Period Loss and Athletic Performance

Apr 2, 2023 | Let's Hear From The Experts

periods and athletic performance

Reilly has been a Sports Dietitian for the last 4 years. She helps athletes meet their performance goals on and off the field with easy and simple nutrition. A previous college soccer player, Reilly now specializes in soccer players and other athletes. She contracts with teams all throughout the United States and also provides virtual support through the Performance Fueling Club. She also has experience in working with athletes in fueling well to overcome period loss and boost athletic performance.

In this Episode:

  • Periods and period loss is a sign of “fitness”
  • Understanding energy availability
  • Getting your period back while training
  • Why some athletes lose their period others do not
  • How a missing period impacts athletic performance

Connect with Reilly: Instagram: @reilly.beatty.nutrition

TikTok: @reilly.beatty.nutrition

Reilly’s podcast: Eat More Carbs

Podcast Transcript

Lindsey Lusson  00:00

Welcome to the food freedom fertility podcast. Here we discuss the challenging, rewarding and life changing process of recovering your period and finding freedom with food and exercise. Whether you’re hoping to regain your cycle to get your health back on track. Or you’re ready to become a mama, this podcast is for you. While the recovery process isn’t always rainbows and butterflies, it’s my hope to bring you both information and inspiration during your own recovery journey. I’m your host, registered dietitian and fellow HA woman Lindsey Lusson.

We have Reilly today who has been a sports dietitian for the last four years. She helps athletes meet their performance goals on and off the field with easy and simple nutrition. As a previous college soccer player Riley now specializes in soccer players and other athletes. She contracts with teams all throughout the United States, and also provides a virtual support through the performance fueling club. Welcome, Riley.

Reilly Beatty  00:57

Hi, Lindsey. Thanks for having me today.

Lindsey Lusson  00:59

Absolutely. I’m excited to jump in and ask you all the questions that I get from my athlete clients! I’m also just discuss something that I feel like is really taboo. And maybe you can shed some light, maybe not so much in the athlete world. But you know, tell us a little bit more about how you kind of got into being a sports dietitian? And what kind of led you to pursue this niche within the dietetics world?

Reilly Beatty  01:23

 So growing up ,I loved like sports so much. I was always playing outside. I was always trying to beat the boys I was I did lots of different competitive sports. And Soccer is the one that kind of stuck with me. So I’ll talk a little bit more about that later. But there’s always been an athlete at heart.

And, I’ve also always loved food. I was always eating playing outside. And I again, just really loves food. But I didn’t really like understand exactly like what was so important about feeling my body properly. And I didn’t really see the importance of food as an athlete. And just as a, you know, as a general person as well. I grew up loving sports, loving food. And when I became like a teenager, and I started to get recruited to go to college for sports. I started to unfortunately, develop an unhealthy relationship with food. And it was unfortunately, something I didn’t even realize at the time.

So went to college, for soccer. Again, just eating started again, have a little bit of an unhealthy relationship with food. And I spent most of my collegiate career hurt, I was always in the athletic training room. And I had four surgeries when I was playing. 

I also never had my period. So as we know, now that is very, very important. But again, at the time we had, I had no idea. And it was almost like a badge of honor. We would go around the locker room talk about how it was so great that we didn’t have a period. We didn’t have to worry about it that month, and all of that stuff. So again, I didn’t really understand the importance of any of this stuff until I graduated and was on the track to go to medical school. But realize, hey, I love food so much. Here’s all the, you know, amazing things you can do with nutrition.

And here’s all the mistakes that I made as I was growing up, so I kind of shifted path. I decided that I wanted to help shed light on all of this stuff. I wanted to help athletes you know, avoid the same mistakes that I made.

Lindsey Lusson  03:30

I love it. I love it whenever people have like a personal story behind kind of like what they do now in their business. And so I think it is so interesting that you as a college athlete didn’t have a period were aware of it. It sounds like other people didn’t to like other people like on your team. Or other people that you connected with that were also athletes or tell me a little bit more?

