HA: Eat More, Exercise Less, Stress Less
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Published Jul 20, 2016, Updated Jun 26, 2020
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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).
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!
You are not alone!! 1 in 7 women is affected with infertility and I too battled with amenorrhea for years! I was told the same thing as you, I also wasn’t even “that skinny”. I quit running for 6 months and only did yoga, I added fat and carbs into my strict diet, I quit counting calories, I quit weighing myself, I tried just weight training but no intense cardio, eventually added cardio back in because I was going nuts, finally added meat back to my diet and coincidentally got my cycle back one year later!! So all together 5 years of no cycle, tried multiple prescriptions from the infertility specialist including prometrium and chlomid, and am currently back at my “starting weight” from before I began a healthy fitness and weight loss journey over 10 years ago. I look better than when I was at this weight the last time, but it still hangs over my head some days. I try to stay focused on the reason I allowed myself to gain this weight; that all of these frustrating years & melt downs over not being like everyone else (getting Prego right away) will pay off. My estrogen levels are finally normal again, where before they were looking worse than a mans. I actually now have melasma on my face from the increase in hormones that have occurred (this is frustrating since I had perfect skin). I am seeing a dermatologist this week to see what we can do about it. All I can say, is keep your focus on what is important to you and Isaac, pray a lot (lol), don’t let guilt and self judgement control you, and listen to your body. Thanks for your transparency!! I used to feel so alone in this.
Thank you so much for sharing your experience. I’m happy to hear that you were able raise your estrogen levels and regain your cycle! I have melasma as well so I can definitely relate. I hope you’re able to get some good treatment options from your dermatologist.
I’ve been following your HA journey for a while and sorry to hear that not much has progressed. It happened to me once when I got off the pill and didn’t have period for a year. I was in the middle of my PhD so my stress level was also high. I was thin but that was normal for me for years. Everyone just told me to eat more and exercise less. I didn’t listen because I needed to exercise to release my stress.
Finally in 2009 I went to China and met a fantastic chinese medicine doctor. I have met many before and tried to take chinese herbs many times and never worked. But this one has a different approach, more integrative and the place is very calming so I gave it a try. I went there for a month, everyday, went through “treatment” for 2 hrs a day, basically acupuncture and acupressure, combined with some herbs. They were sometimes painful but I was committed. Right before i took flight to come back, I got my period. Then for 2-3 years I went back to China every summer and went to the same doctor. Since then I got regular period and have 2 beautiful daughters now.
My point is… eating more and move less is not prescription for everyone. You have to trust your body. Also, give a try to chinese medicine if you can find a good doctor. It has a different approach and might work on you too. Email me if you have more questions. Good luck!
I totally agree, Coco. Everyone is different and at this point I don’t know that the exercise less, eat more approach will work for me, but it has seemed to help many other women. I am currently working with an acupuncturist but I’d love to learn more about Chinese medicine. That said, right now I can only afford to go to acupuncture twice a month. If I could, I would go every day!
Thank you for sharing your story. It really isn’t talked about enough.
Five years ago I stopped taking the pill in the midst of my anorexia recovery and discovered that I had lost my period. My husband and I waited for almost 2.5 years to see if it would come back before finally going to a fertility specialist. (Obviously I wasn’t at a healthy weight yet and was still exercising too much at that point!) Six months later, after undergoing IVF, I was pregnant and I now have a beautiful 2 year old boy. I breastfed for 13 months and my period still didn’t return. We decided to use our frozen embryos last fall in the hopes of having another baby. I got pregnant with our very last embryo but unfortunately miscarried around 7 weeks. The silver lining (I guess!?) is that the miscarriage kicked my hormones into gear and I started to cycle. With only the use of Clomid to help time ovulation, I became pregnant again in February. I am now 24 weeks and still cannot believe we did it on our own! I am hopeful that after giving birth this time, I will start to cycle again on my own.
While I understand your desire to get your period back (because it really is better for your long term health), please know that if you want to start a family there are ways to do so. I was devastated when I realized we were going to have to do IVF, but now when I look at my little boy it doesn’t matter how he got here. Best of luck with everything.
Thank you so much for sharing your experience and the kind words, Amy. Congrats on your latest pregnancy. <3
Thanks for your post – this is such a hard thing to deal with but there IS hope! I never regained my period after going off the pill for 3 years. I did all of the wrong things (way too thin, over exercising, food restriction). I did gain a bit of weight, but finally got pregnant using fertility drugs. After having my baby a year ago I’m about 5-7 pounds heavier and get a regular period every month! I still exercise and eat healthy, but my body is at the weight it should have been all along. I can definitely link it to weight as I got the stomach flu one month and dipped back to my pre-baby weight and alas, no period that month. I really think your body has a certain weight threshold, as well as a level of stress and sleep that it likes to maintain. Once that gets out of whack, everything does! There is definitely hope 🙂 Keep us updated!
