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 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 doubt, eat 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.
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!! 🙂
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“It may be because your body fat percentage is lower than what your body would naturally like.” But…I still have a higher body fat percentage than I’d like as a professional performance-athlete, and I have not menstruated consistently for nearly 3 years (by ‘consistently’ I mean I get it once or twice every 6-7 months). I’m afraid that, since I was an overweight pubescent girl who fell into the vicious cycle of eating disorders before my body had fully matured, I’m stuck with a body that ‘needs’ a high body-fat percentage! And I tend to gain fat in my midsection, not my hips and thighs, which according to everyone ever is the worst possible place for fat. I feel so let down by my body so often.
Perhaps, Zoe – though there is in all likelihood a perfectly healthy, sexy place that is a nice medium between your professional performance-athlete body and your ‘old’ body. There are very few women out there who can be professional performance athletes with super lean bodies and retain full reproductive function. I would encourage you to try not to be disappointed by your body for not being able or wanting to maintain a highly demanding, perhaps unnaturally lean shape.
Should I be worried about how my body stores fat (mostly in the middle, with thin legs–I’d rather NOT have a thigh gap!!!)?Is there a way to change it?
Great article, for me it took about 3 years of major stress reduction techniques, relaxation, supplements, eating more calories, gaining 10 lbs, bio-identical hormones (getting off birth control after 10 yrs), cleansing, and cutting out chronic cardio exercise like cycling. My body just does not do well on too much cardio and I have to be careful with that. I wouldn’t say it is perfection and I still deal with acne but it is so much better. Stress reduction has to be a continuous awareness for me because I tend to do too much and then my body definitely lets me know lol
Really good article! I needed to hear this. I went through four major life changes last year, within 6 months of each other, and my body has went side-ways on me. I put on 18 lbs. I’m so uncomfortable in my skin. My doctor has me on Nature-Throid while I’m working on healing my body. I know that my health issues have been caused my stress. I am working on figuring out the “relaxing” thing. It is difficult to do this daily…I don’t know how….but I’m working on it. Being patient with my body and giving myself time to recover, heal, and then transform back is the most difficult part. Thanks again for the information!
Stefani –
I can agree to this article whole-heartedly. While I have yet to have a normal cycle (4 years and counting) I am happy to say that things certainly have improved immensely after cutting the cardio, sleeping more, gaining 20 lbs, etc. Also, taking vitex really was when I started to see real improvement, so sometimes herbal supplements really can get the ball rolling!
I’ve been at all sizes and keep battling this,it’s probably bc of the Critters (Lyme,viruses etc.) that I carry.
Anyway,it seems that digestive stress is a big part in it too,especially fructose….anything even remotely a bit higher in free fructose (even using spices like Turmeric) cause IBS problems.
So,I’ve now made a list with various veggies,fruits,herbs&spices,(non-grain) starches etc. and am gonna look up every single one on Cronometer to view the free gluc/fruc ratio…..and hopefully that’ll lead me towards good results for once and for good.:/ (….I’m really at a loss,whether I’m destined to low carb for life or that it’s the free fructose that wreaks havoc)
Another brilliant post Stefani.
Relax, big life changes, stress, mental shifts…so need to remember these points daily.
Have shingles – so can’t do much of anything now but relax. If that isn’t a sign from the Universe that I need to slow down, I don’t know what is.
And as for big life changes and stress and mental shifts – well losing my husband to cancer and being his home hospice caretaker, and being a single mom, have certainly caused huge life changes in ways I couldn’t have ever imagined.
But managing stress is now not just one of those things that sound “nice” – because stress is what caused the shingles and this is a beast I wouldn’t wish upon anyone.
I too had shingles (at 28)– for me, the “last straw” of stressing my body out in order to strive for “health” (i.e. as low of a scale reading as possible).
My experience: after dropping from 150 to 108 over ~two years, I had no period for five years (stopped ~130, I think). I tried various herbs, cutting back on exercise, gaining to 125, meditation and stress reduction, but it was gaining back to 140 that brought my period back (and other pleasant side effects: emotional strength and more normal eating habits). That was four months ago.
Gaining weight wasn’t easy, mentally. It still isn’t, but it has become easier. Talking to people about it helps. I don’t really think of myself as vain/overly concerned with physical appearance, so it was hard to acknowledge how much of my brain has been dedicated to this for so long.
I’m now healing from a couple bones broken in rapid succession; curious if bone density may have been affected by this time period as well as a similar episode in my teens.
Long story short, for those like me, getting your period (and perhaps a chunk of your brain) back is possible! 🙂
This is beautiful. thank you so so so much for sharing <3
(PS, yes, I think bone density could definitely have been an issue)
I almost never coment here, because most of the time all I can do is stand in awe. I profoundly admire your knowledge, your sensitivity, your “sttuborness” (when you confront tradicional and radical paleo folks), and your amazing ability to translate all of this into words. Your texts have been a significant part of my journey into self-love, self-respect, loving my body, overcoming so many things, your words always go so directly into my issues! Thanks for helping! Thanks for existing! The Paleo word needs you. Big hugs!!
