Have you been struggling with hypothalamic amenorrhea (HA)? This post has been a long, wishful, time in the making. And honestly… I didn’t know if I’d ever be able to write this post. But thankfully, I got my period back naturally after disordered eating (finally!) and I’m going to share with you exactly how I did it!
- What hypothalamic amenorrhea is and what causes it.
- The difference between hypothalamic amenorrhea (HA) and PCOS.
- Why I didn’t use birth control to fix my hormones.
- My personal timeline of events that led to me getting my period back.
- How I found a doctor that worked with me on getting my period back naturally.
- 3 major steps that I used to get my period back naturally.
I would also like to point out that I’m not a doctor and this is not medical advice. If you’re experiencing medical issues, consult your doctor. I’m only sharing my experiences and what has worked for me.
What is Hypothalamic Amenorrhea?
Amenorrhea is the general loss of periods. Hypothalamic amenorrhea is a specific type of amenorrhea. According to Dr. Lara Briden, a naturopathic doctor and period specialist, HA is caused by undereating. She even mentions how it’s especially caused by undereating carbs. (1)
Undereating can also be caused by overexercising, and there are typically 2 scenarios for losing your period when it comes to exercise.
- You’re not eating enough food to support your activity level (not just on workout days, ALL the days).
- You’re exercising too much for your body to handle, no matter how well you fuel your workouts.
But HA isn’t the only way to lose your period. You can also lose your period because of another condition, called PCOS.
Hypothalamic Amenorrhea (HA) vs. Polycystic Overy Syndrome (PCOS)
HA and PCOS are similar in some ways, but they’re also very different. Hypothalamic amenorrhea is the loss of a caused by undereating, while PCOS is irregular periods caused by insulin resistance and elevated androgens. (1)
Dr. Lara Briden also says, “The two conditions are quite different—almost the opposite. PCOS is caused by too much sugar, and HA is caused by too little carbohydrates or too little food.”(1) The best way for you to figure out which one you’re dealing with is to ask your doctor and do some self-evaluation of your eating habits.
Why Did I Lose My Period?
The simple answer? I was undereating. I was:
- Strict paleo for a year.
- Super low carb for 2 years.
- Undereating and overexercising with orthorexia during it all.
I see now that it’s OBVIOUS that I was setting myself up to lose my period!! I was undereating, overexercising, and undereating carbs specifically. All of which are major contributors to HA. I was struggling with EXACTLY what Dr. Lara Briden explained are the causes of hypothalamic amenorrhea.
What About Birth Control?
Honestly, being on the birth control pill while I was battling with restriction and orthorexia makes the date I lost my period a lot more confusing to figure out. The thing is, birth control can “give you a period”, but it’s not actually a period. You’re not ovulating if you’re on the pill, so your body isn’t producing the hormones you need to actually have a period.
So, while I didn’t have a period “bleed” for 2 years, without birth control, I may have realized I lost my period a lot sooner than I thought I did. I may have actually been without a period for 4-5 years. You can learn more about birth control pills and periods here.
Do You Really Need a Period?
The answer I learned recently: YES! Yes, we need to have a cycle because we ovulate for lots of healthy reasons for our bodies.
As women, we benefit from our own hormones. That should be stating the obvious, but for some reason, it needs to be said. Women need estrogen and progesterone and NOT just for reproduction. We need them for bones, muscles, metabolism, and mood. We need them for general health. Just as, say, men need testosterone and not just for reproduction. Would anyone honestly make the argument that men need testosterone only when they’re trying to father a child? – Dr. Lara Briden (2)
I also really loved Dr. Briden’s explanation of the role of periods on Steph Gaudreau’s podcast Harder to Kill Radio, which you can listen to here.
How Did Dieting, Orthorexia, and the Pill Impact My Period?
In case this information is helpful, I wanted to give you an idea of what exactly I went through with my period. This way, you can see the steps I took and also make sense of how complex and unique your own situation really is.
- I got my period super late (age 16).
- It was irregular for 2 years, then I went on the birth control pill (age 18).
- I was on the birth control pill for 3.5 years.
- A year after being on the pill, I started struggling with restrictive dieting and overexercising, which turned into orthorexia and binge eating.
- I went off birth control on my own (without my doctor’s support) because I started learning about the repercussions of using hormonal birth control pills (age 21).
- Frustratingly, I visited my original doctor who only wanted to put me *back* on the pill to get my period again.
Then I Tried Something Different:
- I never went back to that doctor and eventually found a new doctor that had a functional medicine background (age 22).
- My new doctor sent me for a hormone panel and blood work tests, an ultrasound, and prescribed progesterone to see if I could have a withdrawal bleed. Well – blood work and hormones were normal, ultrasound was normal, and progesterone worked which ruled out endometriosis, thyroid issues, and PCOS. I was then diagnosed with hypothalamic amenorrhea. (The first step is always to work with a doctor for proper testing!)
- I still struggled with restriction and orthorexia at times, but I started eating more, exercising less, and reducing my stress.
- Finally, I started my Food Freedom Journey and restored my body’s natural healthy weight (age 22).
- I lived with Food Freedom and maintained my body’s natural healthy weight while also adding more carbs back into my diet (age 23).
- I got my period back!!! (Yesterday, age 23).
Do Hormones Take Time to Heal?
Yes, yes, yes, YES!!! Hormones take time to heal. Honestly, I had no idea how long it was going to be before I got my period back. There were times that I thought my period would be coming any day, but it never came. And then there were times that I lost hope of ever getting it back. I was so distraught, upset, stressed, and anxious because I didn’t know what to do or what would happen to me. So, if you’re feeling any of those things, you’re not alone. Healing takes time, but the amount of time is totally influenced by your ability to take action, so start taking action!
