Have you heard the phase: “your period is a marker of health”?

As research into RED-S and energy availability in climbing has developed, this phrase is becoming more well known.

But what exactly does it mean? What is RED-S? And does a period automatically mean we’re healthy?

What is RED-S?

RED-S stands for Relative Energy Deficiency in Sport.

It describes a state of low energy availability that occurs if our energy intake does not balance our energy expenditure.

Energy in < Energy out

We may think that energy expenditure simply equals exercise (in our case climbing), but that is not the case.

Energy out ≠ Exercise

In reality, our bodies need energy to perform a number of processes.

Energy out = Exercise + Body Processes

How does RED-S affect our periods?

If we have low energy availability, our bodies downregulate sex hormone production in order to prioritise energy for movement.

↘ low energy ⇒ ↘ sex hormone production

Because our sex hormones control our menstrual cycle, this can result in periods becoming irregular , flow or cycle length changing, or stopping altogether.

Although a doctor should always be consulted to rule out medical conditions, this can be a red flag when it comes to overtraining or underfueling. This is why periods have been termed a ‘marker of health’.

Deviation from a normal cycle can be seen as an indicator of too much stress and too little energy intake and/or recovery.

How else could RED-S affect you?

There are lots of athletes (mainly from the world of running) sharing their stories with RED-S. However, in their cases, they have had multiple stress fractures before experiencing a change in their period!

So having a period does not necessarily equal a healthy athlete.

Let’s consider the BIG PICTURE!

There are indicators of low energy availability other than your period and these are also useful!

Things such as repeated injuries, poor response to strength training, reduced concentration/mood/motivation, repeated illness.

These may be signs of RED-S in anyone, regardless of a menstrual cycle.

Additionally, some hormonal contraceptives can disrupt our hormonal cycle and therefore may mask menstrual dysfunction. (For example, the bleed on the combined oral contraceptive pill is not caused by the natural cycle of hormones and therefore is not considered a natural period.)

In this case, your period isn’t an accurate marker of health.

Conclusion: Are our periods a marker of health?

Although RED-S should be assessed with a medical professional, there is always a spectrum before getting to this point. This is where awareness can help keep us on the right track when it comes to balancing health and performance.

If we notice variations in our cycle, we can try reducing training, introducing more frequent rest weeks, or fueling a bit more.

Changes in our period may be an indicator of a change in health or low energy availability. Our period can help us understand our energy expenditure vs intake, but it isn’t the only marker we should be paying attention to.

We should listen to our whole body to assess our health.

Read more training tips.

Read more about training with a menstrual cycle.

Read about tracking your cycle for training.

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