Hypothalamic amenorrhea is a diagnose that doesn't make anyone happy.
First of all, no one wants to have health issues in general.
Secondly, no one wants to gain weight, which is usually needed to recover from hypothalamic amenorrhea.
Weight gain is so scary that we don't want to believe that we have hypothalamic amenorrhea in the first place. That's why, even if we have all the symptoms and our workout and eating history supports it, we don't want to admit it. We're hoping to find another answer.
Here are some of the things that I've seen women say as to why they can't possibly have hypothalamic amenorrhea (and therefore, don't need to put on weight to recover…)
“Under eating is not my problem, I just need to just clean up my diet”
How many times have we seen that! We actually think that our diets are not clean enough for us to get a period. This is BS.
I would actually say the opposite — your diet is likely too clean!
No, I'm not going crazy when I tell you that you could use much more freedom when it comes to your diet. Removing sugar, grains, oils, carbs, fats, whatever — is going to make things worse and move you even farther away from recovery (of course, don't consume these things if you have medical reasons to avoid them or to keep them to a minimum).
The diet industry has led us to believe that there's something wrong with certain foods and that they should be avoided at all cost. Sugar is the demon. Let's all go keto. Intermittent fasting will heal all your problems.
They don't. Stop fasting. Eat carbs. Sugar is okay and even encouraged during recovery, because it's a really fast source of carbs and our hypothalamus loves it. So let's stop posting about massive glasses of green juices on our social media and say in the caption that we do it to heal from hypothalamic amenorrhea. Instead, eat three large meals, a few snacks and a cookie for dessert and your period will come back.
“I just have to get rid of that stress”
Yes, stress plays a big role in hypothalamic amenorrhea. Finding ways to reduce mental and emotional stress is really important, as they can affect your sleep, encourage negative self-talk and make you feel really burnt out. So yes, absolutely, find ways to de-stress — do yoga, journal, laugh a lot, have long conversations with your spouse or girlfriends. It all helps.
But do you know what's the biggest stressor, when you have hypothalamic amenorrhea?
Not eating enough puts your body in the state of stress. That's why it stops some functions, like keeping your hair growth normal, maintaining good body temperature and of course, menstruating. You can read much more about it in the book called No Period, Now What. Your body doesn't know whether or not there will be food available and how much there will be, so it has to really think where it can afford to put the energy.
While mental and emotional stress reduction is important, in my experience, the physical stressors pay bigger role in hypothalamic amenorrhea. If you're only addressing your mental and emotional stress but keep eating too low calories, your period likely won't come back.
“I guess I have some form of hypothalamic amenorrhea”
We're getting closer…
I've seen this one a few times. You finally start believing that you really have hypothalamic amenorrhea, but it's so hard to admit it fully!
So you may say: “I have some form of hypothalamic amenorrhea”, but what does it even mean? “Some form” leaves things open and room for you to stop recovery or even not get started. You may take some half-hearted attempts to fix it, but not really…
So you may up your calories a bit, still keep working out a few times, and share beautiful pictures of green juices on social media, because you think your situation is a little bit different. You just can't have hypothalamic amenorrhea, there must be another reason.
I don't know that there are many forms of hypothalamic amenorrhea. Sure, the reasons may vary a bit. For some, insufficient calories are the main problem, while others have just worked out too much although their eating was good (that was me). But to say that you have “some form” of hypothalamic amenorrhea and hoping that it will go away with very minimal lifestyle changes is just not going to be enough to heal.
“I've reached my “ideal weight” but still have no period. I don't think I have hypothalamic amenorrhea”
First question that comes to my mind is this: How do you know what your “ideal weight” is?
If you have hypothalamic amenorrhea and you're actively trying to recover from it, then it's your body that tells you when you have reached your ideal weight. It tells you by giving you your period!
You may think that your “ideal weight” is X number, but your body may have a different opinion. You can't decide this number for your body and stop trying to recover once you've reached it and still don't have your period. You may have to go higher, you may have to “overshoot” your weight in order to heal.
It's not to say that the weight you reached during your recovery, will be the ideal weight for you forever. As your body stops being in the panic mode, scared that it will be starved again, and as your body starts trusting you again, you may be able to drop a few pounds or kilograms. If your periods stay regular and you feel and look healthy otherwise, then this is your new “ideal weight”.
No one wants to have hypothalamic amenorrhea, and initially, no one wants to put on weight. I say initially because many of those who recover, later find that it wasn't that terrible and that they actually really like their “new” bodies.
But the first steps are hard. If you don't have a period and you have a history of regular, often too frequent exercise, weight loss and dieting, then there's a good chance that you do have hypothalamic amenorrhea. It's better to face the truth instead of trying to come up with reasons why you shouldn't be having it.
If you need support on your journey to recover from hypothalamic amenorrhea, my ebook is available for you! You can also email me — I get back to every email, so let me know if I can help.
I have made it through the most important phases of recovery and this week I just got my first period in 2 years!!! I think it was quite normal – 6 days : the first 3 it was heavier and the last 3 it was spotting here and there and also some bleeding. But even before getting my period, I haven’t seen any cervical mucus, almost at all( I actually had some in the first months of my recovery) but after the first 3 months I barely have seen any cervical mucus and then suddenly after 6 months in recovery I got my period. I really didn’t expect this.
I have heard that if there isn’t any cervical mucus, that could indicate that ovulation does not occur, even if you are bleeding.
Is this true? Is it possible to get a period after HA without ovulating? Is the lack of cervical mucus a bad sign or is it correlated to anything?
Now that I got my first period, is it considered that I have healed from HA? Or should I wait for the next cycles?
Kersten Kimura says
Hi Lena! Yes, it is possible to have anovulatory periods (period occurs but no ovulation). That means that your hormones are improving but they aren’t quite there yet. You do want to ovulate every cycle (although a few anovulatory cycles once in a while happen and should not be a huge deal), because this is when we really get the health benefits that a proper hormonal balance can offer. Also, we improve our bone density when we ovulate.
I would keep eating the same way you did to get your period, and keep the stress and exercise level low. You can also try and track your body temperature every day the first thing you wake up in the morning. After you see a significant rise in your temperature, you’ve likely ovulated. But you should still see some CM as well.
I wouldn’t say that getting your first period means you’ve fully recovered. You want your periods to be ovulatory and (at least somewhat) regular. Also, your mindset matters – to me, fully recovered also means not having obsessive behaviors around food and not weighing yourself obsessively, being able to go out to eat and be social, etc.
I hope this helps!
Thank you very much for your response! This really made things more clear.
I am currently still in “Recovery mode”, because I am still very very hungry and my body just asks for a lot of food (and of course I am still gaining weight). Fortunately, I never had issues with exercise, it was always about how much I was eating.
So I’m just continuing this way and see what happens.
Btw, I also got my reproductive hormones tested during my period and they have improved since the beginning of recovery, but estrogen for example is still under the lower normal limit.
Thank you again very very much!!!!