For Real, Though

Missed, delayed, and irregular periods are often pushed aside, even by medical professionals. Doctors and other medical professionals are not taught about hypothalamic amenorrhea and the five factors that cause a loss of a menstrual cycle.

An energy deficit is the biggest one, and can cause significant damage to bone health in both men and women, but it is not the only cause. Running, stress, weight loss, and genetics can all play a role in why running causes periods to stop.

In this episode, author of No Period. Now What?, Dr Nicola Rinaldi is on the podcast to talk about why this is more common than we realize, and how our desire to be healthy has caused the reproductive system of many women to shut down. As running is a high intensity activity, it can be stressful enough on the body that it feels it needs to reserve energy to keep moving.

Birth control pills can mask a deeper problem, and today we talk about how even if you are having regular periods on the pill, you might still have an issue, which will go undetected until you come off the pill.

We also have Heidi Greenwood, former professional runner, on the show. Heidi shares her story of transitioning away from running to start a family because of her amenorrhea. Heidi shares her powerful and heartbreaking story of how she had to say goodbye to her daughter Jules at 28 weeks because of anencephaly.

This is a long episode, but so important to discuss and bring attention to.

You or someone close to you could have struggled with missed, irregular, or complete loss of a menstrual cycle. This episode shows just how prevalent amenorrhea is, and how birth control pills may be masking the problem for many seemingly healthy women.

Dr. Nicola Rinaldi is the author of No Period. Now What?, researcher and driving force behind the awareness of hypothalamic amenorrhea. Heidi Greenwood is a 2:42 marathoner who ran in the 2016 US Olympic Trials for Oiselle.

Dr Nic and Heidi will teach you about why it is so important to ask questions and seek further information, especially when it comes to your health and fertility.

• How difficult it is to get your menstrual cycle back once you have lost it
• How much weight a female needs to gain and what BMI a females body should get to for the best chance to restore cycles.
• Why it is so important  to find other ways to manage stress as the psychological side of stress is more important than initially thought.
• Why if your doctor prescribes birth control as the solution to amenorrhea, you might want to reconsider.
• Why Dr Nicola does not recommend birth control pills regardless of whether you have periods or not.
• Why hypothalamic amenorrhea research is lacking and what can be done in the future. Why you play an important part in growing awareness.

The hypothalamus is one of the master regulators in your body and when it senses a lack of energy or too much stress, which can be either physical or psychological, it will shut down your reproductive system and other systems to try to conserve energy...it will use the energy to the things you need to stay alive.-Nicola

I feel like there is a huge stigma, that if you don't get a period, you have an eating disorder, so what does the person do who doesn't get their period? Stay quiet, because they don't want people to think they have an eating disorder.-Heidi

There are 4-5 factors involved in HA. You can be extreme on any one of those factors, and shut down your hypothalamus and menstruation…for most of us, it is not just one of those aspects, but a whole bunch of things together.-Nicola

It is important to be eating freely, not restricting any food groups, definitely eating enough to support whatever exercise you are doing.- Nicola

Women, especially young women, don't realize that we need to ask questions. Heidi

I have not seen any impact on fertility from having HA. Once you ovulate and get your period, you have the same chance of getting pregnant as anyone else, in fact in some ways, it might even be better. -Nicola

High intensity exercise has been demonstrated to increase cortisol, and an increase in cortisol shuts down the hypothalamus, so I really recommend people do walking, gently yoga, and maybe easy biking and elliptical. -Nicola

I typically suggest cutting out high intensity exercise completely.- Nicola

Even if you take 6 months to a year off to restore your cycle, you can always go back to it later.- Nicola

I would have never waited till after the trials to start a family with my husband...time is too precious for things like starting a family, things that bring you joy. -Heidi

Everyone thinks, "oh, I am going to be different, I have read the stuff, but thats not really true for me". I hear that over and over again.-Nicola

We have been taught for so many years that you need to be thin, you need to eat right, you need to exercise as much as possible. To recover from HA, you need to do the opposite of that, which is really hard. For many of us, for decades we have been taught this "healthy lifestyle" that turns to not be healthy when you take it too far even if its unintentional. It is really hard to wrap your mind around that.- Nicola

We become numb to the workload we make our bodies do...we train our body to withstand long amounts of exercise, its like brushing our teeth, we just go do it, we don't even think about it. We forget that actually, we are making our body work!-Heidi

When you don't have your cycle, you are almost assuredly not ovulating because you are not having the monthly hormonal fluctuations.- Nicola

Any more than one period missing, I would be concerned. The sooner you take care of whatever the issue is, the easier it is to do. The longer you let something like that go, the more ingrained you get in the habits that have caused your periods to go missing, and the harder it is to recover.

