Ask the Experts: Kick Cramps to the Curb

I'm training for my third marathon this year and stopped having periods. Can running be causing this? I'm healthy and in my mid-30s. I've never had any problems before.

Running may be causing your missed periods, but it is important to explore other options as well. Pregnancy is, of course, the most common cause of missing periods so be sure to see your doctor if that's a possibility.

Other causes include, but are not limited to, thyroid problems, abnormalities of the prolactin gland (the part of your brain that helps you make milk and reduces the chance you'll get pregnant during early exclusive breastfeeding), and extreme stress.

Long-distance running, usually in association with low body weight, is well known to suppress the hypothalamus--the part of the brain that signals the production of many of our hormones. Without these hormone signals, the ovaries do not ovulate and cause a period. In the short term, this is not dangerous. However, over time, the body misses out on estrogen, which can lead to osteoporosis.

If you are not using hormonal birth control and you aren't pregnant, you should talk to your physician if you miss more than two periods in a row. Assuming long-distance running is the cause, cutting back on your mileage and increasing your weight can reverse the process.

My breasts get really sore when I'm on my period. It hurts to run, and my nipples chafe. What can I do to alleviate this?

A little Vaseline on the nipples prior to the run and an extra supportive sports bra (some people even need two) can make a big difference with breast soreness and nipple chafe. Of all the pain medications, ibuprofen is probably best for breast pain and can be taken before your run.

If your breasts are very sore during your period and have a cobblestone texture upon self-exam, you may have fibrocystic breast changes. Be sure to ask your physician about this benign condition. It does not increase your chance of breast cancer, but it can make your breasts quite uncomfortable. These symptoms may be ameliorated by reducing your caffeine intake, increasing your vitamin E consumption and taking ibuprofen during your period.

When I'm on my period, I feel horrible! I get cramps, and I am bloated, lethargic and cranky. I never want to exercise. But I just started running regularly, and I don't want to get off my schedule. What should I do?

Get out and run! It's hard not to push the snooze on the alarm clock, but it will help you feel better during your period by mobilizing excess fluid and giving you an injection of endorphins--the feel-good hormones triggered by exercise.

If you are open to the idea of hormonal contraceptives, such as the birth control pill, patch, shot or ring, all of them suppress ovulation and decrease the hormonal changes of the menses. Indeed, you can take these methods continuously and not have to have a period. With the use of such birth control, you should feel better exercising during your period.

My girlfriends and I want to settle an argument once and for all. I think that when I have PMS, I run slower and don't perform as well in races. They say it's in my head. What's the truth?

Your performance may be suboptimal just before your period, but it's probably not as bad as it feels. During PMS, there are hormonal changes that can lead to fluid shifts and irritability--both of which will make you feel less comfortable in your body. Some people are more sensitive to these hormone than others.

It's not all in your head: The physiological changes are legitimate. However, a positive attitude will do a lot to overcome them. In addition, resisting the urge to binge on sweets and carbs at this time can help keep your body's sugar levels even, which prevents energy lows and mood swings.

Dr. Amanda Williams Calhoun is an OB-GYN at the Kaiser Permanente Medical Group in Richmond, California, and the assistant director of women's health at Kaiser Permanente Northern California. A former track captain at Harvard, she's now a "weekend warrior" who runs pushing her two sons in a jogging stroller.

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