How Did I Start the Process?
Finally, my mom pushed me to go see a doctor, which is when I found a female gynecologist with a functional medicine background (I honestly just googled functional medicine doctor + hormone health + my city). I wanted someone who would actually solve the ROOT of the problem, and not just tell me to go back on the pill to get a period. (I mean seriously?! How does that fix anything?!) News flash: birth control doesn’t heal amenorrhea. (2) So, I started working with a doctor, and she ruled out PCOS, endometriosis, thyroid issues, ovarian cysts, and any other causes of amenorrhea. Therefore, she came to the conclusion of hypothalamic amenorrhea.
How Did I Cope with Knowing I Had Hypothalamic Amenorrhea?
Honestly, I was really scared and upset at first with the diagnosis, but I was happier FINALLY knowing what was going on with my body. I needed to take that first step of seeing a doctor who would listen to me because I needed to know if there were underlying conditions… and most importantly, I needed to be told what to do next.
That’s where Steph Gaudreau’s Harder to Kill Radio episode with Dr. Lara Briden came in and I had a HUGE lightbulb moment because I realized I was self-inducing my own amenorrhea. How crazy is that?! I was making myself unhealthy in the pursuit of being healthy! By restricting my diet and overexercising to the extreme extent that I was, my habits caused me to lose my period. And I was scared. I was scared because I knew that I was truly facing repercussions of disordered eating, and I was scared about what I had to do to get better.
4 Things I Had to Do:
- Eat more carbs, specifically.
- Eat more food, in general.
- Exercise less (a lot less).
- Prioritize my hormone health, not my “abs”.
Believe me, those 3 things were the last things I wanted to have to do. That’s when the fear of eating more and gaining weight really became obvious. I didn’t want to make big changes! But when it came to getting my period back naturally, there were no band-aid fixes to try. If I wanted to get my period back (without going on the pill) I had to heal the root cause of what was causing me to lose my period: my restrictive dieting and my disordered relationship with food, my body, and exercise.
What the Heck Do You Do Next?
So, the next step is to stop freaking out (always step one!) and empower yourself with knowledge. My head started spinning with all the questions I had…
- Will this hurt my chances of getting pregnant? (You need to ovulate in order to get pregnant)
- Will I ever have a period again? (There’s a ton you CAN do to get it back)
- Is it no big deal to not have a period? (NO! Hormone function is essential to vitality!!)
That’s when I truly dove deep into my recovery. And by using this knowledge, I realized I didn’t have to be scared anymore. And for the first time in a long time, I felt relieved. (Which made me feel empowered!) I chose to nourish my body and put my health before my food, fitness, and body image. And in order to do it all, I chose to find food freedom!
And there are 3 specific steps I took to heal my hypothalamic amenorrhea and get my period back.
3 Steps I Used to Get My Period Back
Step 1: Confirm Hypothalamic Amenorrhea with Your Doctor
Before you do anything, ask your doctor. Seriously. You need to work with someone that will help you and can make sure that what you’re going through is actually what you think you’re going through. The treatment protocols for each cause of amenorrhea are different (example: PCOS vs HA) so you really want to make sure you’re doing what’s going to help. (1)
Step 2: Eat More Food, Especially More Carbs (And Exercise Less)
When I was diagnosed with hypothalamic amenorrhea, I learned 3 things you can’t do if you want your period back. You can’t:
- Undereat carbs.
- Undereat, in general.
And these are all relative to YOU. Depending on your body, your history, your needs… what’s too much or too little for someone might not be too much or too little for YOU. So really, do YOU. Hypothalamic amenorrhea isn’t a comparison game, it’s a “figure out what YOUR body needs to heal” (and find YOUR own Food Freedom) strategy. And the easiest way for you to figure out if your habits are unhealthy is to ask yourself WHY you’re doing something.
- You’re going to the gym a lot? WHY?
- You’re skipping carbs at breakfast? WHY?
- You’re going for a run? WHY?
- You’re skipping dessert? WHY?
- You’re limiting your portions? WHY?
If the answers have anything to do with the fear of eating more or gaining weight… (BE HONEST) then you really need to rethink your choices! If you DON’T reevaluate your habits honestly… and you KEEP undereating and/or overexercising… you are NOT helping yourself get your period back naturally.
It’s the Honest Truth!
So, after I started researching what to do next, I took ACTION. I started eating more carbs and specifically starch, not sugar. I added starchy carbs to every meal like potatoes, rice, quinoa, oats, squash. (Read more about starch vs. sugar for hormone health, here.)
I also stopped restricting my portions of healthy foods and started honoring my hunger and my drive to eat. And you can take a doctor’s word for it on why this works:
Under-eating causes amenorrhea, and this is true even if you have a healthy body weight (BMI). Your hypothalamus cares less about body fat and more about whether you eat enough to keep up with your activity level… If you don’t eat enough, your hypothalamus thinks you’re in a famine and makes the executive decision to halt reproduction. – Dr. Lara Briden (3)
Step 3: Heal Your Relationship with Food
In order to do all of this successfully, for the long-term… I had to actually HEAL my relationship with food and get past the fear of eating more, gaining weight, and constantly feeling anxious about my food, fitness, and body image. I had to find Food Freedom.
Takeaway: I Got My Period Back Naturally
I hope this helps you figure out how to heal your own relationship with food! If you’re trying to get your period back, know that women get it back after years and years… so have faith that yours will come back too! 🙂 But it’s not always some magic appearance one day. You have to DO something about it! Getting your period back comes from honoring your body’s needs, putting yourself first, and finding food freedom. Use these food freedom freebies to get started.