Dear Dr. Garner,
I am 28 years old and love to exercise. In fact, I believe I have become addicted. I feel very nervous when I don’t exercise. My mother has told me that too much exercise can cause problems. Could you verify this and give me some guidance as to how to cure this “addiction?”
Exercised Out in Elmhurst
Dear Exercised Out,
The benefit of exercise in women is well-known. It leads to reduction in cholesterol, blood pressure, weight loss and even improvement in mood. Most studies in the past have studied the effects of exercise and men.
New studies show that the effects of exercise are not the same for men and women and that women must be aware of possible hazards of excessive exercise. With normal moderate exercise, there can be phenomenal benefits for women. Excessive exercise, however, can cause many problems.
For example, excessive exercise is one of the general warning signs of an eating disorder. This has a significant association with anorexia and bulimia.
What is excessive? Excessive is defined as exercise two to three hours a day, or a focus on exercising that interferes with daily routines and impairs your ability to carry out other daily activities.
Women with high levels of anxiety and perfectionism are particularly likely to exercise to an extreme. Doctors need to assess exercise behavior carefully as a clue to underlying problems. Loss of menstruation is common in women who exercise with high intensity and for long periods of time. The loss of periods is estimated to occur between five and 25 percent. The part of the brain that controls the hormonal cycle, the hypothalamus, gets turned off.
In young girls who exercise heavily, there may be delayed onset of menstruation. In addition, these young girls are at risk for broken bones, curvature of the spine and even hair loss. A recent study found that 24 to 40 percent of young ballet dancers had curvature of the spine related to decreased bone mass from exercising.
Swimmers who exercise to excess often lose their periods without necessarily having their weight decrease. The ovaries of female athletes may become polycystic. This is a condition in which there is infertility. Overuse of joints may lead to arthritis later on in life, becoming more common in those who participated in the “Jane Fonda” series.
There is a condition known as the “female athlete triad,” which consists of amenorrhea (no periods), osteoporosis (bone loss) and eating disorder (anorexia and bulimia). The key to prevention of this entity is moderation.
Anywhere from 30 to 60 minutes a day of moderate exercise, including housework, walking upstairs, raking the lawn or other such activities, is fine.
If you are doing more than this, I suggest a visit to your doctor and/or physical trainer to discuss your workout. As you note, you feel addicted to working out. This addiction can be similar and as deadly as an addiction to drugs and other medications. I urge you and your doctor to devise a plan, which may include medications to help alleviate this addiction.
In summary, exercise is excellent, provided it is done in a sensible and moderate way.
I hope this has been a helpful discussion regarding exercise in women. This is a topic that has long been ignored. As you can see, there are many potential pitfalls as well as benefits to exercising. Anyone contemplating an exercise plan should visit her physician, as well as a physical trainer prior to commencing a new program.
[hr]Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.[hr]