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There are many different problems that can cause women to stop menstruating. In rare cases amenorrhea comes from genetic defects and physical abnormalities. These cases usually require medical intervention.

More commonly, women stop menstruating due to conditions like PCOS or hypothalamic amenorrhea, both of which are highly influenced by (and overcome with) diet and lifestyle choices.

Because there are so many possible causes of amenorrhea, the most important thing you can do to overcome a problem with your fertility is to investigate. 

Figuring out your problem is the first step towards solving it. 

If you once had normal menstrual cycles but now do not, there is a very good chance that some underlying health problem is the culprit. PCOS, like I mentioned, is one potential culprit. Another potential and common culprit is hypothalamic amenorrhea.

In this post I discuss hypothalalmic amenorrhea symptoms and causes. This will help provide a road map for your healing – and will hopefully help you get moving in the right direction.

What is hypothalamic amenorrhea?

Hypothalamic amenorrhea is the technical name for when the hypothalamus stops sending “go ahead and reproduce” signals to the pituitary gland. This results in menstrual cycles being lost, along with other symptoms.

The primary hormone used for this signalling process is GnRH (gonadotropin releasing hormone). The hormones that the pituitary gland would then ordinarily produce but in hypothalamic amenorrhea fails to do so are LH (luteinizing hormone), FSH (follicle-stimulating hormone), and prolactin. Hormone levels that then fall as a result of those hormone levels falling are estrogen, progesterone, and testosterone (usually – though sometimes some of these may stay elevated for complicated reasons).

I like to think of the system a set of dominoes: hormones are produced in a cascade. If there is no agent (the hypothalamus) that knocks down the first domino at the beginning of the process, then none of the dominoes (hormones) get knocked down. Hormones do not get made if the hypothalamus does not tell the pituitary gland to make them. 

A staggering 10% of American women suffer from hypothalamic amenorrhea at some point in their lives. And interestingly enough, hypothalamic amenorrhea is not confined to humans! Other primates also experience impaired fertility and lose their menstrual cycles due to hypothalamic dysfunction.

Hypothalamic Amenorrhea Symptoms

There are many symptoms of hypothalamic amenorrhea. These are the most common:

-Loss of menstrual cycles, or sometimes very light bleeding

-Failure to ovulate

-Low libido

-Sleep disturbances

-Depression, anxiety, or other chronic mood symptoms

-Cystic acne (occasionally, especially when you simultaneously have PCOS)

-Low energy

-Constant hunger, or changes to hunger cues

-Always feeling cold

-Other symptoms of hypothyroidism, which often accompanies hypothalamic amenorrhea, such as brittle hair and nails

These are problems that are a result  of hypothalamic amenorrhea. There are many other signs that may indicate or even cause hypothalamic amenorrhea. They are:

-Low body fat percentage

-Rapid weight loss

-Excessive exercise (different for every woman – challenging workouts 1 or more times a day is generally a good, rough guideline for too much)


-Low fat diet

-Low carbohydrate diet

-Low calorie diet

Causes of hypothalamic amenorrhea

There is a common theme to the “signs” of hypothalamic amneorrhea I listed above:

each of them are a threat to a healthy pregnancy.

The science of this takes us back millions of years.

Way back in human history, when people hunted and gathered on the savannah, it was very important to be in a safe environment while pregnant. Famine could very easily kill a pregnant woman. Starving could very easily kill a pregnant woman. A stressful circumstance like war or a long hike could also be too much for a pregnant woman to bear.

Any sign of an “unsafe” condition on the savannah was life-threatening to a pregnant woman. In order to prevent pregnancy at an unsafe time, the female body developed a very keen sensitivity to starvation signals.

When the body detects “starvation,” it shuts down reproductive function. This prevents you from becoming pregnant while stressed – something which might very well have killed you on the savannah.

Having inadequate food, losing a lot of body weight, exercising a lot, having a low body fat percentage, eating too little fat or too few carbohydrates, or being under extreme emotional duress are all important starvation signals.

When we mimic these life-threatening savannah conditions in the modern world – and we do this so often by starving ourselves for the sake of diets, slenderness, or for atheltic goals – our bodies respond with the old programming of hormonal shut-down.

Hypothalamic amenorrhea special case: birth control pills

One final yet important thing to discuss about hypothalamic amenorrhea is what happens when women come off of birth control pills. Sometimes, women do so without any problems. Yet quite frequently when women come off of birth control they stop menstruating.

The reason this happens is two-fold: 1) while on the pill, the liver is responsible for filtering out “old” hormones. Sometimes hormone surplus builds up in the liver, such that when you come off of the pill the body still feels like it’s on it because the hormones are being released into the bloodstream by the liver.

2) The body does its best to maintain stable hormone levels throughout time. While on the pill, hormones enter the body from the outside. This means the pituitary gland doesn’t have to work as hard as it used to. Then, when coming off of the pill, the pituitary gland is still “lazy” and takes some time to kick back into gear.

Sometimes this problem of being infertile coming off of the pill takes several months if not a year or two to overcome. Sometimes it is primarily a hypothalamic amenorrhea-type problem – other times it is more like PCOS.

In all cases, a nutrient-rich diet full of organic vegetables and fruits, organ meats (here’s a supplement in case you do not like to eat liver), eggs, fermented foods (here are my favorites) and the rockstar superfood cod liver oil that focuses on eating more rather than less will almost always greatly accelerate healing.

I also happened to write a guide on birth control options and how to be as healthy as possible while using them (or not) – which you can read about and download here.

Hypothalamic Amenorrhea Symptoms: What to do about them

The solution to hypothalamic amenorrhea is simultaneously complex and simple. It is complex because every woman is unique and must meet her own specific needs. It is simple because it very often boils down to two very simple principles:




In hypothalamic amenorrhea, women suffer because their bodies want love. They want nourishment. They want reassurance. They want to feel safe and to feel fed. I talk about this in more detail in this post – but really most of all what it all boils down to is eating and love and eating and love.


And that is it for hypothalamic amenorrhea symptoms and causes. What do you think? What are your hypothalamic amenorrhea symptoms? What caused your hypothalamic amenorrhea? Then head on over to this post and tell me all about your progress on your journey overcoming it!

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