No periods, osteopenia, anxiety and bald patches...
(Does this seem like #fitspo to you?)
Former model Emma Quinlan on how her quest to be lean for her Instagram lifestyle left her with a serious and dangerous condition
EVERY day we are bombarded with messages to ‘eat clean’ or ‘lift heavy’, follow the latest fad diet or fitness regime. Today, many of us turn to social media, and in particular Instagram, for fitness inspiration, or #fitspo.
An ex-model and dancer, I am one of them – I am also recovering from four years of Hypothalamic Amenorrhea (HA). That means I was working out so much, without feeding my body what it needed, that my periods stopped and my fertility was put at risk. I also suffered from a host of other serious health issues as a result of my so-called ‘healthy’ lifestyle.
With type 2 diabetes and other lifestyle-related conditions on the rise not just in Ireland but across the world, the move towards fitness should ultimately benefit us all — yet there is a very dark side to the trend fuelled by social media and Instagram.
There are certain things our bodies do without us having to think about it — like breathing, sleeping and digesting our food. As women, from our teens to our mid-40s, we get a period, a monthly cycle of when our body prepares for the wondrous possibility of motherhood.
Of course, we tend to see our periods as both a chore and a blessing when we are younger and single. They usually come with bloating, cramps and inconvenience. But it is much worse when they disappear altogether. So how did it happen to me?
When I modelled I was always slim, albeit blessed with a rather large bosom. I never dieted. I ate reasonably well by choice, because I like vegetables and fresh food. As I was on the road regularly I also ate a lot of junk food. I never felt pressure to be thin because I listened to my body, ate when I was hungry, and moved around a lot. Between dancing, walking my dogs and running around festivals and airports, I had a step count that would be the envy of the most obsessed ‘Fit Bit-ers’.
THEN, in my late 20s, an autoimmune condition that had been lingering for many years showed its nasty face for a prolonged period of time and, coupled with stress from a break up, I became unwell and was prescribed steroidal medication.
The medication had side-effects: it hurt my joints and made me gain water weight. I became sore and stiff, and stopped dancing and moving. I then gained weight, as I was still eating the same amount I used to. I went from 54kg at my smallest to 70kg, which is a lot for me.
It was only when watching a playback of an episode on the Celebrity Apprentice while we were still on set that I looked at myself on the screen and saw how much weight I had gained. I knew I needed to take action, and after crying for a night, made the decision to ‘get better’ again, now. I changed my doctor and came off the medication. Within eight weeks I lost 2½ stone, a lot of this was water weight but I ‘helped’ the process by eating just 1,000 calories a day.
A month later I joined my first gym. I did strength and conditioning classes six times a week — and soon my period disappeared. For the first few months I thought nothing of it, even after visiting my doctor, who put it down to stress.
I was within normal weight and BMI parameters for my height, age and weight — at the time 170cm, 29 years old and 61kg. I continued to ‘get healthy’, training harder, eating cleaner and getting leaner. My weight dropped to 57kg and I had abs — but still no period.
A lot of women have actually asked me ‘Is that not a good thing?’ They mean, I don’t have to worry about pregnancy and I don’t get the monthly cramps, pimples and bloating that come with menstruation. The answer is a resounding no.
Your menstrual cycle is not just what allows you get pregnant, it is part of a complex system that maintains other parts of the body and hormone production. Hypothalamic amenorrhoea, or HA, is a condition of reduced ovarian function and can be caused by several factors such as stress, weight loss, and/or over-exercise.
Amenorrhoea can happen with those who train intensively or excessively, when the amount of calories isn’t enough to let the body recover and carry out necessary ‘life’ functions such as digestion, heart and lung function. When the body is not getting adequate fuel, fight or flight mode kicks in — the same mode our bodies would have jumped into prehistorically when being chased by a tiger or bear. It is a state that should only last a few minutes at most, where the body shuts down nonvital functions and puts all the energy to the heart, lungs and everything needed to keep us alive.
