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Hypothalamic amenorrhea is the technical name for when the hypothalamus stops sending “go ahead and reproduce!” signals to the pituitary gland. This problem results in infertility, loss of the menstrual cycle, low libido, and many other disruptive symptoms. A staggering 10% of American women suffer from hypothalamic amenorrhea at some point in their lives. What to do for hypothalamic amenorrhea treatment is a hotly debated topic. There are many different tricks or “biohacks” that women propose that you can find all over forums on the internet — such as by taking high doses of certain vitamins — in order to overcome it.Yet after years of research, after healing from my own experience of hypothalamic amenorrhea, and after working with hundreds of women, I have arrived at what I believe are the most powerful, most critical, most-helpful and most time-effective principles for overcoming hypothalamic amenorrhea. There are only two of them. And they have nothing to do with biohacking. So what is the best hypothalamic amenorrhea treatment?

1) Hypothalamic amenorrhea treatment: step one is education

The most important thing you can do to help yourself on your journey with hypothalamic amenorrhea is to educate yourself about what causes hypothalamic amenorrhea. Then you can start taking steps to eliminate those problems in your life, and also to help you mitigate their effects.

Here is hypothalamic amenorrhea in a nutshell:

Hypothalamic amenorrhea is caused by any factor (though usually several factors at once) that signals to the body that it is in too stressful a situation to have a baby.

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 stress and starvation signals.

Today, we unknowingly recreate these problems for ourselves. We eat too little, we lose too much weight too fast, we have too little body fat, we deprive ourselves of fat or carbohydrates or both, and we subject ourselves to extreme stress through school, work, relationships, finances, and life generally, our bodies respond by shutting down hormone production.

You can read more about the physical and psychological causes of hypothalamic amenorrhea in my (now so old!) posts on them here and here, respectively.

2) Hypothalamic amenorrhea treatment: the reality of healing

I mentioned earlier that many women propose “hacks.” which I did myself for several years. There just had to be a way for me to be able to maintain my low body fat percentage and still regain my fertility and my clean skin. I wanted to have my cake and eat it, too.

If I took enough vitamin E or ate enough liver…

I really thought that something like that would be my answer.

When none of those ideas worked, I began investigating pharmaceutical options.

Sometimes, doctors will proscribe a progesterone pill for women to take, which triggers a menstrual period. But this pill very, very rarely gets women starting to menstruate naturally on a regular basis. Instead, it really only usually works as a “one-off” pill — as this is what it was designed to do. 

This pill is called Provera, and it may be wise to take it once every few months to help keep your reproductive organs from becoming “clogged” if you do not menstruate.

And that is the only pharmaceutical option, really. Doctors can also proscribe birth control pills or an estrogen patch to help manage the symptoms of anovulation, low libido, acne, and low bone density, but this will never heal the underlying problem. In fact, this sometimes makes hypothalamic amenorrhea worse because it makes women dependent on the pills in the long-run. You can read more about this in my quick guide to birth control, if you are interested.

So far as different supplements or pharmaceutical options, go, then, they are incredibly limited.

Pharmaceuticals do not really heal you; supplements or other biohacking type tricks do not heal you either.

This is often a very hard fact for women with hypothalamic amenorrhea to face. It definitely was for me. It took me several years to come to terms with my limited hypothalamic amenorrhea treatment options.

I also deal with this with my clients on almost a weekly basis. Everyone – my former self included – wants to have their cake and eat it, too. So many women want to be able to stay super thin or to exercise for several hours a day and get their periods back… but that just. usually. doesn’t. happen.

3) Hypothalamic amenorrhea treatment: two basic principles

There are two basic principles I proscribe when dealing with hypothalamic amenorrhea treatment:

A: Relax.

hypothalamic amenorrhea treatment

Hypothalamic amenorrhea can sometimes solely be a result of stress! In fact, in studies on different species of primates, researchers have found that monkeys on the lower end of the social ladder have impaired fertility and menstrual cycles compared to their more popular peers. Their diets are 100% the same. The only difference is that the less popular monkeys are  less happy.

