stopped well within the "normal" weight range, above the target weight initially set for me at my first TWO hospital stays.* So their measurements might have left them scratching their heads a bit.

Also, there was no mention of whether these girls were screened for eating disorders before participating in the study. Which strikes me as something kind of important to look for.

I don't want to criticize the existence of such research because I do think it's important. Yet the elevated ghrelin levels, to me, simply say that this girl isn't eating enough for her activity level. Or that her activity level is too high for her food intake. It's not a hormone disorder . It's the result of an energy deficit. What I think is going on? Ghrelin levels are elevated when you aren't eating enough. The girls without their periods just aren't eating enough.

It would be interesting to look at ghrelin levels in athletes both during the current episode of amenorrhea and after menstruation resumes. This might help identify girls particularly at risk. But even if we do identify high-risk girls, I'm not so sure of the usefulness of such information. Because ALL girls should be eating enough to menstruate properly, ghrelin "disorder" be damned.

*And yes, I told them the actual weight at which my periods stopped. They still lowballed it. I didn't mind it at the time, but looking back, all I can do is shake my head.
Comments (1)
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You are making conclusions with out a scientific back up.

I recently lost my period and in my investigation of what it could be i found about Ghrelin

My metabolism is super slow and im constantly hungry. This matches with the high Ghrelin levels. I'm not an athlete, I dont even excersice so why would a lack of proper eating be the causant of my menstruation loss. I tried proper nutrition, fiber and many other things to accelerate my metabolism but nothing will help. I am also having issues with my digestive system and it is one of the areas this hormone controls. Just to leave it clear I'm not anorexic or bulimic and my height and weith are 5'4" and 120. At first i believed all the anormalities were due to my treatment for Chronic Myelogenous Leukemia. two moths passed that i was off the treatment  and i still had those symptoms. When i researched I found cancer and its treatment may alter Ghrelin levels, which would match.

 I'm not saying you could be wrong 

But dont make conclusions when you haven't even done a research of your own, You are just making up conclusions in personal beliefs

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