What would I do?

Imagine you're a coach.

Maybe you already are.

Your star female athlete, after months of concern, has finally plucked up the confidence to speak to you. She’s heard and read much about the consequences of amenorrhoea, and feels that it’s time she shared with you the things that have been bothering her.

She hasn’t had a period since she upped her mileage and became more disciplined (read: “obsessive”) about her diet, eighteen months ago. The nagging pain in her foot, which gets worse the further she runs, is also a concern.

How, as a coach, do you respond?

Is your first reaction: “Oh no, the ‘P’ word! Periods are too embarrassing for me to talk about!”

Now, just imagine you’ve got past the initial discomfort, and accepted that it’s probably more awkward for the athlete to talk about periods than it is for you. Do you then question why you need to know?

Are you unaware of the risks of amenorrhoea (i.e. the absences of a regular period), under-eating, increased training and the resultant energy imbalance? And that the persistent, nagging pain might indicate a stress fracture?

Or maybe you know a bit about the issues (or have quickly educated yourself via your search engine of choice), but still question how this is relevant to you? Afterall, you’re a coach, not a doctor!

And it can’t be that bad, can it? Your athlete doesn’t have an eating disorder. If she had an eating disorder you’d know about it, wouldn’t you? She’s not even that thin, you think. If she’s not that thin, there can’t be a problem, right?

Wrong!

Now, let’s just suppose that your athlete is excessively thin. Everyone has been remarking about how ‘in shape’ she looks. She is lean and running well. Changes have happened since she’s upped her training and visited the nutritionist. And there’s been the big race wins, the personal bests and international call-ups.

Long may the good-times roll!

Then someone suggests that her thinness may be becoming excessive. Having been away at university all term, her parents haven’t seen her in a few months. When they do see her, they barely recognise her, and express their concern.

Do you try to reassure them by saying that’s all part of the bigger plan? She’s turning into a real athlete now, and being thin is all part of that.

Are you too close to notice just how excessive, dramatic and damaging the changes have been?

When the parents suggest that her absent periods may also be an issue, do you explain that away too as a normal by-product of training harder. Do you remind them that this happens to many female athletes? Do you suggest that it’s more difficult to find an endurance athlete with a regular period than it is to find one that doesn’t?

Are you naive enough to question if she’s better off without them anyway?

Or do you know and understand the risks, and the devastating long-term affect on an athlete’s health, but either consciously, or unconsciously, feel that this is something that just happens to athletes in other training groups?

Or do you know and care, and want to help, but just don’t know where to start, or who can help? Afterall there’s lots of information out there on the dangers, but very little advice on what to do next!

Have you tried seeking assistance for cases like this in the past, and struggled to get the assistance and advice you needed?

Are you being told by the ‘professionals’ that this is ‘normal’, or that issues with your athlete are not yet bad enough to warrant intervention?

Or, do you fall into the most dangerous category of all? Do you see all the warning signs, and say nothing? Do you simply hope that your athlete will be the one athlete that gets away with it?

Long may the good times roll, eh?

But they don’t, do they? The bad times roll much longer.

Always!