Reilly Beatty  03:51

That, ya know, again, like looking back at it, everything made so much sense now. But at the time I didn’t, I remember that my period would get lighter or disappear when I would go into bouts of hard training or when I would go into season. I thought oh my gosh, that means I’m fit.  And then I would see people on my team that were quote, unquote, fit as well. And they wouldn’t have their periods. So we started to associate like the lack of a period with a positive performance outcome, which is super crazy. And I also think the craziest thing is and now working in this space, too. We don’t hear about this in team sports. We often hear about it and cross country runners or marathon runners. But athletes of all sports are struggle with this.

Lindsey Lusson  04:36

Yeah, yeah. And thanks so much for shedding light on that too. Because I think that if we look at like textbook definitions of hypothalamic amenorrhea, or female athlete triad, they often associated with sports that have an aesthetic component. So like ballet figure skating, gymnastics or dance. They don’t they’re not grouping into team sports, like you mentioned, and so do you. I mean, I guess that kind of leads me to my next question. In your experience, do you are you do you work with all different types of athletes? Or you work with more college athletes right now?

Reilly Beatty  05:09

Um, so I actually I work with a team in the NWSL. So I work with Gotham. They’re a soccer team in the NWSL. And I actually work with two of the Team USA teams. I work with field hockey, and I work with taekwondo. So very different sports. It’s so interesting. And I get to learn so much more about new sports all the time and new nutrition all the time. And then I just have private practice clients, too. So my team sports runners.

Lindsey Lusson  05:35

And so do you see period loss and HA with a variety of different sports? Or do you feel like it is more in certain type of sports? In your experience?

Reilly Beatty  05:47

I think it’s a it’s completely across the board. I think there’s athletes who are like you mentioned and those like textbook sports. The ones that habit and I think they are also more aware of it. But what I’ve been finding is a lot of these athletes that might not be “textbook” are also struggling. But there’s not been education around around this.

Lindsey Lusson  06:08

So can you kind of paint a timeframe for us? What was the what were the years that you were in college?

Reilly Beatty  06:15

Oh, let’s think I always get confused with high school and college. I graduated college, or I graduated high school in 2010. And then I went to school and graduated college in 2014. Okay, so 2010 to 2014.

Lindsey Lusson  06:30

And it sounds like at that point in time, people were athletes were losing your period. It wasn’t specific to specific sports people were talking about. But people were talking about it more as a oh, this is a fit and healthy thing. And so what’s your experience now working as a sports dietitian? Should? Are people recognizing that this is actually a red flag? And that it’s not helping? Or is it still kind of a badge of honor?

Reilly Beatty  06:50

I don’t necessarily know if it’s a badge of honor now. But I do think that athletes are still getting this information about it. And the more that we’ve talked about it, the more that there’s awareness about it. And again, like you mentioned, like, what does textbook sports, I do think most people in those spaces understand it? But I don’t know, if they completely understand like all of the health implications that are related to it. They just say, oh, I should get my period. Okay. Some of these silent symptoms that you can’t directly see from like the outside are happening. But they don’t realize that so I think there is a little bit more education. But I still think we have a long way to go.

Lindsey Lusson  07:30

Yeah. 100%. So I work more with like recreational athletes or just people who like really like to exercise. And I think when I was doing research, I’m trying to figure out why I wasn’t getting a period. I kept coming across stuff aboout Female Athlete Triad. I’m like, okay, that’s me. But actually, I’m not an athlete. So it was like, I could never fit into the box.

I think that the miseducation component of just not having a period as an active woman, or as an athlete, there’s just still lacking information. And it’s sad to me, because I, you know, dealt with this issue for well over a decade. It’s sad that the same things that I was told when I was 24 or 25, are still being thrown around today. So feel like we’ve got people like you that are spreading awareness. I also feel like we still have a lot of work to do.

Reilly Beatty  08:25

Yeah. And even like the recreational woman, too, I think they underestimate how active they actually are.

