A blog by runners. For runners.

Common female running problems: part two


In part one, we detailed some of the more common discomforts that affect women runners. In this part, we’ll talk about some of the more serious issues female runners deal with.

Iron-deficiency anemia: If you feel especially tired, weak, dizzy, or cranky, you may be anemic. Iron-deficiency anemia occurs when you have low levels of iron in your body. Women already have a higher risk of anemia because of blood lost through menstruation. Plus, women don’t tend to eat as much iron-rich foods — we’re talking about you, red meat — as men. Studies show that runners have an especially high risk of anemia for several possible reasons:

  • Iron is depleted through heavy sweating.
  • Red blood cells are destroyed when your foot hits the ground hard.
  • Iron loss is associated with muscle tissue inflammation.

Anemia is often fairly easy to diagnose and treat. Your doctor may prescribe an iron supplement and encourage you to eat more iron-rich foods.

The female athlete triad: Women who exercise intensely are at risk for a group of problems that together are called the “female athlete triad”. The triad consists of these factors:

  • Disordered eating: It’s not uncommon for runners to follow a strict diet to lose weight and/ or improve their athletic performance. Disordered eating as part of the triad can mean anything from avoiding certain food groups to clinical eating disorders like anorexia nervosa or bulimia nervosa.
  • Amenorrhea: Amenorrhea is “the absence of menstruation” meaning a woman doesn’t get her period. Training hard combined with not eating enough can disrupt the hormones that regulate the menstrual cycle. It’s normal to miss a period once in a while, but going 3 to 4 months without one should be a red flag.
  • Osteoporosis: Low hormone levels and a diet that’s not balanced, especially one that’s low in calcium, can cause osteoporosis. Osteoporosis is the weakening of bones due to the loss of bone density, and it usually strikes older women. Osteoporosis significantly ups the risk for stress fractures.

Infertility: As mentioned above, running hard combined with not eating enough can cause amenorrhea. Not having a period means you don’t ovulate — which means you can’t get pregnant (without medical help). However, some women runners have regular periods but still have difficulty trying to conceive. Doctors used to believe as long as a women’s body mass index (BMI) was in the “healthy” range (18.5- 24.9), she could run as much as she wants without impacting her fertility. But new studies show some women runners with a healthy BMI of around 21 cannot get pregnant if they run often – defined in one study as anything more than two hours total per week. For some unknown reason, running disrupts fertility more than any other sport. If you’ve been trying to get pregnant without success, your doctor may ask you to significantly cut your mileage and gain a little bit of weight even if you’re at a healthy weight.

Note that running doesn’t directly cause any of this health problems. Running is associated with these conditions, but that doesn’t mean that every female runner will deal with them. I’m sure most of us know a women who got pregnant during the peak of marathon training!

Written by Jen Matz.