Why Did My Period Stop After Weight Loss? the Connection

Weight loss to the point of missing menstruation?

Hello Dr.
Minghua, I started my weight loss journey in mid-January of this year.
I am 169 cm tall and weighed 61 kg before starting at the age of 19.
During my weight loss period, I tried to minimize oil intake and avoided sugary drinks and desserts, as well as reduced my salt consumption.
I drink at least 1200 cc of plain water daily (sometimes substituting with unsweetened green tea), and I keep my daily calorie intake under 1200 calories.
I almost do 30 minutes of exercise daily, or at least four times a week.
After approximately 11 months of effort, I lost 14 kg (averaging a healthy weight loss of 1-2 kg per month), and my body fat percentage decreased from 28% to 16%.
I have not taken any medications; I relied solely on dieting and exercise to lose weight! However, I have not had my period since August.
I heard that excessive exercise can lead to missed periods; is that true? Is 30 minutes of exercise daily too intense? How can I encourage my menstrual cycle to return? Thank you!

Xiao Qiao, 10~19 year old female. Ask Date: 2002/11/19

Dr. Qi Minghua reply Nutrition

Hello, I hope your menstrual period has arrived by now, which would be great! First of all, I was quite worried to hear that your period has not come, especially since you are only 19 years old.
If excessive weight loss leads to infertility, it would be quite detrimental.
Given your height of 169 cm, your ideal weight range should be between 56 to 68 kg.
You were 61 kg before losing weight, which is already considered a normal weight.
The standard body fat percentage for women is 17-24% for those under 30 years old and 20-27% for those over 30 years old.
You were at 28% body fat before losing weight, and you only needed to reduce it to 17-24%, yet you have now dropped to 16%, which is too low.
From your description of your daily diet, it is clear that you are not consuming enough nutrients—specifically protein, fats, and total calories.
This deficiency has caused both your weight and body fat percentage to fall below the standard range, leading to insufficient secretion of hormones (such as progesterone and female hormones), which is why your period has not come.
A nutritionist would advise you to quickly restore a balanced diet, meaning you should include foods from all six food groups, while simply controlling the portion sizes.
As for sugary foods and sweets, they should not be consumed frequently, and your daily caloric intake should be at least 1400 calories or more; otherwise, you will not meet the nutritional needs for your height of 169 cm.
I believe that after a month, your menstrual cycle should return to normal.
You can continue exercising, as it is not a direct cause of menstrual irregularities, even if it is intense.
I hope you will have good news as your nutritional status improves.

Reply Date: 2002/11/19

More Info

Dear User,
Thank you for your question regarding the cessation of your menstrual cycle after significant weight loss. This is a common concern among individuals who undergo rapid weight loss or engage in intense exercise regimens. Let’s explore the connection between weight loss, exercise, and menstrual health.

Firstly, it’s important to understand that the menstrual cycle is regulated by a complex interplay of hormones, primarily estrogen and progesterone. These hormones are produced by the ovaries and are influenced by various factors, including body weight, body fat percentage, and stress levels. When you lose a significant amount of weight, especially if it is rapid or if your body fat percentage drops below a certain threshold, it can lead to hormonal imbalances that may disrupt your menstrual cycle.

In your case, you mentioned that you lost 14 kg over 11 months, which is a healthy rate of weight loss. However, your body fat percentage decreased from 28% to 16%. This is a significant reduction, and for many women, a body fat percentage below 20% can lead to irregularities in the menstrual cycle or even amenorrhea (the absence of menstruation). Your body may perceive this low body fat as a signal of stress or an energy deficit, leading to a temporary halt in ovulation and menstruation.

Additionally, the intensity and frequency of your exercise routine can also play a role. While 30 minutes of exercise daily is generally considered beneficial, if you are engaging in high-intensity workouts or if your body is not adequately recovering, it can lead to a condition known as "exercise-induced amenorrhea." This occurs when the body prioritizes energy for essential functions and may suppress reproductive functions due to perceived stress or energy deficiency.

To address your concerns and potentially restore your menstrual cycle, consider the following recommendations:
1. Evaluate Your Caloric Intake: While you mentioned keeping your caloric intake around 1200 calories, it’s essential to ensure that this amount is sufficient for your body’s needs, especially given your activity level. A registered dietitian can help you determine your ideal caloric intake based on your age, height, weight, and activity level.

2. Incorporate Balanced Nutrition: Ensure that your diet includes a variety of nutrients, including healthy fats, carbohydrates, and proteins. Healthy fats, in particular, are crucial for hormone production. Foods like avocados, nuts, seeds, and fatty fish can support hormonal balance.

3. Moderate Exercise Intensity: While exercise is beneficial, consider moderating the intensity or frequency of your workouts. Incorporating rest days and focusing on low-impact activities like yoga or walking can help reduce stress on your body.

4. Manage Stress: High levels of stress can also impact your menstrual cycle. Incorporating stress-reducing practices such as mindfulness, meditation, or gentle yoga can be beneficial.

5. Consult a Healthcare Professional: If your menstrual cycle does not resume after making these adjustments, it’s advisable to consult with a healthcare provider. They can evaluate your overall health, check for any underlying conditions, and provide personalized recommendations.

In summary, the cessation of your menstrual cycle after weight loss can be attributed to hormonal changes due to reduced body fat and possibly the intensity of your exercise routine. By ensuring adequate nutrition, moderating exercise intensity, and managing stress, you may be able to restore your menstrual cycle. If symptoms persist, seeking medical advice is crucial for further evaluation and support.

Best wishes on your health journey!

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