‘You 100% have REDs’
Oh, shit.
This is what I was told when I visited a Sports Doctor recently and opened up about EVERYTHING. My training load, my diet, my mental health and my (lack of) menstrual cycle. Was it a shock? To be honest, no. But was it still scary? Absolutely.
I have known something wasn’t quite right for a while. Since May 2017 I have had a grand total of 3 natural period cycles. My periods returned for a short time last summer when I was injured but apart from one very light day in November, they have completely disappeared. Now don’t get me wrong, I totally get the idea of not having a period sounds great – no bloating, no pain, no feeling uncomfortable, but unfortunately for females, periods are so so so important, and without them you can really be putting your health at risk.
I am going to be sharing my recovery journey with you. As always I am going to be brutally honest. I have no doubt this is going to be tough, but I hope that in sharing my story it will not only raise awareness, but hopefully if any of you are going through this too, it will help you with your own recovery.
So, here’s to getting my periods back, to getting my body working normally again, to being happy & healthy, and to becoming the best athlete I can be.
In this post I am going to give an overview of what REDs is, my own experience & where you can seek help if you need it.
And just to confirm, I am not in any way qualified to diagnose or offer professional advice. If you are at all concerned about yourself, or a friend or family member please seek professional help by either making an appointment with your GP, a Sports Doctor or a dietician that specialises in working with Athletes.
For more information & resources you can also visit the fantastic Train Brave website by clicking here.
What is RED-S?
RED-S stands for ‘Relative Energy Deficiency Syndrome’ – This was previously known as the ‘Female Athlete Triad’
In really simple terms, it basically means you are not giving your body the calories it needs to function properly. But this doesn’t always mean you are starving yourself. I eat a lot of food, but compared to the amount of exercise I do, it is obviously not enough for the rest of my body to keep working properly.
The diagram below shows the various risks that can be associated with RED-S. But please remember, even if you don’t have every single one on the list, it doesn’t mean you don’t have the condition.
It is also important to note here that RED-S can affect both female AND male athletes, but it is somewhat easier to first diagnose in females as one of the biggest warning signs is a lack of periods.
Warning Signs
I have taken these directly from the Train Brave website, again if you have any of these signs please do not ignore them & seek professional advice.
Physiological
- Lack of three consecutive periods in females or a change to a previously regular menstrual cycle
- Decline in morning erectile function in male athletes
- Poor development of muscle mass
- Difficulties staying warm in the winter and cool in the summer months
- Downy growth of hair all over the body
- Constipation or feeling bloated
Behavioural
- Pre-occupation and constantly talking about food
- Poor sleep patterns
- Restricting or strict control of food intake
- Overtraining or difficulties taking rest days
Psychological
- Irrational behaviour
- Fear of food and weight restoration
- Severe anxiety
- Becoming withdrawn and reclusive
Performance
- Poor recovery between training sessions
- Digestive issues –athletes often become constipated and bloated
- Recurrent injuries, including stress fractures
My Experience
As I said, you do not need to have every single sign or symptom to be affected with this, I certainly don’t, but there are quite a few on the lists I can tick off, including;
- Lack of periods
- Difficulty in controlling body temperature
- Constipation & Bloating
- Poor Sleep patterns
- Restricting & control over food intake
- Fear of gaining weight
And here are some other fun ones that I can also add to the list which I am sure are down to hormonal imbalances (I’ll warn you, they aren’t pretty!)
- Irregular bowel movements (similar to IBS)
- Night sweats
- Binge Eating (due to restricting & guilt around food)
I feel very fortunate that up until this point, I have not suffered any serious injuries, but I know this if I continue down this road, I wont always be this lucky. As a runner, one of my biggest fears is getting a stress fracture, and this is one of the biggest risks if your body is not producing the hormones needed to keep your bones strong & healthy (so if you hadn’t realised, periods are SO much more than just about having babies!)
Next Steps
My diagnosis is technically unofficial, so the next steps for me is to get various blood & hormone tests to really get an understanding of what is going on inside my body.
We are very fortunate to have the NHS in the UK, and I have already got my follow up appointment booked to go through by blood results in two weeks time. And after that? I am not so sure. Depending on the results I may then be referred for a DEXA Scan (to check my bone health & density) which personally I am really going to try and push for.
In the mean time, I have been advised that I need to eat more. A lot more. Now I know this sounds like the dream, but it’s not as fun as it sounds. More food = more calories = gaining weight.