Birth control pills can completely mask this, as you bleed every month. That is not any indicator of a healthy menstrual cycle. Nicola

Clomid or femera are probably not going to work, unless you have started making lifestyle changes.- Nicola

I have learned so much through the process of recovery. Learning to cope with stress in other ways, other than through exercising and to realize how limiting my food restrictions were. I think that is a common feeling among women who have recovered from HA, they are really thankful for the process and for having to go through it, as hard as it is at the time.- Nicola

We are in communities where this is quite prevalent, but in the overall population, doctors don't see this that much...for a typical OBGYN, they are not seeing that much of this, they are seeing more PCOS, so it is not on their radar screen, and they were not taught about this in medical schools.-Nicola

Don't let running determine when you want to start a family. Running will always be there.- Heidi

Don't have fear foods. Every food can have a place in what you eat. If you have a cookie, it's not the end of the world. It is really important to avoid any kind food restriction and eat what you feel like, eat what your family is eating, eat what your friends are eating. let your food be your fuel for the rest of your life, as opposed to feeling like you have to control it.- Nicola

• No Period. Now What?
• ESPN article:Why Tina Muir retired from running, at the peak of her career
• Runners World article: After 9 Years Without a Period, I’ve Stopped Running
• Dr Nicola's Guest post on my blog
• The 5 factors involved in amenorrhea
• Heidi Twitter
• Heidi Instagram
• No Period Now What? Instagram
• No Period Now What? Twitter
• No Period Now What? Facebook

Thanks for Listening! I hope you enjoyed today's episode.

Angie and Trevor from Marathon Training Academy have really set the gold standard when it comes to running podcasts. I have listened to them for years, and have had the luxury of being on their podcast twice. They are so easy to chat to, and I always end up laughing my way through.

This time was no exception, but through all the laughs, they give lots of great advice, especially for beginner runners hoping to race their first marathon. We talk about everything from what qualifies you as a real runner to what to tell yourself when you are in the starting area of a race to make sure nerves do not overtake you.

We talk about how to make sure running does not become your whole identity, and why we need to stop trying to keep up with people we admire, and instead look into our own lives and what we can do to be our best runner.

Oh, and in case you are wondering, Trevor does have a website, and does love the Tupelo marathon (you will see what I mean when you listen in!)

This is for you if you love to travel and race marathons. Angie and Trevor give lots of suggestions for marathons to try if you are looking for something different, as well as advice for newer runners getting ready for their first marathon.

Angie and Trevor from Marathon Training Academy

The Marathon Training Academy podcast is one of the best known running podcasts out there. I interview the hosts and running celebrities to pick their brains about the best advice for runners they have learned through the seven years they have been hosting the podcast and racing marathons.

• Angie and Trevor's favorite, weirdest, best post race food, toughest marathon
• What makes you a real runner? What do you need to do to qualify as a runner?
• Why putting cues in your environment will help you stay committed
• How to stop running becoming your whole identity
• Why our egos get us in trouble
• How to handle pre race nerves

You can gut your way through a 5k, especially if you are not trying to run the top speed, training for a half marathon is challenging but if you look at the marathon, less than 1% of the population will complete a marathon in their lifetime.- Angie

It's a daunting challenge, it's an epic challenge, but it is one that is within reach to most people, that really makes it unique. - Trevor

There is something to be said about respecting the distance of a marathon. no matter how many you have run, you could go out there one day and run a marathon and it just humbles you, so much could go wrong. -Trevor

If you have run marathons, you have this superpower to the larger population around you. -Trevor

If you do any amount of running and you identify yourself as a runner, you are a runner. There isn't any level you have to attain. -Angie

You are a runner if you decide to be and you begin to form that identity, and then running becomes easier because if you identify as a runner, you are going to be more prone to get your shoes on, lace them up, and go out there, as you want to live in congruency with your identity.- Trevor

Ego gets us in trouble when we take a good thing, like running, and make it into an ultimate thing, so that so much of our self-worth and feelings about ourself is based on that area. It can be crushing if you start to experience setbacks, in your pursuit to reaching that ultimate thing we set for ourselves. -Trevor

