Healing Hypothalamic Amenorrhea

I have a hypothalamic amenorrhea update for you and as I’m sure you’ve gathered from the post title, it’s good news. I got my period back!!! Cue the confetti, girl dancing in the red dress emoji. Seriously, I was so happy the day it arrived. I was literally doing a happy dance in our foyer.

Healing Hypothalamic Amenorrhea

If you’re new to the blog or don’t know why the heck I’m talking about my period today, check out my previous posts here: Part 1: Dealing with Post Pill Amenorrhea Part 2: Amenorrhea Update Part 3: HA: Eat More, Exercise Less, Stress Less. Long story short, I have been without my menstrual cycle since September 2014 so getting it again was like winning the lottery! Okay, maybe not THAT exciting, but still pretty awesome.

I wanted to write a blog post immediately, but I waited because I didn’t want to speak too soon and jinx myself. As of this month I’ve had three cycles so I feel comfortable sharing, mainly for all the other women out there struggling with a similar issue. I want to give each of you a hug and talk to you personally, but this post will have to do. I want you to know that healing hypothalamic amenorrhea is possible! The journey may not be fun or easy, but it’s definitely possible.

I’ve talked my situation through with some of my close friends, my family and doctor(s) and we’ve all come to the same conclusion — there’s no way to determine exactly what caused my period to come back or even why it stopped.

My functional medicine doctor, Tressa Breindel, likes to describe it as a perfect storm and says it was probably a combo of things, specifically these three (she sent me this content in an email):

1. DNA — Having a genetic predisposition that sets the foundation for what sort of response to the environmental/life factors that manifested. Possible gene polymorphisms that could lead to abnormal hormonal regulation.

2. Stress — This could mean anything. We all have a limited amount of internal resources to deal with our physical and emotional energy demands. We can look at this like a pie. So even if these demands are “positive” in essence, if our pie pieces are taken up, then we may not have much energy left for incoming demands, and could easily feel overwhelmed by any new demands.

Chronic mood issues or illness can take up a significant amount of our energy demands, outside of external pressures and issues. When we are dealing with chronic internal emotional and physical dysregulation, we probably don’t have much left over when something else does come up, and can feel easily overwhelmed.

Also, if we are feeling depressed, anxious or ill, we are more likely to perceive external issues as threatening, exhausting and taxing. Whereas if we were feeling balanced, well and resourced, we may look forward to an external challenge.

The point being, is what stresses one person out is dependent on their perception, their internal and external health resources and their internal emotional and physical health status. What is bad or intolerable stress to one person, may elicit no reaction or be a welcome challenge to another -or to the same person at a different, more resourced period of their life.

Common stressors that may play a role in women’s fertility:

  • Excessive exercise, either quantity or intensity
  • Calorie and other macronutrient (fat, carbs, protein) restriction
  • Emotional stress — internally or externally generated
  • Environmental stressors — anything that triggers inflammation, infection, increased need for antioxidant or endocrine function. This would interact strongly with genetic/epigenetic precursors for ability to handle them
  • SAD — standard American diet. Or any diet poor in nutrients and/or variety

3. Exogenous Hormones — AKA Birth control. It has liberated women and gave us control of our bodies and the direction of our lives, but it also can have negative physical consequences for some depending on our genetic and environmental factors.

So there’s not a single cause for hypothalamic amenorrhea and someone with the exact same diagnoses or symptoms might have different precursors and may need a different treatment plan. That said, I’m happy to share my experience in hopes that it might help others.

If you’ve read my previous posts you’ll know that when I was first diagnosed with HA my doctor’s main recommendation was to eat more and exercise less. I reluctantly took his advice to heart, gained weight quickly and decided to give up after about 2-3 weeks. I went back to my regular exercise and healthy eating habits. It wasn’t until June 2016 that I actually decided to full give my body the nourishment it needed. See below for a list of the items I think contributed the most to healing my body from hypothalamic amenorrhea.

1. Acupuncture — This is one thing that I swear by and I feel certain that it helped with my healing. If I could afford weekly sessions I would have gone once a week, but with our budget I did bi-monthly sessions. There is a ton of research suggesting acupuncture is good for hormonal balance and for fertility so if you’re struggling with either I highly recommend finding a good acupuncturist in your area. If you’re in the Richmond area I highly recommend Tressa Breindel at Integrative Health Richmond and Keith Bell at Oriental Medicine Specialists.

2. Cutting Out Exercise — This was tough, especially since my workout schedule seemed moderate (3-4 days a week, 1 hour or less),  but I decided I had to give it a try. It was the one big thing I hadn’t tried and I figured it was worth a shot, especially since I heard it worked for others. I could have cut back slowly, but I wanted to go all-in rather than taking baby steps. At this point I was determined to get my period back and was willing to do whatever it took so I basically cut out all exercise besides normal daily activity. The first week or so was the hardest, but after a while it was really nice not worrying over when I was going to squeeze in a workout. I also had way less laundry and a little extra free time each day. Sometimes I was productive with this extra time and sometimes not so much. To be honest, about two months in with no exercise I was getting ready to toss in the towel, feeling as though the process wasn’t working and that’s when I got my first period!

