HA: Eat More, Exercise Less, Stress Less

Sharing my experience with hypothalamic amenorrhea and where I’m at with it right now.

Exactly one year ago I wrote about dealing with post-pill amenorrhea. At the time I had been off birth control for about 10 months and hadn’t regained my cycle. I initially thought my body just needed time to get back on track after being on the pill for such a long time, but after some blood work I was diagnosed with hypothalamic amenorrhea (HA).

Girl dressed in all black standing against a red brick wall.

My doctor’s main recommendation was to eat more and exercise less. As a health coach, personal trainer and healthy living blogger this was crazy talk to me. I thought what I was doing for the past 10 years was super healthy so how could my body not be working properly? After being upset (with a WHY ME, I’m not even THAT skinny attitude) for a few days I took his advice to heart, scaled back on exercise, stopped running and started eating whatever I wanted without worrying whether or not it was healthy.  The “eat everything” mindset was fun for a while, until I gained about 7 lbs in two weeks. My clothes became uncomfortably tight and I was unhappy with how I looked and felt.

A few months later a new fitness studio called OrangeTheory opened in Richmond. I decided to try it, LOVED the workouts and started going 3-4 times a week, taking 3-4 days of rest. OTF is a lot of running and high intensity, but I justified it because I was working out less than my old routine of moderate exercise (PureBarre, walking, running or strength training) 6-7 days a week. I was running faster than I had ever run before, I felt stronger and I really enjoyed the community there.

I also started back tracking my food again, working to lose a few of the extra pounds I had put on and feel better about my body. Even with doing OTF and eating cleaner/less, my body wasn’t responding. It was holding on to everything. Definitely a sign that something was off.

Eat More, Exercise Less?

While all of this was going on I found a few online groups with other ladies who have dealt or are currently dealing with HA and everything I read talked about the solution being to exercise less and eat more, just as my doctor had suggested.

Finally I decided that I most likely need to give the whole eat more, exercise less another go if I want to regain my cycle. I haven’t worked out in about 4 weeks. I have attended 3-4 gentle yoga classes, gone on walks (mostly Pokeman hunts) or bike rides with Isaac, but that’s about it. I’ve also given myself the freedom to eat whatever I want while trying to be mindful and intuitive. I naturally crave healthy food so I’m still eating well, but I’m not giving myself any restrictions.

I’m not sure how much weight I’ve gained because I’m not weighing myself, but I know I have gained because all of my shorts are tight, some I can’t wear at all. It’s definitely been hard. Some days are harder than others, especially since it’s summer and bathing suit season. I’ve had moments of tears and moments where I question if this is really the solution. One thing that has really helped is the book Intuitive Eating. I started reading it a few weeks ago and I love all the advice about listening to your body and ending the dieting, deprivation, guilt cycle. It’s been an awesome thing to read while going through this process. I highly recommend it if you haven’t read it.

High Cortisol Levels

I also recently had updated blood work taken and received the results last week. My LH, FSH and TSH have all increased and my Estrogen levels have doubled over the past year. Great news! At this point everything is in the normal range except Free Testosterone, which is low and Cortisol (stress hormone), which is high.

From my research I know that stress, both metabolic and psychological, can affect the HPA axis and reproductive health negatively. This article does a great job explaining it. With this in mind, my main goal right now is to work to decrease stress and therefore decrease my cortisol levels. Cutting out intense exercise will surely help and doing more yoga and light walking should help too. Caffeine can also increase cortisol so as of this week I’ve decided I need to cut back on coffee. As a coffee lover this is going to be a big change for me, but totally doable.

As I shared in my amenorrhea update in November of last year, I had some additional tests done that showed debris in my uterus as well as a bit of uterine lining migrating into the muscle around my uterus. This info is scary and I’m still not sure if these issues are part of the reason my period is missing.

Sorry for the lengthy post. I just wanted to share where I’m at with this journey right now. I know there are a ton of ladies dealing with similar situations and I just want you to know that you’re not alone. HA, and infertility issues in general, aren’t talked about very often and if you don’t have any close friends who’ve gone through something similar, it can feel really isolating. I know I’ve felt that way at times. Here’s to increasing awareness around these issues and healing our bodies!

2020 UPDATE: Just wanted to share that I was able to heal hypothalamic amenorrhea, get my cycle back, became pregnant and had a beautiful baby girl. If you’re currently struggling with HA right now I’m sending hope, love and positive vibes your way!