Whatever happens during the race, it is still really amazing that you get to be there and so many people wish they could be in that position, gratitude is such a big part of it.- Angie

• Kentucky Derby Marathon
• Marathon Training Academy
• New Orleans Marathon
• Marine Corps Marathon
• Shadow of the Giants 50k
• Tupelo Marathon
• Missoula Marathon
• Indianapolis Monumental Marathon
• Wineglass Marathon
• Facebook live chat on eating before and after races 
• Krispy Kreme Challenge
• Leadville Trail Marathon
• Ego is the Enemy

Thanks for Listening! I hope you enjoyed today's episode.

To share your thoughts:

• Leave a note in the comment section below.
• Join the Running for Real Facebook Group and share your thoughts on the episode (or future guests you would like to hear from)
• Share this show on Twitter, Facebook, Instagram, or Pinterest.

To help out the show:

• Leave an honest review on iTunes. Your ratings and reviews will really help me climb up the iTunes rankings and I promise, I read every single one.
• Subscribe on iTunes or your favorite podcast player.

Not sure how to leave a review or subscribe, you can find out here.

Thank you to Trevor and Angie, I look forward to hearing your thoughts on the show.

The best running tips, marathon training advice, and lessons learned from 2:36 marathon runner Tina Muir. Helping you achieve your running goals and dreams. On this running podcast, you will learn from sports psychologists, nutritionists, scientists, runn

You love learning about mental toughness, mental running tips, and how to mentally prepare for a big race.

I love learning about the mental aspect of running, and therefore, there are going to be a lot of sports psychologists and mental coaches on the Running for Real podcast.

Dr Bhrett McCabe has authored one of my favorite mental training books, and you are going to love this one too.

Dr. McCabe might not be a runner himself, but the running advice he gives us in this podcast is absolute gold.

We talk about why we feel like we are holding ourselves back, why we compare ourselves to others, how our goals often become our identities, and why we shouldn't focus on fixing problems in our running, but instead learn how to focus on mastery.

And of course, how to switch your mindset around each of these.

Dr McCabe, like me, is not a fan of goals, but he suggests we should focus on desires, wants, and visions for ourselves to achieve our potential. Oh, and he does explain exactly how to figure out what you really do want.

We talk about doubts, fears, insecurities, and why they are so damaging to our running (and the rest of our lives), and how we can overcome those to push through the pain barrier in a race.

There is so much good advice in here, I am confident you will want to note this one down as one to go back to over and over again.

This is for you if you struggle with the mental aspect of running and racing. If you have self doubt and struggle with self belief as a runner. Every runner can learn something from this episode, no matter what your running desires and wants are.

Bhrett McCabe

Dr. Bhrett McCabe is a practicing Sports & Performance Psychologist. He recently authored The MindSide Manifesto and has published several academic journal articles, presented numerous scientific presentations, as well as provided insight and authored numerous articles for trade magazines.

• Why we always feel like we fall short of our goals and how we can stop the feeling of inadequacy.
• How to know what it is you really want (and why it is the million dollar question!)
• The difference between fixing problems and constantly growing.
• Why we should see ourselves as a work in progress.
• Training is like investing in yourself, but you are not entitled to a good performance. Get out of that expectations mindset.
• How to stop adding bricks to your backpack.

One of the reasons we feel inadequate when we compare ourselves to others is because we never compare ourselves to areas we have strengths. 

We identify things in other people that are our inherent insecurities

We cannot be content in life, we simply can't, because if we are content, we would never grow, and if we never grow, we stop getting new experiences, and having new, valuable learnings.

A lot of us are afraid to really open up and be honest and be vulnerable to ourselves to say, I want this, I really do. 

We want success all the time, a part of us deep down wants success because we have to have it in order to feel valued by ourselves.

If you don't fully declare it (your manifesto), how do you know if you ever achieved it?

People who have a growth mindset, believe that they are constantly a work in progress, and that is a very powerful and successful mindset to have. Everything I do, is not a determinant of who I am, everything I do is an opportunity to build who I am.

Where we get in trouble is where we take the moments of today and the outcomes of today to prove, to validate our underlying ability.

Expectations are entitlements, they are based on something we have done in the past trying predict something we want to do in the future based on something we usually fear.