oh my god no the paleo world needs YOU! without women actually doing the things none of the world will ever change. thanks for reaching out, Aline. I love you too! 🙂
Hi Stefani, I am from Australia and have just hit 40. My menstrual cycle went haywire a few months back, literally, zip, nada, nothing. I had ultrasounds, gyno visits, everyone’s response was the same…”It’s perimenopause, your hormones WILL do this.” Gah! It was such a frustrating period in my life. Finally I did some of my own detective work (including stumbling upon your site! :)) and realised that I was killing my thyroid and my reproductive hormones by going low carb (for me, low carb meant under 100g of net carbs per day). I upped my fruit and sweet potato intake, (since I like to keep grains for occasional use) and voila! My menstrual cycle returned. Okay, so they are not perfectly regular, which may indeed be ‘perimenopause’, but they ARE there and I feel SO much better. I hope this helps someone else out there, because when our hormones are balanced, we girls feel like rockstars! You are doing such an awesome job. Sunshine hugs from Aussie land xx.
Your blog posts on HA has been so helpful to me! I live in Finland and have been suffering from adrenal fatigue for three years (well longer actually but I crashed/had a burnout in 2012 and a “relapse” again the year after.) Two years ago I stopped birth control and since then no period) When I crashed 3 years ago I was underwieght but been normal weight for the past year or so but the doctor I visited said I need to gain even more allthough the weight I was at that time was the same as when I had a normal menstrual cycle. To my frustration she ignored the fact that I have been under a lot of stress and all my hormones are out of whack, She just kept focusing on the weight and said I could not loose my period just because of the stress!! And she is a gynecologist/endorinologist!! I have gained about 4 kg in just a couple of months without even changing anything in my lifestyle and I guess that´s good but at the same time I have begun to feel worse again with signs of hypothyroidism even though all the blood works come out “normal” (as usual….) A temperature of 35.0-35.7 Celcius and some days I can bearly get up the stairs. Feel like if my body wants to put on weight to get healthy then why am I feeling worse when I gain? Have been eating a low carb diet for about 3 years also which I know now might not have been the best idea for recovery…so now I´m trying to increase my carb intake to see if that helps. I find it very difficult to handle stress and I know that´s a big issue when trying to recover. Started my own business as a reflexologist and dietitian (focus on paleo type eating) and I am so happy I finally found something I love working with, it´s just that I can bearly find the energy at the moment and still can´t seem to handle any type of stress at all even after three years of recovery. Even having a cold leaves me exhausted afterwards. I feel like I end up crashing again and again without really recovering. But I guess I just need to have patients and somehow try to figure out how not to stress over things, allthough my body is reacting so quickly to any kind of stress even before I realise it myself…seems there´s no tolerance at all sometimes.
Sorry for the long comment! 🙂 I´m gonna try to follow your advice and get even better at listening to my body. Thank´s for all the good work you do!
Do you know of any specific diet for women trying to raise their progesterone and estrogen levels for fertility?
Wow, this was pretty amazing advice for just general living. I tend to have a packed, very stressful life, and I’ve learned to do many of those things – yoga, rest, sleep, tea, NOT exercising when my body says NO, etc.
I had years (decades, really) of eating a low-fat diet to maintain a certain “weight”. And I had difficulty getting pregnant. Now, a lot of that was age (mid 30’s). I eventually got pregnant at 35. I couldn’t get pregnant a 2nd time, so I gave up. I decided to try and lose weight again, and decided to try a 21 day Primal Challenge, got pregnant right after (at 41).
The body is a funny thing.
Wonderful post. I’ll just add my story to the mix. I suffered from hypothalamic amenorrhea for 13 years. I wasn’t underweight. I probably ran too much but nothing too nuts. I was pretty crazy driven in my academic/career life though and a fair amount of stress snuck into my daily life.
Gradually, I made some smallish changes over the past year. I started a (not super strict) paleo diet. I started to eat fat by the tablespoon when I was hungry. I pursued a different, less competitive career. I lifted more weights instead of running more miles. I probably had more sex. Over the holidays when I was eating more junk than usual, my body finally realized the world was a good place to make babies and I started menstruating regularly again. It’s only been a few months, but I have high hopes.
Through all this, negligible weight gain.
My big lesson? A lot of little changes can add up to finally hit that tipping point.
I just need you to know this post (among so many others of yours) is changing my life. You. Are. Amazing. Thank you!
This post is wonderful! I have been struggling with hypothalamic amenorrhea for about two years now. I thought that gaining weight would help so I brought my slightly underweight body to a BMI of 21-22. I’ve been here for maybe a couple months, but still no visit from Flow 🙁 I do not exercise a lot, and I eat PLENTY of fat! I have reduced stress significantly… I don’t know what else to do. Unfortunately, the endocrinologist just wanted to put me on birth control, but I really want to get it back naturally. I am completely at a loss, but it sounds like I am on the right track? … Perhaps it is just a matter of being patient?
Patience is definitely a better call than birth control in terms of long term healing! The more ‘damage’ that has been done, the longer you need to heal. You may also need to gain more weight, at least initially… it’s possible. you can check out the hypothalamic amenorrhea thread at http://fertilethoughts.org – lots of women there talk about their experiences and how much they had to eat / gain weight /etc for their fertility 🙂
such an important message – thank you so much – i had HA for 4 years and finally went ‘all in’ to get my body back into normal working shape – nixed all exercise, ate like no other, finally started ovulating and got pregnant naturally. so many women have no idea that they are literally starving themselves of the calories necessary to maintain a healthy balance.