Prolonged periods of time spent in fight or flight mode shuts down the menstrual cycle to allow the ‘survival’ organs to work. Digestion is also massively affected. Prolonged amenorrhea leads to other nasty conditions — and I have suffered them all.
You develop osteopenia, your bones begin to break down and stress fractures are regular.
YOUR hair falls out in lumps and you get bald patches. Digestion stops (or you think you’ve developed some intolerance, but really it’s just stress) and you bloat severely, you may only visit the toilet once a week or less.
The stress hormone cortisol shoots up, so you can’t sleep even though you’re exhausted. Insulin is affected and so diabetes becomes a real risk. You feel anxious all the time.
But the worst one of all, you lose the ability to ‘feel’. You forget how to be sad, although you are anxious all the time. A friend died and while I knew I was upset, I didn’t feel it. I was unable to even be angry at myself for not feeling it. I forgot how to be happy.
My lack of any sort of feeling disheartened me the most. For the first two years of HA, I used to pretend I didn’t care, because I was lean and mirror selfies were how I judged my worth. Yes, I was lean. But I was not strong, because I was starving. I was a controlled eater who in reality looked like an anorexic wearing a muscle jacket.
People would even pay me compliments. When the reality is I was a lean, starving, unsexy, miserable 30-year-old who weighed her porridge and chicken
so it ‘fitted her macros’. I would also binge on a Saturday night every few weeks because I was starving.
Thankfully, all is not lost. I have recovered. This will be my 10th month of a 28-day menstrual cycle (I had three periods over nine months within the recovery phase).
It took 16 months to recover in total and it was not easy to face the demons I created — these demons made the process of recovery longer. I would not have been able to recover if not for family support, my mom, sisters, brothers (they were sick of hearing about periods) and my boyfriend.
My mother kept telling me not to be afraid to question the condition or doctors who wouldn’t look for a solution. Most physicians recommended the pill to protect my bone health, and Clomid cycles if I wanted to conceive.
FINALLY, I found Dr Nicola Rinaldi, based in the US and author of ‘No Period, Now What?’. She runs many support groups online from women with HA, some hoping to conceive after over-training, some retired professional athletes, or women who just lost a lot of weight too quickly.
Here are some of the things I learned and had to do to recover. Stop all exercise. Everything. Throw out that gym membership. I was lucky to have a coach who supported my recovery. By all means go for a walk, but be mindful, exercise addicts will try and power walk. Stop and look around at where you are, be present, breathe. Keep the heart rate low.
Gain weight and eat a lot — between 2,000 and 3,000 calories a day. Gaining weight will happen very quickly at the start because your body is starving and this is really difficult to cope with.
Some women have had to gain as much as 10kg on recovery. I gained 6kg; after I recovered my body naturally found equilibrium and the weight I gained came off over eight months without me trying.
Trusting the process and going ‘all in’ by eating and stopping intense exercise allowed my body to recover. After six months of 28-day cycles I have started to exercise again, but now I limit it to three days a week.
Talk about it out loud. Your health is important, especially your periods. The ability to have a child now was my determining factor to get well. I realised it’s all I’ve ever wanted to do, to be a mother, and that was slipping away.
Most importantly, for your mental health, unfollow #fitspos on Instagram — in particular those who show what they eat daily, as this can trigger your own restrictive eating and exercise habits.
Amenorrhea and its prevalence is being fed by online media, confusing people into thinking that fit = lean = healthy. None of these are the same.
You can be fit and fat, just as you can be fit and sick. ‘Be the best version of you’ is a term you see too much under a bikini or diet picture on social media. The best version of you is the you who enjoys and loves all aspects of life, balanced and without restrictions. Nourish your body with good food, chocolate, sleep and moderate exercise.
Life is only punishment if you make it so. I would hope that issues around new eating disorders such as orthorexia are addressed with some form of regulation, for example, for diet plans being sold by unqualified people who are ‘instafamous’ and personal trainers online.
We need to ask ourselves what our priorities really are, if the ultimate price of ‘looking fit’ affects our fertility and ability to reproduce and increases the risk of health problems in later life.