Thanks so much for sharing, Becca. It definitely seems weight related in your case, given the experience you had with the flu. It’s interesting how quickly your body responded. I will definitely keep you all updated.
I’m so glad you wrote this update. I’ve thought about you often since you wrote this post. It took me 6 years to regain my cycle, and it wasn’t about food and exercise. For me, it was the high stress of my 60-80 hour a week consulting job. About six months after I quit my job and slowed down my lifestyle, everything came back to me. That said, I am still very sensitive to stress and have to be careful. I notice my cycle will often stop mid-cycle if I’m under too much stress or not getting enough sleep. Overall, I feel 100% better than I did back then. I really believe that the medical community needs to do a much better job of talking to people about the dangers of stress because it can do devastating things to your body. I was also going to ask you if you had your thyroid tested. I discovered I have Hashimoto’s disease which is intimately related to cortisol and HPA axis.
Hi Megan. Thanks so much for sharing. I agree that stress can cause so many issues and illnesses. It’s crazy! I did have my thyroid tested and everything seems normal, but I’m glad you asked because I know it’s all connected.
You are so brave to open up to us, Brittany. As someone who craves exercise I know how hard it can be to force yourself to slow down. I’ve also been an ultrasound tech for the last 10 years and I can’t tell you how many women I’ve scanned for amenorrhea and endometriosis. It’s an epidemic that I think is largely part of our stress driven lifestyles.
There’s a book you might want to check out called The Woman Code by Alicia Vitti. She’s done a lot of research on women’s hormone cycles and has had some impressive results. I highly recommend it.
In the meantime, try to stay positive and have faith that everything will work out. Because it will. <3
Thanks so much for the support, Sarah. <3 I have been following Alisa Vitti for a while now, but despite having it recommended to me several times I still haven't read it. I need to put it in my amazon cart right now!
I am so happy you’re reading Intuitive Eating — that book is pure GOLD!! Here’s to healing xo
Seriously!I haven’t finished it yet, but I’m loving it so much.
Thank you for sharing your journey! It is so true how isolating this can feel. After being diagnosed with PCOS last year and knowing this was the case for a while, I really struggled to find others who understand the frustration of feeling out of balance. You cannot imagine how happy I was to find your site and reading about your experience has helped me to put myself back on the road to recovery.
Thank you so much for sharing this, Amber. Honestly I’d rather not put all my period business out on the internet for the world to see, but I’m so glad I have because I know it’s helped others and it’s helped me feel less alone as well. I’m so glad to hear that you’re on a path to recovery. Sending you lots of love and healing vibes. <3
While I did not have 100% of your symptoms/diagnoses, I went through fertility struggles/miscarriage prior to successfully getting pregnant (and giving birth to) my daughter. I know that the less focus that a person puts on these things, the more your body just does it’s thing. Relax- massages/acupuncture/yoga- all work wonders. Also, as hard as it is (believe me I know) focusing too much on these issues makes it worse because you are creating stress for your body. I have known so many folks that stressed for years and years and faced struggles, but then when they put it in God’s hands and just said you know what I am going to live and let things be, it finally happened for them. I am not pushing religion, just saying to trust what is meant to be will be. And enjoy your life in the mean time! Acupuncture and less running (through an ankle sprain actually) happened to work for me.
Thanks so much for the kind words and advice! I know that stressing over the issue makes it much much worse so I’ve been trying to let it go and be patient with my body. For the most part this is working, but there are definitely good and bad days. I’ve quit running completely and I’m doing acupuncture so hopefully my body will catch on soon. 🙂
Thinking of you during this time…. Have you tried additional therapies? I had a hard time with my cycle (different situation though, due to endometriosis) and saw Kristina at Essential Acupuncture in Richmond. She took a totally different holistic approach and Jon and I both ended up changing our diets, taking herbs and doing acupuncture based on eastern medicine recommendations. I believe that in combination with some help from doctors helped regulate a lot of craziness that was happening in my uterus and now we are expecting August 3rd.
Let me know if you want to know more about our experience with acupuncture and Kristina. It wasn’t a quick fix, but I totally chalk changes in my reproductive health up to acupuncture