Hey, How long did it take you to regain your cycle? I went all in at the beginning of this year…I’ve gained 20 pounds over all and so I know my fat percentages are finally in a healthy place…yet no cycle. I haven’t done any exercise aside from yoga and I failed hormone therapy twice! I’m getting a little freaked out that it will never return! Any advice??!
–Lacy–
I’d recommend taking a look at http://fertilethoughts.org to see what other women had to do in order to get theirs back. Sometimes even a ‘healthy’ weight isn’t enough. I haven’t worked with anyone who has done leptin therapy so I’d be interested to see how it goes for you
What is the dosage you recommend on the cod liver oil and desiccated liver?
Thanks!
I always hesitate to recommend doses because everyone is so different. I am very sensitive and personally would take probably one or two FCLO’s and 1 liver capsule/day (at most for the liver-I would probably take a few a week). People with less sensitive systems could take about 5x that – with 5 fclo capsules / day and 5 liver capsules / wk on the higher end of the range.
Nena, for some suggestions about this that I have gathered from many sources, please see the post I made further down this comments page (it is dated July 23, 2015) on Vitamin A and Cod Liver Oil.
Thank you so much for this post. Thank you, thank you, thank you. I have not had a period for about 5 years now and have hopped from doctor to doctor exhausting their knowledge- looking for a solution- not PCOS, not endometriosis, not a pituitary tumor- I even had a laparoscopy recently. Everything is normal except my hypothalamus does not function. My long distance running schedule has never been too intense, but since I’ve started running, my body weight has probably dropped on the lower range of “normal”. No doctor would even consider hypothalamic amenorrhea because my running is not super intense and my body weight is not super low. I am now on estrogen/progesterone due to diagnosed osteopenia, but have been eating like it’s my job and have cut back on the running a little. I call it the fat and sassy diet and have put on about 10 pounds. Hoping to put on at least another 5. I’m hoping this does the trick! At 28, the thought of hormone replacement for the rest of my “child bearing” years is scary. Thank you for this post! Way too many women do not realize how so very important our woman curves are for hormones and normal body function.
Fat and Sassy! I LOVE. 🙂 Thanks for writing, so glad you’re walking this path!!!
Hey Stefani-
I’ve had HA for over 2 years now…..I’ve gained the necessary weight…am pretty chill on what I eat and I don’t count calories or do stress induced exercise. I recently cut out caffeine and I sleep a ton. I haven’t had any change in my hormones and I didn’t respond to provera or estrogen. I’ve looked into leptin treatments as another option and will hopefully go back to the endocrinologist soon. Do you have any thoughts on leptin therapy for women with HA?
True! I have PCOS as well, not very sure how to heal myself, because doctors dont realy know how to help me. I was never fat but got PCOS. My cyle was always a mess, but when i was diagnosed with PCOS i got metformin and i started to eating less (i though it would help my skin, cyle, hair..) I lost my period and i was crying even more and i was stressed out from the beginig, frightened and lost. All thet caused my amenorrhea. When i started to eat more and started to take 1000mg of metformin and not 2000mg and i just one month of my rutine brought my period back, not sure if vitex helped (i was taking it just for 12 days).
Doctors still dont know how to help me, i dont know what to eat, im affraid of food now. My symptoms are getting worse, cystic acne, hair loss, body hair… I know the couse of my PCOS, but doctors just dont listen. Is stress(for years, lot of stress), sleeping problems since i was little (cuz of stress), weight problems( i was loosing weight every summer), not eathing well and gut problems since i wass a baby (probably got them from my father). I already have glucose intolerance and lipid problems, but i am thin!!!!!! I am sooo scared of getting diabetes and other problems, i lost my life when i was diagnosed. I think my problems come from the gut (i already read your post about lacky gut). Iam so tired all the time and have no energy, have stomach problemsm, headache… I want to eat more but dont know what, becuase “food for getting fat” makes me sick or stomack problems, like gases and pain. I also start taking vitex, only 25 days now, i hope it will help me a litte bit. Even birth control pill are not for me, they makes me sick, stomach pain, vomit… Too much for 2 years, 2 years of suffering, i lost everything, my youth. Im only 22 years old and is too much for me. I scared of loosing my period again, too lose my hair nad that leads to even more stress, i have to go to school and others keep asking me whats wrong with me. Im also ashamed of how i look. I use to me happy, party, social girl who was laughing too much, but know i dont even want to leave my house. I am not myself anymore and my school performance is at lowest. I am so cold all the time, is like i am dying. I try to relax, sleep a lot, dont push myself to much but when i get back to reality is just so sad, i am crying so much even my mom is crying for me. They put me on metformin( 8 mounths)and spirolactone(3 months already) with no resaults yet.
I read your story, you are such a brave girl. They dont sell your book in my country, i live so far away. What should i do?
First I want to thank you for making all this information available to women who need it. I know you’ve certainly helped me a lot. I used to have HA and was felling horrible. I don’t want to be dramatic, but sometimes I feel like this information saved my life.