Lindsey Lusson  08:31

Yeah, and, you know, that kind of comes with a whole slew of things, right? Because it’s, it’s usually just the, you know, act, it’s not just the level of activity, right? Because some people have their period, and some people don’t. So, you know, when you’re working with athletes to try to restore their period, do you guys address exercise? Because obviously, somebody’s a competitive athlete, they can’t just like pull out of other sports? Or maybe they’re like getting paid, maybe that’s their job. So like, what is what is kind of your approach? What tips would you share for someone who’s wanting to recover their period and not have to sacrifice their training again? Especially if it’s like, part of their job?

Reilly Beatty  09:08

Yeah, it’s so tricky. It’s so tricky. Especially with these high level athletes, because you’re exactly right, where you don’t want to like pull them from training, but then it’s this huge health issue. And they’re at risk for so many things as they continue on doing what they’re doing. So you really have to take each athlete with like an individualized approach. And I know that’s not like the best answer, but that’s really what it is.

Some athletes, when you look at energy availability, that’s going to be the biggest thing that we’re focusing on. So how can we make sure that we have enough energy available for your training. But then also for just being healthy as a person first. And I’ve worked with many athletes that we’ve had to remove from play. Or we’ve had to shorten their training load in order to overcome and get back that available energy that they need to function properly.

Lindsey Lusson  10:00

Ah, yeah. For those unfamiliar, can you explain what energy availability is?

Reilly Beatty  10:03

Yeah. So it’s basically just try to make it a very simple level, the energy that is needed through sport, and the energy that’s needed for our body to function properly. We have a basic metabolic rate that we would need to function properly if we just laid in bed all day. And then on top of that, when you look at an athlete, you look at their exercise, and you look at the other components of metabolism. You have to make sure that you’re fueling for so that everything’s happening properly.

Lindsey Lusson  10:36

Yeah, awesome. Thanks for that. So when you’re working with athletes who don’t want to give up their training, it sounds like it’s, it’s a tricky scenario. It’s gonna depend upon the individual what their goals are. And it sounds like it’s something that some people can get their period back by closing the energy deficit. Some people can get their period back while still training by closing the energy deficit, and some people cannot. Or it takes them longer? Can you tell me a little bit more?

Reilly Beatty  11:01

Yeah, so to overcome an energy deficit, right, we have to either eat more. We have to fuel our bodies more, or we have to, you know, lower the exercise load. So athletes who are able to increase their energy intake, increase their calories, and also do that, with nutrient timing.

So doing it’s at the right time of the day as well, not just doing it all at night. And not just doing it all at morning. It’s making sure that they’re consistently consuming enough energy throughout the day, can get their cycle back with their current training load.  I’ve had athletes who’ve done that. But that can also mean you’re eating 4000 calories a day, which can sound very scary for certain people and certain athletes. So if an athlete isn’t there yet, they’re not able to do that, then, removal from sport or decreasing that training load might be necessary.

So again, it’s very individualized. And it’s also going to depend on how long the athlete has been without a period as well. So usually, it takes athletes anywhere from six months to a year. And if they remove themselves from sport, it will come back.

Lindsey Lusson  12:12

Yeah. That makes total sense, because you’re obviously burning less calories and bodies under a little bit less stress. And so what I’m hearing is, it is possible to get your period back while still doing training. But you have to be extra vigilant with your nutrition. You probably need to be working with sports dietitian, like Riley. You need to have the expectation that it’s going to be you’re kind of playing the long game here. It’s probably not going to be the quickest process for you. Is that correct?

Reilly Beatty  12:38

Correct. So again, like looking at an athlete’s training box, looking at their schedule. Looking at what’s coming up and seeing like, okay, when can we decrease training load? I think a lot of times the athlete is like oh my gosh, if I stop training, then this is gonna hurt my performance. And it’s like, well, if you don’t have your period, that’s also going to hurt your performance. So if it takes a little bit of time. Like in the beginning, if we need to remove you from sport for a couple of months to overcome that energy balance, it’s actually going to benefit you more in the long term.

Lindsey Lusson  13:06

Yeah. Do you see athletes be able to regain their cycles easier, like during an offseason versus in season training?