3. Yoga — My only exercise throughout the healing process was yoga and walking. To make sure I didn’t stress out my body I stuck with restorative yoga classes. These classes helped me feel active, reduce stress, and be more mindful. I strongly recommend restorative yoga and meditation to anyone with HA.

4. No Diet Restrictions — I started to embrace the Intuitive Eating principles, stopping food journaling and gave up the diet mindset of good and bad foods. All foods are equal, some maybe be more nutritious than others but they’re all fair-game. If there’s one good thing that came from this experience it’s that I found the Intuitive Eating approach. Previous to being diagnosed with HA I had already added meat back into my diet after being pescatarian for six years, but I still ate a “clean” diet and avoided gluten (based on a doctor’s recommendation). There were times when I would feel guilty about eating too much or foods that weren’t “healthy.” When I went all-in with trying to heal myself I decided that I would take away all the restrictions and allow my body to eat whatever I was craving. So now if there’s something I really want to eat that has gluten in it, I’ll eat it.

5. Weight Gain — When diagnosed with HA I wasn’t underweight (which is why I didn’t want to believe the diagnoses). My BMI was 21, which is normal, but my doctor still thought gaining weight might help, hence the exercise less and eat more treatment plan. With this approach I have gained almost 20 pounds in four months. I thought that by eating healthy and working out regularly I was doing everything right, but apparently it wasn’t what my body needed. Gaining weight is hard. The number has never bothered me, it’s just a number. But not being able to wear my favorite clothes is sad. Luckily I have a great support system, including Isaac who has been my rock through all of this. Literally one day I was getting dressed to go out with friends and started feeling pretty awful about nothing in my closet fitting. I was crying in our bedroom when he offered to take me to the store to pick something new out. He’s a keeper. 🙂

6. Herbal Supplements — When I was first diagnosed I googled natural remedies for hypothalamic amenorrhea. I found a few supplements for balancing hormones and started taking them. About a year in I was fed up with spending a ton of money on the supplements and taking like 10 pills twice a day without knowing if they were actually working. There were a few months when I just stopped taking all the supplements. Once I started working with my functional medicine doctor she made me a blend of herbs based on my cycle so I have one blend to take for days 1-14 and another for days 14-28. I’m not 100% sure what all is in each blend, but it seems that they’ve been helpful. I highly recommend working with a professional to figure out what supplements you should be taking rather than doing what I did originally by just buying whatever I saw recommended online.

7. A Support System — Having a loving support system during this process has been so helpful. All my friends and family have been incredible. Listening to me talk about this for hours on end, reminding me I’m still beautiful even though I’ve gained weight, etc. I know it’s been hard on Isaac but he’s been strong, encouraging and positive throughout everything. I also found a few online communities through Facebook for women with HA and they’ve been amazing — giving me support when I needed it most and helping me feel less alone with this whole process.

Last but not least, here are a few books I recommend for others going through HA  — Intuitive Eating, Taking Charge of Your Fertility and No Period. Now What?.

I hope this post is helpful. I know when I was in the middle of healing, hearing from women on the other side always gave me hope so I trust this post will do the same for you! <3

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    67 comments
  1. Hi! I just wanted to let you know even though this post is a bit old, it’s still one of the few things that pops up when searching for HA; and it helped me so much when I got my diagnosis. For years I was told I had PCOS even though I was very thin and had no acne or high male hormones on lab tests so I was prescribed birth control to “regulate.” Well I know now that’s just a withdrawal bleed. Anyway, 11 months ago I decided to get off the pill bc they kept discontinuing the ones I was taking, then I had to start taking a new pill each time, and it was making me feel crazy with all the new side effects each time. After I got off the pill no signs of any period. It had been nearly 6 years since I had a natural period so I was beginning to lose hope. I took all your advice – first I gained 8lbs (which was really hard from a purely superficial standpoint, but I was very slightly underweight), I read intuitive eating to make sure I was really listening to my body when hungry and honoring these signs, changed my workouts from 4 days a week of Barre3 (the harder, longer more cardio based workouts) to only 3 days and really listened to my body and took it easy while doing them, did acupuncture once a week and took Acetyl L-Carnitine twice a day. Within 2 months of doing these things I got my first natural period today. Thank you so much for posting about your journey and giving me hope. I also hope this comment can help anyone like me who is here because of the lack of resources on this topic.

  2. Hi I had a similar story to yours, 3 years off the pill and still no periods when I was trying to get pregnant. I just came across this post so I am a bit late.

    I never got my period back- I got pregnant directly instead! Wow!

    I realized however that while I thought I was doing everything correctly, I wasn’t. First, exercising 3-4 times/week for one hour doesn’t qualify as little, it qualifies as moderate to intensive, depending on what you do.

    Second, food journalling UNLESS you have a really big issue with loosing weight is a sign of orthorexia, which is a HUGE stress for your body. Congratulations on realizing what the issue was!