3 years ago I lost a lot of weight through exercice and stopped getting my period (and started getting horrible mood swings). My fiance, who studied food science, suggested it was because I was underweight, without really knowing about HA or anything, he was just guessing, so I raised my BMI to 18.5 and stayed that way for a year, but I was still not getting my period. Then I found your website and learned about HA. It took me a whole year to accept that I needed to gain more weight, but When I did, I raised my BMI to 20 and within 50 days, my period was back. My cycle is still a bit long but came every month ever since. My fiance and I are now TTC, but without success. Even if I am getting my period regularly, when I had my last blood test 6 months ago (6 months after my period came back), my estrogen and progesterone levels were still low. I still get a LOT of acne (I know I don’t have PCOS because I had numerous ultrasounds in the last year and I am on the lowest dose of synthroid to keep my thyroid as close to 1 as possible) and it seems it is getting worse, not better. I sleep 8 hours a night, I do yoga, I eat plenty of fruits and vegetables, meat, healthy fats, starchy foods and I walk every day for exercise. I am obviously still doing something wrong, but I can’t figure out what is missing.
Stefani, I appreciate your unique blog and all the great information that you share. A couple of years ago, your cautionary post on intermittent (and other types of) fasting by women helped me a lot, and since then, at various times, in the comment sections of newspaper/magazine articles and other blogs’ articles about fasting, I have posted a link to that article by you so women who are thinking of doing some kind of fast will have a more nuanced understanding of what it might entail for them (as females).
Regarding the topic of hypothalmic amenorrhea and other endocrinological issues, I would like to mention to readers who have not received hypothalmic amenorrhea as an “official” diagnosis by a doctor, but who have an array of confusing symptoms and are trying to figure out what it might mean, that what they are dealing with may not be this, but may be another endocrinological problem. One of the readers who commented earlier here mentioned that her doctors had looked into endometriosis, cystic ovaries, and a pituitary tumor. Another reader said that her doctors had postulated that it might be peri-menopause and were not very concerned about looking into it even though she was only about 40 years old.
I was told by doctors for three decades that my symptoms were not a big deal (even though they were causing me lots of pain and problems) and nothing could be done for me except to take ibuprofen (which I took so much of, at their recommendation, that it gave me stomach problems and long-lasting gastro-esophageal reflux disease – GERD), and in the last 5 years, I’ve been told that maybe it’s just perimenopause and it’s all quite typical — until finally I began to rapidly lose my eyesight and I insisted on getting checked out more seriously, and due to the wonders of modern imaging technology and surgery, we found out that I do have stage 4 endometriosis (the worst level), I do have cystic ovaries (extra-large cysts on both ovaries the size of canteloupes), and I do have a pituitary tumor. I had surgeries for all those things last year, and they have all returned (though currently at a smaller size than they were before the surgeries). They are causing my hormones, my energy, and my body to be all over the place, with big, abnormal highs and lows, and it’s exhausting and worrying, because I’m only just in the middle of “middle age” and I don’t know what I will be dealing with during the “second half” of my life.
Because of the GERD, I’ve been trying not to eat for 3 to 4 hours before lying down to sleep so I won’t have acid reflux in my throat (which is a common strategy for people with GERD), but doing that is resulting in my doing at least a 12 hour fast each day, sometimes even going 14 to 16 hours between eating dinner and breakfast/lunch, which I’m absolutely fine with, but I think doing that, plus the GERD itself (which makes me feel full quite quickly, and I get reflux in my throat with the mildest of foods), are resulting in a lowering of my appetite and of my food intake overall, and I am beginning to think that I am not eating enough food these days, even though my weight has been constant for a number of years. This month, I didn’t have a period, which is a new experience for me (generally I have lots of heavy periods — my cycle is only about 22 days long) and I am wondering if this missed period is a sign that menopause is around the corner. But I don’t know — it could be so many different things, since my endocrine system is really out of whack, what with the tumor pressure on my pituitary, the cysts on my ovaries, my perimenopausal hormones going bonkers, etc. And I’ve been hypothyroid for a couple of decades, too.
Today I’m just searching online to get ideas about what I might be able to do myself, to bring on a normal period and feel a little better in general, and I have just come across your series of posts about hypothalmic amenorrhea.
A few weeks ago, separately, I hit on the idea that I am probably not ingesting enough pre-formed (animal-derived) Vitamin A, so I started to take a low dose of cod liver oil that has a modest amount of pre-formed Vitamin A in it. I think it is helping my skin and my bowels.
After reading your posts on hypothalmic amenorrhea, even though I would doubt that my missed period is due to hypothalmic amenorrhea (because so many other things are going on with me), I am going to try:
– to eat more food volume each day
– to increase my carb grams (which I am quite relaxed about anyway – I eat healthfully but certainly not “paleo” or low-carb – but I do avoid American wheat that has artificial folic acid added to it because I have the two main MTHFR mutations, and I avoid goitrogenic starches like millet and tapioca since I have hypothyroidism)
– actually to increase my exercise (because I am way too sedentary right now, since most physical exertions leave me feeling quite tired)
– to add a little more enjoyment to my daily routine
– to treat my body/spirit as if it’s “safe to have a baby” (even though, sadly, I don’t think that I am very fertile, and I’m almost at menopause, so mentally and emotionally I have had to come to terms with the idea that I probably will never be a mother, which makes me terribly sad — so, yeah, I shouldn’t really expect my body to feel like it might be making a baby at any moment, since my body is no dummy!)