Reilly Beatty  13:16

Yes, that is so so common, actually, that I see that I see a lot of athletes who don’t get their cycle in season and when they get their cycle in the offseason are out of season. And I work with a lot of athletes to help regulate that. Because that clearly shows that there’s something wrong when you look at energy availability.

Lindsey Lusson  13:34

Yeah. And that makes total sense. Now, let’s talk about you know how to prevent even getting here, right? Because I feel like a lot of the people that I work with who experience period loss with HA start to play the like “why me” game. Like why did I lose my period, but there’s this other girl in my CrossFit class that’s so lean. And she exercises twice a day, and she still gets her period. So what what differences have you noticed among athletes who are training and tend to get a regular healthy cycle? And those that don’t?

Reilly Beatty  14:05

I think the first thing is like, you are an individual. It’s very individualized. And you also don’t always know what’s happening with your teammates. You don’t know if they have female athlete triad. You don’t know if they have read so you don’t know exactly what’s going on with them. So let’s try not to compare. And I think that’s one of probably the hardest things like, like you mentioned, why me?  Why does she have a six pack and I don’t and then I’m losing my period? So try not to compare because, but that’s always that’s always easier said than done. Right?

And I also think too, like it is about the quality of the food. It’s about the macronutrients and it’s also about like the nutrient timing too. We want to make sure that you have energy available for the work that’s required from your sport. So again, if you’re eating, you know, 3000 calories a day, but most of that’s coming at night. And you have, you know, two training blocks in the morning? Well, energy is mainly going to be available or the right energy is not going to be available for your training session. And that’s going to put you into an energy deficit. And that could affect your cycle.

Lindsey Lusson  15:12

Yeah, totally. Now in, you know, we’ll just use like your professional experience today, because we’ll probably have more insight. So I’m curious if like the teams that you’ve worked with in the past, like, if the topic of losing your period is something that people talk about, like, have you given talks on this? Is this something that like athletic directors, or coaches, or athletic trainers are like wanting people to have education around? Or does it tend to be more of a taboo subject, like a lot of things in woman’s health?

Reilly Beatty  15:43

I think, a little bit of both. When the colleges and the NCAA institutions, we would always do like a screening process anytime we would onboard new athletes. And that’s how I do it in my private practice, as well. Where we do a questionnaire we ask the question, again, it might be a little awkward for the athlete. But we’re just asking questions, and we’re trying to make it not taboo. The groups that I’ve worked with, I don’t think they’re ready for a group conversation about this yet. I think it still might be a little like taboo for them for that. But I do like screenings and all of that stuff in my private practice. And all of the institutions I’ve worked for do that as well.

Lindsey Lusson  16:20

Yeah, yeah. So we’re getting there. Maybe it’s not like the hottest topic on canvas. But it sounds like it’s nice. It’s part of an assessment that athletes are under it, a female athletes are undergoing a lot. And that’s really good to see, you know, we mentioned about like nutrient timing, which makes total sense. Like if somebody’s taking in all their calories, at the end of the day, they don’t have as much energy available. Especially if they’re training or their other like lifestyle factors. Or maybe differences in training that you’ve noticed among athletes who maybe have no period or regular periods versus those that tend to have a healthy cycle?

Reilly Beatty  16:54

I definitely think like looking at the stress of an athlete, making sure that an athlete’s not stressed. Looking at just like, like general healthy lifestyle behaviors, I think are super important. I haven’t been able to like maybe pinpoint exactly when one or two things that cause this. Except for, you know, energy availability, but basically, just trying to have good sleep, you know, good mental health, you have relaxation, low stress, and then you know, fueling your body and surrounding yourself with people who also like value, you know, feeling your body in a good way, I think is also really important.

Lindsey Lusson  17:31

I think the culture we subject ourselves to, and I think that sometimes you get in trouble with social media with this one is if you know, athlete or not, if you’re surrounding yourself with people who are always dieting, restricting food and have disordered relationships with food that can directly impact you as well. Do you find that the athletes that you’ve worked with who struggle with period loss also struggle with like overtraining, like exercising outside of their practice, like doing more exercise on top of like what’s recommended as part of their score?

