Hypothalamic amenorrhea: Learn about this common side-effect of disordered eating

Have you lost your period or are trying to get it back?

Maybe you are unsure why you have lost it in the first place.

If you struggle with your relationship with food and you’ve lost your period; you’re in the right place.

In this blog, we will discuss what is hypothalamic amenorrhea, what causes it, the symptoms, and how to overcome it.

What is hypothalamic amenorrhea?

Amenorrhea is when your menstrual cycle goes missing.

There are two forms: primary and secondary.

  • Primary amenorrhea is when you have no period before 16 years old.
  • Secondary amenorrhea (functional hypothalamic amenorrhea, FHA) is when your periods stop due to a disruption in hormone health.

The secondary form is often referred to as simply hypothalamic amenorrhea (HA) because it’s caused by a disruption of the hypothalamus gland. The cause of HA is a communication problem between the ovaries to the hypothalamus gland.

 

What does hypothalamic mean?

The hypothalamus gland is like a control centre. It controls many functions, including reproduction. It produces a hormone called gonadotropin releasing hormone. This hormone then triggers the pituitary gland another part of the brain.

The pituitary gland releases two hormones called folic stimulating hormone and luteinising hormone. These hormones signal the ovaries to produce sex hormones used in the menstrual cycle.

Hypothalamic amenorrhea is your brain telling your ovaries to slow down and reduce the production of sex hormones and ovulation.

Also known as “I can’t get pregnant right now – there’s too much going on.”

Hypothalamic refers to the hypothalamic gland. This is a gland in the brain that controls body functions, including making hormones. Hormones are of course needed to have menstrual cycles, so a disturbance in this gland means your menstrual cycle is disturbed.

Hypothalamic amenorrhea causes

There are a few factors that can cause hypothalamic amenorrhea such as over-exercising, under-nourishment and weight changes.

Let’s dive into the main reasons for period loss…

Eating too little

You can lose your period if you are not eating enough food to keep your body fueled and thriving.

This is common among people who have an eating disorder, dieting or who participate in high-intensity sports or exercise.

Stress

 

Long-term or chronic stress has a big impact on your periods. That’s because when you’re stressed, you produce more cortisol.

Cortisol lowers the production of estrogen by the body. Meaning you won’t ovulate or menstruate.

Body weight

A sudden drop in body weight (intentional or not) can cause you to lose your period. Inadequate body fuel causes the breakdown of fat for energy. Adequate body fat is essential for maintaining healthy hormone levels and a regular menstrual cycle

Fat is required to maintain healthy hormones and a regular menstrual cycle.

This can happen at any body size; it is not just women with lower body weight.

Exercising too much

During over-exercising you can develop hypothalamic amenorrhea from having an energy deficit.

This is energy deprivation from not eating enough and exercising too much.

It slows down your metabolism, so you stop ovulating to conserve energy.

Poor sleep

Sleep deprivation suppresses melatonin production as well as excessive HPA activation which is required for stress adaptation.

Medical conditions

Medical conditions such as PCOS can contribute to losing your period, due to a deficiency in certain hormones.

Birth control such as post-pill fatigue can also cause period loss.

Symptoms of hypothalamic amenorrhoea

Physical symptoms

    • Low levels of reproductive hormones. The body pauses the production of the reproductive hormones which will cause an interference with menstruation and ovulation.
    • Feeling constantly cold
    • Feeling fatigued
    • Weakened bones
    • Brittle hair and nails
    • Digestive issues

Psychological symptom

    • The feeling of anxiety or depression
    • Having a poor body image or being fixated on bodies
    • High levels of stress

Behavioural symptoms

    • Having an obsession with food and your eating patterns
    • Engaging in restrictive behaviour around food like avoiding certain food or food groups and controlling the portion sizes
    • Over-exercising and having feelings of guilt if you have a rest day or exercising when you are sick or injured

How to heal hypothalamic amenorrhea and get your period back

1. Ensure regular eating

This includes having three meals a day and three days throughout the day.

2. Focus on eating enough food

Including catching up on lost calories from exercise.

It can be hard to say what enough food is but eating adequate amounts for your daily activities like breathing, thinking, your heart beating, cleaning and cooking.

3. Focus on less intense exercise

You need to evaluate if the exercise you are doing is greater than the energy intake.

If yes, then reconsider if exercise is beneficial in your recovery or significantly reduces the volume and intensity of the exercising.

 

4. Stress relief

Find activities you enjoy that relieve your stress, like reading, cooking/baking or painting.

5. Adequate and restful sleep

Sleep is so important for our bodies. It helps our brains, keeps our emotions in check and reduces stress. Missing your period is a tricky situation to be in. Especially if you’ve lost it due to under-eating and/or over-exercise.

What should you do if you have hypothalamic amenorrhea?

Ready to transform your relationship with food and get your period back? We recommend getting in touch with us. You can read about the private nutrition therapy support we offer to see if we’re a good fit to help you.

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