My message is — yes, one might be having hypothalmic amenorrhea, one might be having hormonal disruption due to not eating enough or being stressed out, one might have her concerns and complaints of pain pooh-poohed by doctors because she “looks normal” and “it’s rare to have x, y, z”, and told to just take painkillers and try not to work such long hours, but it’s possible to have other serious endocrinological issues (cysts, tumors, extreme malfunction) that actually require surgery and/or prescription hormone medications, either instead of or in addition to hypothalamus malfunction.
If you think that something really isn’t right, and your symptoms fit certain patterns, you might want to have a transvaginal ultrasound of your ovaries, and maybe even get an MRI of your pituitary. If your doctor/insurance company won’t send you for that kind of imaging, sometimes you can get those scans at a relatively good “cash” price if you call around to facilities.
I had to go to several different doctors over the course of several years who told me not to worry and just relax, before I found a new eye doctor who agreed with my concern that I had a pituitary tumor — who said, after his vision examination showed that I was rapidly losing my eyesight in a particular pattern, “Holy Moly, you must have an MRI immediately!” My experiences have taught me that doctors, even decently-well-educated ones, can often be wrong. I could have been blinded by the extra-large pituitary tumor that was finally removed last year, my extra-large ovarian cysts could have burst, and my endometriosis grew tangled masses of scar tissue around my internal organs, pulling them out of position and binding them together unnaturally, and some of that can never be repaired. I’m not finished with these maladies because all have returned, but they are not so big as to require more surgery (at the present time, anyway). Ibuprofen and working fewer hours, the main advice I received for decades from my doctors, were just not adequate against those issues. (Oh — the doctors did recommend that I take the birth control pill for my heavy, painful periods, and I did so for 20 years — it did help tremendously with the pain, the anemia, etc., even though I think the Pill harmed my romantic relationships and my chances to be a mother.)
By the way, I thought I’d add to my previous post that at the start of this year, I was having problems with foot fungus that I got from a hotel shower, as well as concerns that I had some yeast issues in my digestive tract, so I read up on oregano oil and I took just 1 capsule a day for just 7 days, and it caused my period to suddenly start (even though it was the middle of my cycle and my period was not due at that time). It was a full period that lasted for days, not just spotting, and I was surprised at that, because up to that point my period had been pretty regular.
I always do extensive research on any supplement that I add to my routine, and I had not noticed when I looked up warnings about oregano oil that one of the side effects is that it brings on menstrual periods, BUT after I experienced it myself and looked the key words up online, I did find plenty of warnings that oregano oil can bring on periods (and it can cause the loss of a pregnancy, which is why oregano oil is VERY dangerous to use if a woman is pregnant or is trying to get pregnant). I also found general warnings that oregano oil is so potent and so multi-faceted that it should be used only with the guidance of an expert in herbs. Apparently it is better at killing MRSA than the specific antibiotics used against MRSA (or something like that). An amazing, powerful plant.
So, with an emphasis on how powerful oregano oil can be, and how it’s best taken under the guidance of an appropriate medical professional,
I did want to say here, to the women who are not having periods and who are reading these posts about amenorrhea trying to find clues and treatments, I wonder if oregano oil would be something they could try, for a very limited time, in a limited dose, to see if it would bring on a period for them, and maybe “jump start” menstruation. I do not know if this would work, I do not know if it would be contraindicated, so please do the research yourself, if you decide to look into it.
Regarding taking preformed Vitamin A, which is from animals (such as the Vitamin A that is found in cod liver oil capsules/liquid, as well as some standalone Vitamin A products):
The “tolerable upper intake level” for adults is *much lower* than one might think it is, given the high amounts of preformed Vitamin A that are in many supplements made by reputable brands.
It is easy to reach a level of toxicity in preformed Vitamin A (the Vitamin A that comes from animals).
(Note: The type of Vitamin A which is in vegetables, such as Beta-Carotene, apparently does not reach toxicity in humans, and the main symptom of taking too much of that kind of Vitamin A is the skin turning orange. However, the different forms of Vitamin A might be metabolized differently by different people, and the vegetable form has to undergo chemical conversions in the human body in order to be used as Vitamin A, and not everyone’s body does that efficiently.
In my experience, I am pretty sure that my body can’t rely on vegetable Vitamin A/Beta-Carotene alone, and it needs a little of the preformed A to be healthy. I seem to have a problem in converting Beta-Carotene, which doesn’t surprise me, because I have some confirmed genetic mutations that mean I have trouble converting some other supplemental vitamins, such as folic acid and artificial Vitamin B12, into usable forms in my body.)
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I do not know if it is allowed to post links here to information and research, but I will try.
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Wikipedia’s main article about Vitamin A says:
“liver toxicities can occur at levels as low as 15,000 IU (4500 micrograms) per day.”
“In people with renal failure, 4000 IU can cause substantial damage.”
“Chronic intake of 1500 RAE of preformed vitamin A may be associated with osteoporosis and hip fractures because it suppresses bone building while simultaneously stimulating bone breakdown.”