Reilly Beatty  18:02

It depends. I don’t necessarily see that too much in team sports. But I think some of the individualized sports, we do see that a little bit more training outside of their training block. Usually with team sports, it’s not been as apparent usually it’s under fuelling so energy restriction, and like the team sports, but maybe in the individualized sports, it’s restriction and the overexercise, but I could be wrong. That’s just kind of my experience.

Lindsey Lusson  18:30

Yeah. Well, another thing too, is I’m just thinking about, like, my history with HA is like, I don’t think I would have honestly been 100% transparent about the amount of exercise I was doing. Like, if I was asked by a trainer or a physician, I think that I would have minimized you know, oh, you know, the Three Mile walks that I do don’t count something the high intensity or something like that. 

So I’m wondering, too, if that’s like, you know, kind of on your honor, like maybe not everybody’s kind of besting not to the amount of movement that they’re doing. But, I mean, it sounds like biggest takeaway here is it is a fueling issue, it’s and under fueling issue, and so it happens whenever we are operating a calorie deficit, we don’t have the energy availability to, to have a period and support other body systems, and it’s something that can be corrected through proper nutrition, proper fueling at the heart of it?

Reilly Beatty  18:50

 Yep.

Lindsey Lusson  19:19

And so, um, you know, with that, I think one of the things that you actually kind of already alluded to, because, like when you lose your period, I think that it’s like something that we can be like, well, this is this is convenient, like, who wants to have a period like I don’t have to deal with hormonal swings, I don’t have to worry about like, you know, bleeding through my pants like this, this isn’t a bad problem to have. But I think you also talked about how like not having a period is unhealthy and how it can impact performance and so like, what from a performance perspective like what benefit would athlete a with a normal healthy menstrual cycle have over athlete B, who’s experiencing amenorrhea?

Reilly Beatty  19:58

So with like HA, you’re going to see like decreased performance outcomes with athletes. So you’re going to see lower endurance, you’re going to see lower power, you’re going to see lower ability to put on muscle mass. Additionally, you’re going to have an increased risk of getting sick. And for an athlete, especially at the high level, right, so, you know, when  I work with Olympic athletes, and they’re traveling all over the world, and flying is a very, you know, easy place to get sick. So we don’t need to lower their immune system, and you know, increase their risk of getting sick.

There’s research that shows like slower cognitive functioning and slower decision making. And especially, I mean, at all levels, we don’t want that to be happening. So there’s definitely some like negative performance outcomes from not having your period. And then when you do have a normal, unhealthy regular menstrual cycle, we can even do more things to help maximize your performance by modifying nutrition around the cycle, maybe, you know, preparing for certain side effects of the cycle with nutrition. So not only are you maybe missing out on these performance outcomes when you don’t have your period, but then you’re also just decreasing performance in general.

Lindsey Lusson  21:10

Yeah, yeah. And it sounds like it kind of comes from like, it’s twofold, right? It’s the fact that somebody is completely under fueling. And those are obviously going to have negative outcomes. But also to as a female athlete, we, I think this is kind of newer research is incredibly fascinating, but knowing how to screen and to fuel around your cycles, so we can anticipate certain things and in a in an individual that has a regular predictable cycle, that we can’t get someone else to the person who has the predictable cycle, and therefore more strategic nutrition and more training has a benefit over someone who doesn’t, because we just don’t know what’s going on. And they’re under fueling.

Reilly Beatty  21:47

Yes, exactly. I would say, especially at the elite level, too, like the little differences are like what gets you silver or what gets you gold, like it’s these little these little things. So it is so super, super important.

Lindsey Lusson  22:00

Yeah, yeah. And, you know, elite athletes, they’re always looking for that, you know, one to 2% better, like, what can I do to help me have a leg up on competition. And so what I’m hearing is having a cycle and being able to understand your cycle and how it impacts retraining is, is huge. Love that.  For someone who is continuing to train and working to get their period back, I think we kind of talked about this, that it can take, you know, six months to a year, but let’s say that somebody is going about this on their own, their training, they’re continuing, you know, they’re they’re working on, you know, eating more. Maybe they’re considering modifying their training, but they really don’t want to.

