What to do when you got your period back but then lost it again?
I got this question in my Instagram DM today and thought that it would make a post that others would like to read as well, so here we go!
First off, do your best to not lose your period again… But that you already know. You remember really well how hard recovery from hypothalamic amenorrhea was, and you don't want to have to do this again!
So, once you've been getting a few post-hypothalamic amenorrhea periods, be careful and keep in mind the following things:
- Re-introducing exercise: Start slowly. Here's a great program that helps you to get started. Avoid HIIT and long distance cardio too soon — in my opinion, these are the least hormone friendly workouts for someone who has had exercise induced amenorrhea. Instead, if you want to work out, stick with a strength program, yoga, flexibility, mobility and other low intensity and low impact workouts.
- Eat. At least during the first couple of months after you've gotten your period back, keep eating pretty much the same way that you did when you were still in recovery.
- Don't increase exercise and decrease food at the same time. Be careful with that, because as you start working out again, you also burn calories. If you now cut calories by reducing food as well, you end up taking in even less. You want to maintain balance.
What Should You Do If You Lost Your Period Again?
Okay, but what should you do when your period hasn't showed up again? Here's my advice:
You may not have even lost your period. It may be just late.
Sometimes women assume that once their first period comes back, it will start showing up super regularly, after every 28 days.
However, this is not the reality for many of us, especially at first, when our cycles are little bit all over the place. I've seen the length of the first recovery cycles varying from 20, to some cases even 70 days!
My first post recovery cycles were around 47 days, then I got a random 28 day cycle, then I had a few 40 days… It's only now, 18 months later, that they have pretty much figured themselves out.
So if you don't get your next period 28 days after getting your first post recovery bleed, don't worry. Don't change anything about your lifestyle, keep doing what you were doing when you were still in recovery, and your period will come again. A few days later is not that big problem.
Also, think how many years you didn't get your period! Give yourself some time to heal fully!
Have You Changed Your Diet?
Have you changed anything about your diet recently?
Many women want to quickly lose the weight after they got their periods back, so they stop eating as much as they did before.
This is a mistake. Don't do it!
If you lost your period because you ate too little, how can you expect a different result when doing the same thing?
Make sure that you're still eating all the things and good amounts. If you have no medical reasons to leave out foods or food groups, please don't do it. Don't get on a low-fat or no-carb or low-carb bandwagon. You need all three macronutrients (again, unless you have a medical reason to avoid or significantly reduce some of them).
Some people don't cut calories intentionally, but it just happens as they start eating more intuitively, or as I like to call it, practice dietless eating. Sometimes it can cause people to under eat. If you haven't intentionally cut your calories but your period went missing, it may be helpful to track your food intake from a few days to a week and see if your intuition is leading you in the right direction. If you find that you're barely eating 2000 calories, you need to up your food intake.
Did You Start Exercising Again?
If you did, that's totally cool — but did you wait at least 2-3 cycles before doing so?
If so, how did you start working out?
Here's my program for you that helps you to get started with working out again, without messing up your hormones.
Sometimes women dive into working out quickly after hypothalamic amenorrhea, hoping that doing so will help them to lose the gained weight and fat.
But just like I said earlier about food: When making one mistake got you in trouble the first time, making the same one the second time will not get you a different result!
You can't expect your body to lose the weight again quickly and still keep the period. It doesn't work that way. If you're doing too much, your balance will be off again.
Just recently, someone contacted me and said that she doesn't know why she lost her period again because she's been eating really well. When I asked about her exercise and how that's different compared to earlier when she was still recovering, she said she used to do just yoga but now she has added in HIIT and dancing.
To me, there's a pretty clear answer — the added exercise is likely to blame, if the food intake has really remained the same.
Not all people start working out in order to lose weight, for some it happens accidentally. They just enjoy movement so much! While it makes me really happy that they're not focusing on weight loss per se, but if they do lose weight which means they get amenorrhea again, they need to cut back a little.
It's not going to be like this forever — remember, your body is more sensitive at first after getting your first periods after not having them for a while. Later, you can add in more exercise and be okay, as long as you eat well and recover properly from your workouts.
Have You Been Traveling?
Traveling can also throw off our cycles, especially if we travel between different time zones. Your circadian rhythm may get disrupted and your body can perceive this as stress. If you didn't get your period that month when you were traveling overseas, don't worry about it too much — it will likely come next month.
Have You Had More Stress Than Usual?
We already talked about physical stressors, like too little food and too much exercise. These things can cause your period to go away. But there are also other types of stressors that you want to minimize, in order to keep your period.
Sometimes we can skip a period or two when we're experiencing difficult times in our lives, for example, change jobs, move, have a lot of work pressure, finals at school, etc. Obviously, sometimes there's nothing to do about these things — you can't just not take your finals, for example.
But you can try to reduce your stress by doing the things that help you to calm down and relax again. Expressive writing, meditation and other techniques have been really useful for me personally during the times when I've had more on my plate than I can handle (figuratively speaking, obviously!).
How Is Your Sleep?
Sleep matters a lot both during recovery and after that. In fact, there's no time in your life when sleep wouldn't matter! It always does, but for someone who has been burned out from too much exercise and/or under eating in the past and as a result, gotten really exhausted from that, sleep is especially important.
Maybe your life has become more stressful so your sleep hasn't been that great. Maybe you've been checking your phone longer at night than you used to. Maybe you've chosen working out in the early morning or late at night, instead of sleeping.
Whatever the reason, do your best to get solid 7-8 hours of sleep every night. If you need to, take naps.
When you miss a period, then first of all, don't panic. It can happen for variety of reasons and is not that uncommon.
But if your period has been missing again for several months, take a closer look at your lifestyle.
If you started to work out again, you may need to cut back or your training duration, volume, intensity or frequency. You may need to eat more food, because energy deficiency is one of the big reasons why our periods go missing.
Sometimes we lose our periods when we have more stress in our lives. Try to reduce that. Focus on sleep and do what you can to improve that.
But most importantly — keep your energy expenditure and calorie intake in balance. Too much deficit can cause you lose your period again.
Don't know how to safely start training again, after you've had hypothalamic amenorrhea? My 16-week bodyweight strength training program, Simple Strength for Women, will help you to start exercising again without losing your period.