This is going to be a whole other step to my recovery, and something I am also going to be seeking professional help for. Don’t get me wrong, I have no problem with the actual eating side of things, I bloody love my food. But the guilt that comes after, and the idea of gaining weight and my body changing is something I don’t quite know how to accept yet. BUT I am determined that I am going to get better. I love running so much & I want it to be part of my life for as long as possible, and unless I start looking after myself properly, that is not going to happen.
So, there we go! I have no idea when my next update will be (or what it will be!) but heres hoping it will be a good one!
Jordan xxx
Project Marathon Girl 
Hi Jordan!
Just wanted to leave you a comment to let you know that I’ve been where you are. I had RED-s for years despite not having a particularly low BF% and after many scans and trying various different things to get my period back, the only thing that worked was gaining weight. It was a very frustrating thing for me to accept that whilst other athlete’s bodies functioned well at the weight I was at or lower, mine just naturally seems to need more body fat to function normally. It’s a tough pill to swallow and I completely understand how mentally hard it is, but it’s more than worth it in the end.
Best of luck!
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Hi Jordan, I’m also just coming through RED-S too. I think you need to let go of the idea of ‘I eat loads’ because that’s totally subjective, and if you already believe you eat loads, it will be psychologically very hard to eat enough to recover from RED-S (and get your period back). We live in a country where 2/3 of the population are overweight and I think this changes the perception of what ‘healthy’ eating is. It’s important to remember that as a serious athlete, you make up a very small proportion of the population, so your needs are VERY different than most people’s, but it comes down to having the confidence to do what works for you, even if it looks very different from everyone else around you. I really struggled with this, and still do at times- it doesn’t change overnight. In addition, I too have had lots of gut problems from RED-S and also from dieting before I even got into running, and I appreciate just how scary it is to need to eat more when you have a delicate stomach AND a fear of gaining weight. I think it’s especially tough for you because you are running very well off suboptimal health. I was able to run really good times as well when I was significantly underfuelling, but in my case I’ve had 9 bone injuries in the 3-4 years that I’ve been running (everything from stress reactions in lower legs to pelvic stress fracture to complete fractures in my feet), so it was a bit easier for me to see that continuing to under eat was damaging my health- even then, the first bad one was Sept 2015 and I’m only just coming up to about 5 months in good energy balance. The other medical thing to note is that RED-S can cause changes in our metabolism that mean even relative large amounts of food for us are not enough to meet our requirements, for example low ferritin (iron stores), commonly found in RED-S (even in amenorrheic women), can raise your metabolic rate by ~15%, which is a significant hole in your energy expenditure. It does this because iron isn’t just used in red cells to carry oxygen around the body, but is a vital component in the enzymes involved in oxidative metabolism with your cells, so when iron stores are low, your cell metabolism becomes really inefficient, causing your body to need to burn more calories to produce the same amount of net energy, In addition, your basal metabolism will be higher if you don’t sleep well and have elevated cortisol levels, again common in RED-S and all adding to the energy debt your body is in. I hope I’m not painting too a bleak picture! RED-S is actually really simple to cure, it’s just a matter of sustained meeting of your energy requirements (but that doesn’t mean it’s an easy journey). I just want you to know you’re not alone and you can come out the other side of this!
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Hi Jordan, Just wanted to wish you a ton of positivity! It’s worrying how poorly understood RED-s is, even in the medical world. In December I had a stress fracture in my foot. I saw 2 different orthopaedic consultants, 2 GP’s and an orthopaedic registrar and not a single one asked me any questions to even consider RED-S. They just treated the fracture.
Luckily I’m fairly clued up and although I had problems years ago when I was a gymnast and under a lot of pressure, after a lot of hard work I’m thankfully much healthier, and happier actually. Well done for being so honest and raising awareness of something that I think probably affects far more people than are ever diagnosed. And huge good luck wishes with your recovery too xx
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Hi Jordon,
I’m where you are at now but so far my cycle is still on point. My headspace isn’t coping with the eat more food = putting on weight and will I still fit into my dresses. The amount of food is a struggle
I love my running and always push beyond my limits.
Just started this journey a few months ago and finding it stressful trying to satisfy the professionals , stick to the restricted plan and be ok with a rest day.
When friends don’t understand the struggle it makes it even harder.
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