Stress is a very real, significant factor for women’s health. I don’t have enough space to talk de-stressing here, but I will break down my own techniques very quickly.

There are many different ways to manage stress. I like to think about it in three different categories. The first category is what I like to think of as “quick fixes” or “immediate strategies.” This entails a small change to your daily life. You can, for example,

  • take up yoga
  • establish a morning ritual
  • carve out ten minutes for yourself every day in which no one is allowed to disturb you
  • meditate
  • make yourself a cup of tea to sit with before bed
  • start doing an activity you’ve always wanted to do, like dancing
  • have a “girl’s night” once a week
  • set aside time to have sex or engage in other romantic activity
  • or otherwise integrate whatever kind of relaxing activities you enjoy into your life.

These activities help take your mind off of life’s challenges and feel more happy and at peace. Or at least they should! Do not add any activities to your life that stress you out!

The second category of stress reduction for me is Big Life Changes. 

Say, for example, that you struggle with your finances. They stress you out. In this case one really great thing you could do for yourself would be to do some research on budgeting and investing, and take steps to change your situation. Do what you need to do to feel more financially secure. Sometimes we exist in stressful environments that we actually have the power to change! 

Other examples of Big Life Changes you might want to make are

  • ending relationships with destructive friends
  • starting to see a therapist
  • working on communication issues with your spouse or other family members
  • or quitting a stressful job. These are big things that require time and effort, but I can almost guarantee you that summoning the courage and strength to address them will help you mightily.

The third category of stress reduction is Mental Shifts. 

If there are stressful things in your life that you simply cannot get rid of – such as a job you need, an elderly parent you must care for, or a series of big projects – re-think them. Sometimes the act of re-thinking can bring blessings because it will help you take some practical steps. For example, you may realize that you can ask for help in certain situations, or you may realize that there is an easier way.

Yet in cases in which you are truly stuck or committed, then you have to find a way to make them less emotionally stressful. What is the problem? Why do you have this stress? Can you accept it? Are you able to tell a meaningful story about your life that includes the stress? Can you accept uncertainty in your current position and embrace the slow progress of the journey you are on? Are you able to even love the stress, because it enables you to protect your loved ones or otherwise make the world a better place? How about learning to stop being so hard on yourself?

This is usually the hardest but sometimes the most rewarding aspect of stress reduction practices. Re-thinking stress can open you up to a whole new world of possibilities and be one of the best hypothalamic amenorrhea treatments.

This was an incredibly brief introduction to the ways in which I handle stress – but perhaps they have given you some ideas to help get you started.

Also a part of the “relax” part of recovery are:

  • sleeping as much as possible
  • taking naps
  • not forcing yourself to exercise when you do not want to (this is very stressful for the body), and
  • otherwise behaving more gently toward your body than you might otherwise be used to.

The whole point of “relax” is to create a more happy, peaceful existence for you. This not only feels totally awesome on an emotional level, but it is also totally awesome for you on a physical level. Your hypothalamus relaxes if you relax, and then it starts sending positive signals to the pituitary gland again, which will then restore libido, ovulation, clear skin, mood balance, and fertility

B: Eat.

When in doubt, eat. If unsure about whether you have eaten enough, eat more. Choose more, rather than less. Always. Do not fast. Eat after exercising, always.
Do not restrict carbohydrates.

Do not restrict fat.

Do not restrict or count calories.

These ideas may sound simple to you – congratulations! Yet to many women with hypothalamic amenorrhea they sound frightening. For most women with hypothalamic amenorrhea, they are at least uncomfortable. Most women with hypothalamic amenorrhea have lived with starvation-type behaviors and the punishing mentality behind them for quite some time. It’s not easy to change them.

The best hypothalamic amenorrhea treatment is to assure the body that it is fed.

