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 the absence of a period for three or more consecutive menstrual cycles.
Hypothalamic amenorrhea is the secondary form. This means you’ve lost a regular period. This is caused by a disruption in the normal process involving hormones between our ovaries to our hypothalamus gland.
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 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.
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 + 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 next? 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.
Shannon Western is a nutritionist and therapist based in Edinburgh, UK.
She is registered as a nutritionist as a Registered Associate Nutritionist with the Association for Nutrition (AfN), and as a therapist with the Association for Coaching, Counselling, and Psychotherapy (ACCPH).