“Excessive vitamin A consumption can lead to nausea, irritability, anorexia (reduced appetite), vomiting, blurry vision, headaches, hair loss, muscle and abdominal pain and weakness, drowsiness, and altered mental status. In chronic cases, hair loss, dry skin, drying of the mucous membranes, fever, insomnia, fatigue, weight loss, bone fractures, anemia, and diarrhea can all be evident on top of the symptoms associated with less serious toxicity.”
https://en.wikipedia.org/wiki/Vitamin_A
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Wikipedia’s specific article about Vitamin A overdose says:
“Hypervitaminosis A can be prevented by not ingesting more than the US Institute of Medicine Daily Tolerable Upper Level of intake for Vitamin A.
This level is for synthetic and natural retinol ester forms of vitamin A. (Carotene forms from dietary sources are not toxic.)
The dose over and above the RDA is among the narrowest of the vitamins and minerals.
Possible pregnancy, liver disease, high alcohol consumption, and smoking are indications for close monitoring and limitation of vitamin A administration.”
According to the chart on that page, the daily Tolerable Upper Limit for females aged 19-69 is only 3000 mcg.
https://en.wikipedia.org/wiki/Hypervitaminosis_A
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Now, Vitamin A is confusing because the measurement of its quantity in terms of supplements is done in 3 different ways: RAE, IU, and MCG. Please see the main Wikipedia entry on Vitamin A for a brief description of how these measurements differ.
Another site that I found helpful in explaining the different measurements of Vitamin A is: http://www.whfoods.com/genpage.php?tname=nutrient&dbid=106
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The National Institutes of Health info sheet on Vitamin A also goes into the different ways to measure Vitamin A: https://ods.od.nih.gov/factsheets/VitaminA-Consumer/
Additionally, the NIH site says, “Getting too much preformed vitamin A (usually from supplements or certain medicines) can cause dizziness, nausea, headaches, coma, and even death. High intakes of preformed vitamin A in pregnant women can also cause birth defects in their babies. Women who might be pregnant should not take high doses of vitamin A supplements.”
They say that the daily upper limit of preformed Vitamin A for adults (male and female) is no more than 10,000 IU.
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The Linus Pauling Institute at Oregon State says, “Overconsumption of preformed vitamin A can be highly toxic and is especially contraindicated prior to and during pregnancy as it can result in severe birth defects.
The tolerable upper intake level (UL) for vitamin A in adults is set at 3,000 mcg RAE/day.
The UL does not apply to vitamin A derived from carotenoids.”
http://lpi.oregonstate.edu/mic/vitamins/vitamin-A
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The Mayo Clinic site says, “the U.S. recommended dietary allowance (RDA) for adults is as follows:
900 micrograms daily (3,000 IU) for men and
700 micrograms daily (2,300 IU) for women”
http://www.mayoclinic.org/drugs-supplements/vitamin-a/dosing/HRB-20060201
They also list many potential interactions between Vitamin A and other supplements/herbs/medications: http://www.mayoclinic.org/drugs-supplements/vitamin-a/interactions/hrb-20060201
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Oddly, given how quickly a modest amount of Vitamin A can become toxic to the body, many preformed Vitamin A/Cod Liver Oil supplements have 15,000 or 20,000 iu per pill. The National Institutes of Health says the daily upper limit is just 10,000 iu. In fact, the advice (that I have seen in several legitimate sources) to women of childbearing age is that they take no more than 2,500 to 5,000 iu of preformed Vitamin A daily.
It is not that easy to find preformed Vitamin A or Cod Liver Oil capsules that have such a small amount in them.
Because I am so sensitive to supplements and medications, I was looking for a supplement that has a really modest amount of preformed Vitamin A, and I found one at a health store in my state (labelled under the store’s own brand). It is a Cod Liver Oil supplement with only 1250 iu of preformed Vitamin A per softgel.
I also found the same formulation (by a different brand) of Cod Liver Oil containing only 1250 iu of Vitamin A per pill at one of the major online supplement stores (I am not sure if I can name them here).
I am taking one softgel a day of that, which gives me a modest amount of preformed Vitamin A — it is enough to help out my body, but not so much that it potentially could build up to toxic levels and cause more harm than good.
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**Therefore, I would caution everyone reading this to be careful with their preformed Vitamin A intake.
Because preformed Vitamin A is fat-soluble and stored in the body, there is not much of a safety zone between a “healthy” level and a “toxic” level.
To be safe, it appears that adult women should take no more than 2500 to 5000 iu a day of _preformed_ Vitamin A (unless they are being guided by an expert medical professional in their Vitamin A intake, of course).
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(Note: For information about getting your preformed Vitamin A from foods instead of supplements, one good resource is naturopath Chris Kresser’s website. Just do a search in his site’s search box.)
What do you suggest for women with type 2 diabetes. I have had HA for 3 years now. I have gained 20lbs and am in a healthy BMI. I have stopped all exercises besides walking and yoga. I eat around 50g of carbs a day. If I go around the suggested 100 g of carbs I spike my blood sugar way high! I have to be on a low carb diet. My hormones are crazy. I have anxiety, impatience, cry, absolutely no sex drive, and depression. Is there anything I can do to get my period back? I have tried all revommendations beside increase carb intake as that is not really an option with my diabetes.
For women with diabetes I typically recommend low amounts of carbs spaced evenly throughout meals. And you are right – I don’t think you should eat more than you can tolerate.
