Veronica Ewers said nothing, despite all the signs, despite the blood test results staring back at her, telling her the hormones in her body were barely present. Because the results came with an all-too-familiar indifference from her doctor.

“Based on this person being an elite athlete, they don’t have their period and that’s fine,” the 31-year-old American cyclist says, reciting her 2022 medical report to The Athletic with a somber half-smile. “So I didn’t flag it.”

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The results should have been Ewers’ crisis point. Instead, she continued to believe that “when a woman loses her period, she’s at peak fitness.”

That is how she operated when playing soccer at Willamette University, a small liberal arts college in Salem, Oregon. She shrugged off signs then, too, leading to wan performances, her body toiling to keep up with demands. Eventually, Ewers was benched.

For nearly a decade after, as Ewers became entrenched in the cycling community and joined the professional peloton, she seemed healthy enough to compete. She finished ninth overall in the 2022 Tour de France Femmes. While some around her expressed concern over her eating and exercise habits, no discussion was had around the ongoing absence of her period, she says.

It took a broken collarbone in 2023, ending her season, before the consequences finally manifested. After being medically cleared to exercise again, she fractured her heel while running and had her bone density levels checked. She was tipping into osteoporosis.

This time, rationalizing the medical results was impossible.

Ewers knows her story is not unique. Swapping stories of similar experiences has become a bonding exercise for many female athletes across the world, she says.

Ewers before the start of the Liège-Bastogne-Liège cycling race. (Luc Classen / Getty)

According to a survey conducted by The Female Athlete Health Report from Project RED-S and Kyniska Advocacy in 2023, 36 percent of female athletes ignored missed periods, thinking it was normal or, in some cases, beneficial for their athletic endeavors.

The survey, which focused on responses from 769 athletes in the United Kingdom assigned female sex at birth, with questions concerning their menstrual cycle and body image, also found that 30 percent of respondents had been told by a medical professional that period abnormalities, including absences, were “normal” given their activity level.

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“Elite sport first, period later.” Kerry McGawley, a professor and senior sports physiologist at the performance optimization company Orreco, recalls the pithy mantra recited to her by a professional Swedish cross-country skier more than a decade ago.

“It was shocking hearing that for the first time,” she says. “But the amount of times I’ve heard it since? That’s more worrying. Athletes coming up to me, one by one. They’re not having any period.