It is truly necessary to feed the body and on a consistent basis, too. It doesn’t help to eat one big meal on a Sunday but then go back to counting calories on Monday. That won’t do. The body won’t be tricked like that. It’s smarter than that. It needs to feel steadily fed and nourished all of the time. It needs regular meals and nourishment every day, day in and day out.

This does not mean that you have to eat constantly. But it does mean that recovery efforts often fail when women let themselves go hungry or deliberately deprive themselves of calories.

This is why I always say: when in doubteat more rather than less. If you do not know how much you have eaten or should have eaten, then choose more. Always choose more.

It takes some time, but you can learn how to do this. Simply take it one day at a time.

Learn to trust your body. Give it what it asks for…

and it will learn to trust you right back.

A good starting point, because I know at least some of you want some numbers to help you get started – is – at minimum – 2200 calories a day. Maybe that sounds terrifying! That’s okay. Slowly work your way up to it.

Eat at minimum 3 meals a day, and do not fear extra meals or snacking.

And do not even worry, unless you are struggling with another disease that needs a specific nutrition program, about sticking strictly to “healthy” foods. Most women I know who overcome hypothalamic amenorrhea do so while eating junky food. What the body really wants to fix its HA is calories. It wants food. It does not necessarily need vitamin A, or E, or what-have-you, in order to get that “fed” feeling. It actually just needs to be fed.

Of course, focusing on healthy foods the majority of time (or all of the time) is the most nourishing and vitamin-packed way to heal. But some calorie dense treats here and there will not hurt your healing journey with HA.

4) Hypothalamic amenorrhea treatment: how long does it take?

The speed of recovery from hypothalamic amenorrhea depends highly upon how “gung ho” you’d like to be. Consider this difference:

You could eat 6000 calories of ice cream every day for two weeks. Or you could gradually add an extra apple or cup of sweet potato to your daily diet, slowly eating more over the course of six or nine or twelve months.

Very rapidly eating a lot of food will help reassure your pituitary gland quickly and may in all likelihood return your menstrual cycle quickly. Taking a more moderate approach to feeding and relaxing may take a longer time.

Whichever option you choose may work well for you – it simply depends on your personal needs.

5) Hypothalamic amenorrhea treatment: do you need to gain weight?

This is a question that I get from nearly every woman I talk to about hypothalamic amenorrhea. Do you need to gain weight in order to recover from it?

The answer, of course, is: it depends.

For me, the answer was “yes.” For you, it may not be. It depends entirely upon what caused your body to feel overly stressed and/or starved. For you it may simply be a matter of emotional stress. It may be because you have been eating a very low fat diet, which prevents the body from being able to healthfully produce hormones. Or because you have been exercising too much.

It could be because your body fat percentage is lower than what your body would naturally like.

This point varies from woman to woman. In my experience, weight gain is necessary for probably more than half of women with hypothalamic amenorrhea. Yet hypothalamic amenorrhea is complex and many factors contribute to it. For some women it is definitely caused by more than one thing.

Whether or not you need to gain weight entirley depends upon your own situation, and you will need to guage this need and respond to it on your own.

6) Hypothalamic amenorrhea treatment: timeline and diet

How long it takes to recover from this sort of thing varies from woman to woman. It does help to eat nutrient dense food.

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.

Nevertheless focusing on the specific problem that you have – whether it be low body fat, exercising to exhaustion too many times a week, or both, or something else entirely – is truly the best thing you can do.

So relax. Eat. Have some patience for both your physical body and your mental self as you experiment with your healing options. Embrace your inner sloth! Slothiness can be one of the most natural and best ways to find your path to inner peace.

Hypothalamic Amenorrhea Treatment


And that’s it for hypothalamic amenorrhea treatment from my perspective! What do you think? What has worked or not worked for your own hypothalamic amenorrhea treatment? Please let me know!! 🙂

Hypothalamic Amenorrhea Treatment

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