Gut healing may be the next step I would try, with a high quality probiotic, fermented foods, making sure your stomach acid is all well and good… this may help keep your blood sugar a bit more stable and reduce inflammation? vitamin D I would also highly recommend.
Hi
I have period irregularities for almost 1 year now. My periods were delayed 4 months for 3 cycles and now its not coming at all. My marriage was 3 years before n I didn want kids for sometym so I was afraid to have sex and bcoz of that I lost interest in sex . And we didn have physical relations for approx 1 year. But now I regret for all these immature acts and now I strongly wish for a baby. But my periods are not coming.
I saw gynecologist and took scan and all other tests. They are saying stress may be the reason.
I want to overcome this and I want my normal periods back in natural way. Plz help me…
Is it possible to still get pregnant at some point in the future if you have had amenorrhea and are able to get your period back? Thanks in advance!
Yes absolutely! 🙂
Would you ever consider creating a hypothalamic amenorrhea ‘diet’ or menu? I know that could be counterproductive since women with HA are supposed to completely relax and just eat intuitively without a specific plan. But it might give a good visual of exactly how much we’re supposed to be eating. It might also be a good way to see how to sneak in extra calories (adding oils, PB, etc), as well as making sure we’re eating every food group (I, for example, had a tendency to cut carbs for the past few years)…I also think it would be helpful to see how we can keep up the calories while still eating nutritiously. It might also put a few girls minds at ease, especially those who were clean eaters or health nuts, knowing there’s a healthy way to gain some lbs. I was skeptical to start eating too much sugar, for instance. Just curious if that’s anything you would consider! Thanks for the post 🙂 very informational and helpful.
This is a good idea, and a great point. I’ve thought about it before. I’m not exactly swimming in free time these days but I’ll work on making something happen in 2017 🙂
Thank you. This helps me immeasurably!
Thanks Stefani–I feel like a giant knob. I knew with a history of adrenal fatigue and hypothyroidism that using intermittent fasting and a Keto diet could likely mess me up, but it worked so well for my husband… I’m a veteran (w/PTSD), competitive fighter, full time consultant, part time small business owner and full time Mom. I miscarried a year ago, I was desperate to get pregnant again. I tried to get my weight back down, using IF and a keto diet and now I’m back at square one. I have been adding a seemingly insane number of carbs back in my diet and making myself eat (I never stopped my periods, just had more of an erratic schedule).
My question relates to hunger signals: is it possible that you spend so much time/energy ignoring or working through hunger signals that they are no longer sensitive? Should I ‘make’ myself eat ~2200 calories a day with moderate carbs regardless of how hungry I feel? I am either not hungry or ravenous now. How do I get back on track quickly?
Wow, what a boss. 🙂 Thanks for commenting.
I wouldn’t, first, worry about the ‘seemingly insane’ amount of carbs. I’m sure it’s perfectly fine, even if they’re 60% of your diet you’re probably not in any trouble. 🙂
Second, yes, I think it’s possible that we can get sort of unhooked from our hunger. I think when you are ravenous you should DEFINITELY listen to your body and eat as much as you want. I think in the times in which you feel full, if you haven’t eaten much, yes, maybe some snacking or testing the water of eating would be good. If it doesn’t feel good after you start eating, then go ahead and let yourself stop and just wait until you feel hungry again. Really, the most important thing is feeding your body when it asks for food, and over time that should become a more regular schedule <3
You know, you may also find that your hunger is fluctuating because you’re changing the macronutrient ratio of your diet. Maybe eating carbs now after having avoided them for so long has sort of played a little bit of havoc with your taste buds and hypothalamus. That being the case, I would still continue to eat as much as you need when your body asks for it, and maybe pay attention to when that is, what you’ve eaten previous to that, or the day prior, and making sure that you’re getting enough of everything all the while, and paying attention also to if you’re feeling hungry after carbs or etc. Its possible that adding carbs to your diet pushed out some fat and therefore you’re accidentally undereating – a lot of people who previously had feared carbs do that when they reintroduce because they overestimate how many calories / etc are in the carby foods they’re eating
Hello Stefani,
I have been strict autoimmune paleo for 1.5 years due to breastfeeding a sensitive baby. I now have low estrogen, amenorrhea, and more food sensitivities than I started with. I have been trying to eat more overall with focus on fats (olive oil, coconut oil, cashew butter, and walnuts). I already consume a lot of carbs (sweet potatoes, potatoes, apples, bananas, raisins, dates, etc) as I do not tolerate a lot of animal protein (vegetarian/vegan for 17 years and sensitivities to beef and pork). I have felt much better on an AIP diet but my body is telling me otherwise. I am struggling with what to do next. I have been eating to achieve higher calories but this leaves me uncomfortably full. I have greatly reduced exercise, gained 13+ pounds (all midsection), and I am working on yoga for relaxation.
I have considered quitting paleo but, as I said, I feel so much better now than before I was eating AIP.
Any suggestions?
Does your book discuss HA any further?