At what point do you recommend like reevaluating somebody’s like training status? like at what point you’re working with an athlete?  Is there a timeframe that you have, whenever you’re like, Okay, it’s time that we need to start reevaluating your training or take things down for your training.

Reilly Beatty  22:53

What I found is, the sooner the better. So if I’ve, if an athlete’s like, Hey, I haven’t got my period this month, it’s like, okay, like, let’s monitor this, like, when missed cycle like, it wasn’t that something’s going on like that. Okay, like what changed? Right? I’ve noticed this, working with athletes like all across the country, okay, you change or sorry, all across the world, like you change time zones, you’re in a different country, okay? Like that’s give your body a month to adjust. 

But like, once we’ve seen like, not seeing a period and three months, it’s like, Okay, what’s going on here? Like, when was the last time you had bloodwork done? Like, let’s look at hormones like, Okay, what’s going on here? Let’s do a food log, let’s, you know, analyze your energy intake, let’s look at your training load. And then I would have that conversation after three months, where it’s like, we need to increase fueling, or we need to modify your training load. Because if this keeps going on for longer, it’s just going to take it’s going to be harder.

Lindsey Lusson  23:46

Do you think that it’s harder for those people because they’re a little bit more set in their habits? Or do you think that’s more on like a, like a hormone and like physiological level about those people having a hard time recovering cycles?

Reilly Beatty  24:01

I think the energy deficit gets larger.

Lindsey Lusson  24:04

Okay.

Reilly Beatty  24:05

I think it just becomes harder. And then again, like you mentioned to you become set in your ways you become set in your routine. So I think that becomes challenging. It’s similar in eating disorders where the kind of the earlier you can catch things. Usually the better the outcome, your recovery, the faster.

Lindsey Lusson  24:22

Yeah, well, so any last tips for someone who is an athlete and they’re listening along? And they are, you know, recognizing they don’t have a period but it seems to be like kind of this convenient little thing for them like what would be the biggest advice you would give to someone who’s maybe wrestling with Do I really need to get my period back with my training seems to be so much more important in my life right now. Would you say back to that person?

Reilly Beatty  24:48

I think I would say like, think about how amazing you could be if you were completely healthy. If you’re doing amazing right now you could be even better with a cycle and feeling properly. So that’s kind of what I If I would say and I would also recommend, like, if you want faster results to reach out to a professional, because I think that’s going to give you like the quickest return to play and return to being 100%.

Lindsey Lusson  25:13

Working with a professional can definitely, you know, I know both Riley and I have experienced period loss and recover from it. And I think there’s something to be said, for working with somebody who has personally experienced because it’s like, we’ve already done all the things wrong. So we know it doesn’t work. And we also know it’s backed by research and does work.  If someone’s listening to this episode, and they do want to get in touch with you, they do want to work with you. What’s the best way to reach out connect with you? Learn more about what you offer? Do you offer any freebies or anything that you would you know, recommend to anybody?

Reilly Beatty  25:43

Yeah, so you can I’m pretty active on Instagram. I know that’s how we connected but you can follow me at it’s at @reilly.beatty.nutrition and yeah, reach out. I do like one on one coaching I do I have ever program. And even if you have questions, or you’re even just looking for more information, I’m happy to also point you into some free resources and things like that.

Lindsey Lusson  26:07

Awesome. Yeah. And we can leave your Instagram at the bottom of the show notes so that people can have access to that and we appreciate you coming on today and sharing all of your knowledge and information for those that are experiencing period loss as an athlete wanting to recover. I hope that this episode like encouraging I mean, I think I would be encouraged if I was an athlete, so we really appreciate your time.

Reilly Beatty  26:28

Yeah, thanks again for having me.

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MEET THE HOST
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I’m a fertility nutritionist and registered dietitian who specializes in hypothalamic amenorrhea. My passion is helping women trying to conceive find freedom with food and exercise, so they can recover their period, and get pregnant naturally.

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