You can lose your period and still have hypothalamic amenorrhea, even if you are at “normal” weight.
When I first started doing my research and trying to figure out why I had lost my period, I came across some blogs that talked about it. But most of them were written by women whose bodyweight was relatively low. By low, I mean at the lower end of what is considered “normal” range on the BMI scale (normal is 18.5–24.9). There were also many women whose BMIs were below that, less than 18.5.
There were women who had done figure or fitness competitions and gotten their body fat percentages extremely low, even 14 or under. Together with that, also their bodyweight dropped quite a bit, so their BMIs were somewhere around 15-17.
There were runners whose BMIs were equally low, because they either thought lighter weight helps them to run faster (not true, because extremely low weight also takes away your strength and overall energy), or they just got so obsessed with being thin that they just ran a lot and ate minimally too maintain that skinny body.
There were girls who had gone through anorexia or other eating disorders or were struggling with disordered eating habits. Also their BMIs were anywhere between 15 to 19… all at “underweight” or low end of the “normal” bodyweight range.
That's what I found from blogs. All the more “formal” information, for what you may, for example, hear from your doctor, only confirms it: If you aren't underweight but have no period, you can't have hypothalamic amenorrhea. Worst case scenario, your doctor tells you not to worry and wants to put you on the birth control pill.
But DON'T do that.
Why I Thought I Can't Have Hypothalamic Amenorrhea
Of course I was confused – why did I lose my period?
I was not underweight. Even at my lowest point about 10 years ago, my BMI was still around 19, so technically I wasn't underweight even then. (However, I now realize that I was very, very thin at BMI 19 and can't even imagine how I'd look like even below that!)
I was able to find only a handful of stories from women who actually weren't that thin. There were a few girls whose BMIs were around 22 or even more, but really just a few.
On the other hand, I still wanted to fight and deny it. I thought: These few girls must have been just exceptions…
I thought I was different, because
- I had gotten rid of binge eating a few years ago and ate normally now
- I had broken up with the scale years ago and totally embraced the idea that how much I weigh doesn't matter
- I was only working out about 30 minutes a day (although I didn't realize that I was actually moving much more than that)
- I looked totally healthy and definitely not underweight.
My acupuncturist wanted me to weigh myself, and I did it, after not having touched the scale for years. It showed 152 lbs, meaning that my BMI was 22.1.
Could I still have hypothalamic amenorrhea????
It Really Was Hypothalamic Amenorrhea
You don't have to be underweight or wear a size 0, to lose your period. As it comes out, it happens also to those whose BMI is 18.5-24.9, or is, in one adjective, “perfect”.
It seems to be true that majority of girls who lose their periods have a BMI that puts them to “Underweight” category, or at least to the lower end of the “Normal” category. But it's not always the case.
This book proved it perfectly. The authors conducted a survey, and the results showed that
- 16% of the respondents had their BMI at least 21 when they realized their period was gone
- 3% had their BMI 23 when they realized their period is missing.
- All these women were still having hypothalamic amenorrhea.
After reading this study, the picture cleared up for me a bit. I also started thinking back to my exercise, weight loss and dieting history, and found many things that pointed to hypothalamic amenorrhea.
Why You May Lose Your Period, Even If You Are at a Normal Weight
There are a few things I learned (from the book and from my own experience) that showed me that low BMI isn't a good criteria for “diagnosing” hypothalamic amenorrhea.
- Body fat matters a lot. BMI doesn’t say anything about body composition. A person with normal or even high BMI may have significant amount of muscle, but female hormone production requires enough body fat. If there isn't enough fat, you can't have your period.
- You may lose your period only because of overtraining, even if you eat sufficiently. Read Christina's story to learn more about it. Constant training means constant cortisol output. Even though exercise may alleviate our mental stress, it is physical stress for the body.
- You may lose your period only because of stress. By that, I mean life stress (finances, relationships, work etc) – this type of stress alone can be enough for you to lose your period, and it may have nothing to do with your bodyweight. However, don't now think that you can exercise more because that way you can relieve your mental stress. I actually thought at first that in order to get my period back, all I have to do is to get rid of my mental stress, but I didn't want to admit that I was still exercising little too much.
- If you ever lost some weight, even if it was just 10 pounds and even if it happened years ago, that may have been enough to stop normal hormonal production. For example, ten years ago, I lost 30 pounds. Over time, I gained about 20 back, but I still didn't get my period. Part of it was because as I switched from running to strength training, I put on a lot of muscle but not so much fat (see point 1 above). But the damage I did 10 years ago, was still affecting me. My period came back when I gained back all 30 lbs, that included also fat.
- If you limit your calories or try different diets over and over again, you may lose your period, even if you aren't underweight. Our bodies don't like this type of yo-yoing. Say that you're limiting your calories a lot and your body is starving. At one point, you can't handle it anymore and you binge, eating all you can. Of course your body doesn't feel safe to produce hormones you need for normal functioning, if you keep going from one extreme to another.
- We’re all different! I want to repeat it one more time: We're all different! There are women who can do figure competitions, drop their body fat percentages to 15 and still have a period and even get pregnant fairly easily. And then there's you, with BMI 22, 23 or 24 and NOT getting a period. It doesn't sound fun but that's just how we are – different. Our eyes, skin color and hair are different, and so is our natural body weight, as well as our ability to handle stress, physical, physiological, mental and emotional.
If you’re someone who doesn’t have a period but isn’t underweight, know that you may still have hypothalamic amenorrhea. I was like that and despite of not wanting to admit it, that was exactly the case.
The cure? Commit to recovery fully, reduce physical, physiological and mental stress and your period will return. You don't only restore your cycle, you also take your health back.
Severe overtraining can cause loss of period, and you don't have to be underweight for that to happen.
If you need support on your journey to recover from overtraining or hypothalamic amenorrhea, my ebook, programs and FREE 20-minute coaching calls are available for you! I get back to every email, so let me know if I can help.