No, none of my books discuss HA in depth. 🙂
I think I would probably think about including as much as possible, and focusing on gut healing foods, especially probiotics and bone broth / a collagen peptide supplement. Then you can gradually increase the foods you eat, hopefully. I think you are right to try and eat as much as possible. But if there is any underlying stress from a nutrient deficiency then trying to get as much variety as possible is a good place to start. At this point I couldn’t say for sure what I would guess is causing the low estrogen and amenorrhea, unfortunately, but gut healing is definitely a good place to start, and trying to get variety back. I personally might seek out a functional medicine doc to see about getting tests done if this kind of approach doesn’t work
Hi Stefani
I have been diagnosed with HA a few months ago I have been off my pill for 9 months now with still no period very frustrating 🙁 I know the reason I got HA was because of excessive exercise and low fat % I got down to 16% body fat and was exercising six times a week cardio and weight training, I am 165cm tall and currently 8 stone 10 I started my journey at 7 stone 12 so I have gained nearly a stone which has been very hard.
I originally cut my exercise down to two days a week yoga no cardio and only 4 weight sessions but still no period not even a sign of it, I religiously counted calories and tracked macros so I thought it was that so I deleted my fitness pal and stopped tracking which was very difficult as I know the calories in everything so how do you switch that off??, still no period and I have been steadily gaining weight so now I am so fed up I decided this week to cut out exercise completely except light walking and yoga/pilates I have my main meals cooked by my husband so I don’t know the calories however I still choose my lunches and breakfast which is hard as I know the calories I am just hoping something will happen, I have never been a big person the heaviest I have been in my whole life was 9 stone 4 so I don’t get why I have to gain more weight i am starting to feel like crap as I can feel the weight gain also visually is there any tips you can give to help me? I don’t know how to switch off thinking about calories and feeling guilty for eating more and I think that is the issue :-(.
I am sorry this is long but any help wound be appreciated.
Helen.
Thank you for the post. Been struggling with HA for the past 3 years. I hope this works out for me. Can’t wait to get myself back to the old me.
I am SO thankful for you, Steph! After 3 years of increasingly severe health issues, I finally found an incredibly knowledgable endocrinologist with a functional medicine background. Although I have not struggled with my ED since my teen years, I am now feeling the health repercussions a decade later.
Listening to your podcasts and reading your blog has provided so much comfort, encouragement, and applicable knowledge. Thank you for all that you do!
Thank YOU Lacey! It’s knowing I can make a difference like this that keeps me going. And your strength inspires me! <3 <3
I don’t know how I haven’t come across your articles before. They are so informative and helpful. I’m absorbing as much as I can.
I have had amenorrhea for over five years (possibly a lot longer as I had a Mirena for ten years) and now also suffer from osteoporosis. My question though is, at 42, if i try to correct it, will a menstrual cycle start again, or have I left it too late and it’s not worth ‘fixing’ as I’m at that stage in life where menopause could just be around the corner.
i think it’s worth making dietary and lifestyle changes that help your body reduce stress and feel less like it’s starving. whether that gets your period back in full force i think is possibly up for question (though i would guess yes) and this would have many other benefits 🙂
this was so helpful and a relief to know I’m not alone, and that other women have healed too! thank you.
I find this article helpful, yet stressful. I have been diagnosed with HA as I have not had a period for over 4 years now. The thing is…I’m not underweight, nor am I stressed. So what’s the answer? I’m 31 and my acne is that of a teenagers. I have a stomach that looks like I’m 6 months pregnant 99% of the time. I feel helpless and lost.
Have you had any blood tests done? how are your hormone levels? What is your stress level like? Do you count calories or otherwise restrict your food? Answers to all of these questions I think are important. don’t feel lost and please don’t hate your body! It mostly needs (most likely, anyway) some tender loving care 🙂
Thank you for writing this article, I’m happy I came across it. It helps me a lot as I’ve been struggling to understand this.
Anyone experience acne with HA?
Oh yes, a significant percentage, including me
Hi Stefani,
I was diagnosed with HA last October while back visiting in NZ. I hadn’t had my period for 8 months after coming off the pill, but i did get it twice when i was at home.
I’m now back in London in a new, stressful job and there has been no sign of my period since January. I’m desperate for it to return to normal and get my libido back!
I eat keto, train hard at the gym (but not excessively) and also intermittent fast, all of which probably arent helping. Please can you guide me to the Top 5 must-dos for me to get things back to normal?
I’d really appreciate your guidance as feel very lost and alone on this.
If I wanted to be fertile and ravenous immediately I’d stop training, stop keto, stop intermittent fasting, sleep as much as possible, and eat as much as I’m craving
Hi Stef,
I love your posts and podcast. I’m almost 30 now, and from 22-26 had exercise-induced amenorrhea. Lots of running and diety-restriction. I am learning about osteoporosis in school and am suddenly FREAKED! How are my bones?? I know you went without a period for a bit, did you consider a DEXA scan? From my research, it seems that bone loss is nearly inevitable and not necessarily un-doable with amenorrhea. Do you have any thoughts on this matter? Thank you!
Yeah. I broke both of my wrists two years ago and did wonder if this was a contributing factor. Docs told me that my bones looked strong enough in the xray though.
I don’t see a point in really panicking as there’s no changing the past. Get lots of vitamin D and eat your fruits and veggies and consider a magnesium supplement and that’ll support you making as strong bones as possible 🙂
Thanks, Stef! I just read this and was agreeing with it ALL and loving every word. Then when I realized it was written by you, I understood why! Thank you for the self reflection stress questions. Gonna use those for some journaling!