Don't should on yourself. Should and must are both ways of telling you that you failed to do something.

Most people run because they love the challenge of themselves.

Most of us are trying harder because we feel like we need to do more, and we don't allow what we are actually doing to work.

"Another fascinating episode of #Running4Real Podcast! Love hearing about the mental side of running" 

• The Mindside Manifesto

Thanks for Listening! I hope you enjoyed today's episode.

To share your thoughts:

• Leave a note in the comment section below.
• Join the Running for Real Facebook Group and share your thoughts on the episode (or future guests you would like to hear from)
• Share this show on Twitter, Facebook, Instagram, or Pinterest.

To help out the show:

• Leave an honest review on iTunes. Your ratings and reviews will really help me climb up the iTunes rankings and I promise, I read every single one.
• Subscribe on iTunes or your favorite podcast player.

Not sure how to leave a review or subscribe, you can find out here.

Thank you to Dr. Bhrett, I look forward to hearing your thoughts on the show.

Nate Helming originally thought of running as a suffer fest (sound familiar?). Years later, after discovering joy in his own running journey, Nate is the co-founder of The Run Experience, and has helped thousands of runners reach their running goals.

You will learn today that Nate is a lot of fun, he has a great attitude, and makes running and strengthening our bodies a way of having fun, rather than a chore we should dread doing.

Taking what he learned from his interest in other sports, including a breakdancing past(!!), Nate looks at runners differently. He believes we have to train like athletes, not just runners. Exercises to strengthen our bodies are the same regardless of what sport we are in. If you learn the correct posture, and how to protect and stabilize your spine, you have a brand new tool set to do everything, so you can adapt it to a variety of sports.

Nate and I discuss why what is safest for the body is always what makes us the most powerful, you should never have to trade your safety to gain strength. He also shares his reasons why he thinks most people end up injured...spoiler alert; it is not because of our running!

We discuss why you should set burpees as punishment to bring your awareness to bad posture you might have throughout your workday, and how to breathe correctly while running.

This is for you if you want to be able to run and enjoy the outdoors and remain injury-free. Nate has helped athletes finish their first races, conquer new distances, overcome pre-existing injuries, set new PRs, reach the podium, and qualify for national and world level events.

Nate Helming

Co-founder of The Run Experience, a community to help runners train better, race better, and be better. Nate is based in San Francisco and in addition to coaching runners, he trains Olympic level cyclists, professional triathletes, elite mountain bikers, and national-level ultra runners on strength and mobility.

• How he accidentally signed up for an ultra as his second marathon and became an accidental triathlete.
• Why becoming a runner is good thing, but it can be limiting, as we do not want to risk injuries
• How to undo the effects of sitting all day
• Why if you are busy and feeling a little overwhelmed, going from 0 to 15-30 mins is very powerful
• Squats, pushups, lunges and burpees

We have treated our business like training for a race, you have to dream for not the impossible, but the edge of what you think you can do, and plan how to get there.

Running is this vehicle we use for physical training, to make ourselves better physically, for a social outlet, to have a shared experience with people online...and it pushes us mentally.

Running takes us to places we don't think we can go

For me, running is the ultimate expression of being an athlete. How my body moves in general.

Running is a gateway drug to being an athlete.

The first time I felt like an athlete, was when I called myself a runner. That is such a powerful Identity.

I am a runner, I can do more.

You need to run a lot to be a good runner, you can't burpee your way to a BQ.

High mileage is a privilege you have to earn, it's not a right.

What’s safe is always whats most powerful, I never have to trade.

We need to give ourselves a transition from our work, sleep, mornings and our runs.

We are giving runners a place to explore their athletic side and develop their inner athlete.

If you don't strava the run, did the run happen?

Our body is a precision machine, and it is going to precisely do what we tell it to do all day long. If we want to change the outputs we care about like running and performance, we need to change the inputs, what we tell it to do on all those other moments.

• Video of Nate Breakdancing (go to 3:08 to see Nate)
• Boston marathon
• Two Oceans Marathon
• Dr Kyle Bowling
• Being an athlete vs a skinny runner 
• The Oxygen Advantage book from Patrick McKeown
• Couch Stretch
• The Run Experience for Running for Real fans
• The Run Experience App

Thanks for Listening! I hope you enjoyed today's episode.

