That Time of the . . . Year

I was not gifted; I knew I had to work hard, and my coaches advised me to lose some weight. The next fall I got leaner, and faster. I worked out four, five, six hours a day. With the constant physical exertion -- I was always the first to the gym and the last to leave -- by the fall of my sophomore year my periods slowed, and then disappeared.

At first I didn't notice, I was so busy. But then, as teammates (they all menstruated together, something not uncommon for women in close quarters) passed Tampons and Advil between lockers, I realized I didn't have the need for either.

The first ob-gyn I visited told me not to worry. "You should feel lucky," he laughed. "Other women would love to be in your position. Enjoy it!"

I learned (not from him) that I had athlete's amenorrhea, a condition that most often strikes elite runners, ballerinas and gymnasts (all sports in which low body fat, and anorexia, are common). Amenorrhea, the cessation of menses, strikes 5 percent of women of reproductive age reproductive women, according to the National Institutes of Health. It means the hypothalamus, pituitary, ovaries or the uterus are not functioning properly and it can also affect women with thyroid problems, obesity, pituitary tumors, severe depression or drug addiction.

My teammates worried about me. Was I exercising too much? There were doubts that I was okay. I was careful about my health; I didn't let myself get too thin (I never have been). But I was also competitive and continued to worked out hard. "That is not okay, Liz," our point guard warned.

In evolutionary terms, my body was too stressed to conceive, so my body shut down my reproductive system. Up until a century ago, women menstruated only 50 times in a lifetime -- the rest of their months they were pregnant, breastfeeding or too lean or stressed to conceive. Now women have up to 500 periods during their reproductive lives.

What is truly "natural," in terms of our bodily adaptation, is serial pregnancy -- something most women (myself included) do not wish to revisit. Yet the tradeoff is 10 times more periods in our lifetimes. That may be more than an inconvenience: Some research links more periods with a higher risk of breast and uterine cancer and anemia. (See "Skipping Periods: The Pros, the Cons, the Science" below.)

I didn't want to get pregnant then so temporary infertility from my amenorrhea wasn't a problem. The lack of hormones, I was to learn, was. The third ob-gyn I saw finally told me that every month I missed my period was a month lost of building bone density -- a month where, instead, I lost bone mass at a rate nearing the steep 5 percent per year of postmenopausal women. This loss, occurring smack in my critical bone-building years, could put me at increased risk of a stress fracture and osteoporosis. That's why menstrual suppression must be balanced with an intake of hormones to build and maintain bone density.

So I started popping Tums for the extra calcium and hormone pills to get the estrogen. I could take hormone pills or birth control pills -- I ended up taking a dozen varieties of both -- to get enough estrogen to stave off osteoporosis. But there was no guarantee when and if I would get my period back. The doctors told me the cure: "Slow down" in your training, they said. But I was faster than ever, and playing better, too.

Still, I wanted my period. I realized that it was more than just blood; it was my body speaking to me, regulating itself with monthly check-ins, both physically and emotionally. Periods were something I had taken for granted as a constant, markers of a time where I was allowed to be a little more reflective and a lot more forgiving of my body and spirit.