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    96 comments
    1. Whole Woman
      November 5, 2016 AT 1:26 am

      Hi Brittany

      I am in recovery from HA after being told I would never have a period again by doctors. The answer really is food and rest. I really recommend the book No Period Now What by Nicola Rinaldi. Recovering from HA can be very very challenging to our sense of what ‘healthy’ is, but it is also an amazing opportunity to truly embrace the healthy, self loving, self nurturing message that so much of the natural health industry purports to promote. Good luck with your journey, if you are struggle I would recommend joining a few of the facebook support groups, they are places of great love and support with women in similar situations.

    2. stephanie
      October 22, 2016 AT 4:23 pm

      I am going through the same thing! I was on beyaz for 11 years! I just started accupunture and vitamins so we will see how it goes! How long has it been since you’ve had a period? I am constantly worried so thank you for sharing this post. I felt I was the only one with these issues. All of mt friends didnt have any problems after getting off BC.

    3. Tina
      August 17, 2016 AT 3:29 pm

      Hi and thank you so much for sharing. I am struggling with the same issue, I was diagnosed with last month. I never heard anything about it and many of my friends don’t know about it either. I was on the pill for about 4.5 years and went off in July 2015, I had 5 cycles following that, they were between 32 and 56 days. In January this year I had my last cycle. The weird thing is that I was exercising a lot more last year in the fall, I was also skinnier, but I still had periods, long cycles, but I had it. I had blood work done and my hormones look normal but on the lower end. My ovaries have follicles too. I did the progestin challenge twice and never had a withdrawal bleeding. Initially I thought this is all post pill related, now that I am learning so much about HA I believe it might be my workouts. I used to exercise 5-6 times a week, this included running up to 5 miles 4 times a week and weight exercises 1 or twice a week. (not too heavy, I’m little!) I ate enough though. Always been a food lover and hate being hungry. I love avocado and nuts and have plenty of healthy fats in my diet. i did track my food intake though and tried to stay under 1800 calories. I am 5.1 and weigh 114.6 lbs, BMI of 21.7. I consider myself healthy and not too skinny. this is my second week with no or low impact exercises and walking. It is really difficult as I don’t want to gain weight, I hope that I can just maintain my weight and regain my period through exercise elimination. I wish you good luck on your journey and hope you get it back soon! I’ve lost too much hair, my skin is dry, my skin is dry, my libido is gone, I get depressed, really need those hormones to do some work for me soon :)!

      1. Lena
        August 31, 2016 AT 5:17 pm

        Hi Tina,
        same here. I went off the pill in July 2015 and had my period 3 times (October, January and the last one in February). I thought it would be like that (a few months between having a period instead of a few weeks) but in May I got a bit worried and went to see a doctor about it. She first checked my hormones (low estrogen) and had me do the progestin challenge – didn’t work. Got an ultrasound two weeks ago, that acutally got me really worried and that’s when I started to research about it and found this blog entry. I am so happy that I found out that there are more women who go through the same problem and know I am happy to know that you also got your period and it stopped again. I have a similar BMI (taller and heavier 😉 my target calorie intake is more like 1300..) but I don’t work out that much. So I guess I’ll keep doing what I am doing and try not to stress out about the situation and relax more 😉 We’ll see and I guess it just takes time.. Too bad we didn’t know about that before. I never heard about it! They should tell you that before you start talking BC..

    4. MEB
      August 7, 2016 AT 1:21 pm

      wow…thank you for your honestly. I cannot believe how many woman have had this experience. I suffered as well in my early 30s (I am 39 now). I was a vegan for 10 years and exercised excessively. I did numerous rounds of IVF and was able to have two beautiful babies through that process but with years of heartbreak that also included unsuccessful rounds and miscarriages. Fast forward to life with 2 kids and a integrative medical doctor who changed my life and told me that I must eat protein and fat and little sugar due to my insulin resistance and messed up hormones. At the age of 38 I started to have a regular cycle and got pregnant for the third time without trying at all (the biggest shock of my life). I believe that it is 100% related the change in my diet. I was only about 5 pounds more between my second and third babies. Not my ideal weight but definitely not a big deal with perspective.

    5. Allison
      August 4, 2016 AT 9:01 pm

      Thanks so much for sharing! As you said, infertility struggles can be so isolating in a world that appears to be full of very fertile women. My husband and I have been working through what is still “unexplained infertility” for the past 20 months. As some other ladies have mentioned, I too have recently started weekly acupuncture and their practice suggests a pretty strict clean-eating diet. I need to dig out my notes from your 28-day program and revisit your wisdom! (Shout out to casual Pokemon walks)

Parchment paper lined with protein balls.

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