Neely Spence-Gracey has been a friend of mine for almost 10 years, and I knew she would make a great guest on the show, as she is always very inspiring for runners of every level. If you don't believe me, just check out her HUGE fan base!

Neely was born while her dad was running the Boston marathon (who was an Olympian by the way!), which means it was her destiny to end up as a runner. She has achieved a lot of running success over the years, including 8 national titles during college, and running some smoking fast times in distances from the mile up to the marathon, but she has also been through her fair share of struggles.

A few years ago, Neely could not catch a break, she shares her story of three broken bones and Lymes disease all within a few years, but she persevered, and stayed positive during the eight months it took for her fitness to come back. For that, she was rewarded and ended up faster than ever.

Neely shares the story of that time, as well as what she learned about injuries and seeking answers when the unknown is driving you crazy. Strength training has been a huge part of staying healthy since that time (now, you know I am a fan of that part), and you can make it part of your routine too.

We talk about how Neely uses mantras during her training, and what she learned about reframing to believe that you can achieve what you set out to do. She is another run by feel girl (go effort scale!) and lets her body tell her what she is ready for that day.

If you are currently injured and struggling to see how you will ever get back to where you were, this episode will motivate you to stay positive, find balance, and believe that you can, and will return, better than ever.

Neely Spence-Gracey is a professional runner for Adidas who has represented the USA on two world teams, and has PRs of 15:27 in the 5k, 1:09 in the half marathon, and 2:34 in the marathon.

You might think life is easy for elite runners, but Neely has been through a lot of setbacks, struggles, and moments of doubt that led her to this point. If you need inspiration that you can come back from injury, this is it.

• Why Neely chose to go to Shippensberg University and keep her dad as her coach.
• Why Neely gets strange looks when she is doing her pool workouts (and it's not from the workout!)
• How the ElliptiGO turned her life around and helped her qualify for a world team when she was injured by helping her get through a tough time.
• Neelys best advice for dealing with injuries
• How to use mantras to practice mental training during workouts to use in races, and how to come up with a mantra that is effective for you
• Why strength training is critical to maximizing recovery and staying healthy
• Why Neely did not race Boston marathon this year

Neely's #R4RPowerPose

Running has been a part of my life, and I was destined for this career path.

The struggles along the way have shaped and defined who I am.

How we are going to be most successful is if we are happy and in a place we feel supported, we have a team we work well with, that there is a good group dynamic, and we have a coach we can really trust to guide us, that’s how we are going to be the best and maximize ourselves.

Where you feel at home is where you are going to run the best.

Running is a brutal sport. It is amazing when things are going great, but it is horrible when things aren’t going well, and it impacts every aspect of our lives.

That is the hardest part about being injured, is that it is so isolating. You are already upset because you can't run and I am a social runner, so that was my social time...all these things that used to be such a positive part of my life are just taken from me.

With each injury, I learned more about myself.

The body will heal itself, but you have to give it the ability and opportunity to do it.

We get faster by stressing the system in different ways, it is the same with strength training, you can't do the same thing over and over.

At some point during a race, every single person is going to have that moment of decision, of where you have to keep pushing even though your body is saying stop. You are tired, you still have a long way to go, and you have to find a way to work through that and make it to the finish line.

If you practice mantras in workouts, you can apply them to races and you will see success.

If you live a life where you feel like you are lucky and things happen to you, they do, and its all because your outlook on life is not putting energy into the negative sides.

We all have good days and we all have bad days, but if you are focusing on the positives, things are always going to look so much better.

Focusing on what you can control is the key.

Injuries are never ideal, but when something flares up, being smart from the get-go is key, because pushing through never results in a positive outcome.

• Neely's website
• Neely's Twitter
• Neely's Instagram
• ElliptiGO
• Upstart Kombucha
• Irondoggy leash
• Kentucky Kombucha
• Neely and her coffee taper
• Coffee Taper video with Chris Heuisler

Thanks for Listening! I hope you enjoyed today's episode.

Win one of FIVE marathon or half marathon training programs from my husband/coach/brains behind my running accomplishment; Steve.

You can win a 16 week training plan with suggestions on how to individualize it for your personal running goals.

Enter by:

1.  Leaving a rating and review on iTunes, Stitcher, or Google Play.
2. Taking a photo/screenshot of your rating and review
3. Emailing me [email protected] with your screenshot, and you will be entered to win.

Contest ends on May 5th.