  3. Hugeeeee win!
    I have HA and 12 years no period. I’ll also be so damn happy when it returns and my body is in a place of harmonious trust.

    Q: my gut is leaky AF post-antibiotics, it’s bad.

    What’s your take on:
    • l-glutamine
    • slippery elm
    • marshmallow root?

    Bless,
    Melanie

  4. Hallo. So happy for you. I also went through this and got my periods back, but mostly thanks to chlorella supplementing (I guess I was undernourished). Well, just a short question – do you have some hormonal issues around your periods _ like cold sores, pimples, back ache etc? I have them now but have never had them before the ammenorhea. Thanks a lot

  5. Hi Brittany, I just want to thank you for being so open about this struggle. I know this is an old post but I came back to read it today because I’m struggling with HA and while I feel very resolute in my efforts to gain weight there are some days that are just HARD. I’ve been consistently eating more each day and it’s been going well but today I just feel FULL. I am underweight to begin with so I’m not at the point where I can just eat intuitively, though that’s my ultimate goal when I get to a point of having enough body fat to maintain a period. Anyway, your story truly inspires me and offers support on days when I need a little nudge! Thanks again!

    • Hi Megan! I’m so happy this post has been helpful. It was really therapeutic for me to share my experience here — it made me feel less alone in this journey — and I know it’s been so helpful for other women going through the process. Sending you lots of love and all the positive vibes. I know the healing process is tough but it’s SO worth it. 🙂

  6. I just read all of your blog posts on this back to back. My story is EXACTLY the same. I finally have had 2 periods on my own and its like i won the world series. This is a topic that should be publicized more, as I too thought i was the only one going through this. Thank you for sharing your story!

  7. This is so so SO scarily similar to my situation right now. I am 1 year post-pill with no period. I tracked my macros for years but stopped about 8 months ago. I also cut down my exercise from 6 days a week to 2-3 times a week (plus yoga) but haven’t managed to take the plunge and stop completely. I kind of feel like doing that causes me to lose who I am? I love working out and it’s a bit part of mine and my husbands lives. But perhaps this is the next step I need to take..
    I am so glad to have found your blog, it has given me a little burst of hope! Thank you x

  8. I’ve just stumbled across your site after searching for a chia pudding recipe and am so glad I did! I’ve had HA for many years now. Even after conceiving my now 8 month old child through IVF I still am slightly underweight and without a cycle. I was looking for a place to ge some wholesome recipes that will nourish my body while I focus on healing. Thanks for posting such wonderful recipes and articles.

  9. I’m just starting my own HA journey. I just came to the realization today that exercise has been my identity for all these years and now it’s the one thing that I have to part with during this season. What did you do to keep busy during the day. Not working out doesn’t scare me it’s the idea of becoming lazy not knowing what to do with my time to be productive. My husband said I was acting like I was retiring after years of hard work and I don’t know what to do with myself…any insight would be greatly appreciated….

    • Hi Dayna! I know EXACTLY how you’re feeling and I went through a similar experience. I ended up focusing on other stuff instead of working out. I called friends, cleaned the house, worked on home projects, etc. I tried to fill the time with things that were fun for me rather than sitting around and dwelling on the fact that I couldn’t work out. Just because you’re not exercising doesn’t mean you can’t move. I still went for leisure walks or bike rides with my husband and did restorative yoga. I highly recommend restorative yoga if you haven’t tried it yet. Also, acupuncture!!

      • Thank you for your input I really appreciate it. Today was day 2 for me of no working out and it was occurred to me today that in eleven years time I have never taken more than 24 hours off from exercise….INSANE! For the past few weeks my eyes have been twitching and I have been experiencing headaches much more frequently, and let’s not forget about the inflammation. My lower body is so inflamed right now that you can actually feel heat radiating from my muscles. These past two days of compete rest feel like heaven to my body. I have already gained the weight but I knew deep down that my addiction and “have to” attitude regarding working out might just be the last piece of the puzzle….thanks again from one Virginia lady to another…

  10. Wow, thank you for posting all of this! I’m dealing with HA too and I’m literally at a loss for what to do––I’m 22 years old and haven’t had a period since stopping birth control a year ago. I lost a lot of weight (20 pounds) after stopping the pill and I wonder if that had something to do with keeping my period from coming back (even though I lost it in a healthy way, no excessive restriction), but I’ve maintained and even gained a little weight in the past few months and still nothing.

    I’m terrified of gaining more weight as my BMI is currently around 22, and I really do not want to cut out exercise completely––I’ve completely fallen in love with strength training the past few months, and I don’t do more than 40 min sessions a few times a week. (I also probably eat well over 2000 kcal a day now!) But at this point I’m just getting more and more worried about my no period situation…it’s been a constant struggle of “should I workout? should I eat more? but what if i gain weight and it doesn’t even come back?”

    Anyway, thanks for sharing…it is so encouraging to hear. x

  11. I just read all of your posts, and wow… I have been considering going off birth control (AGAIN) and this gives me hope. I have been on BC for almost 13 years, less two 6 month trials. Both times I didn’t get my period back, got worried, went to my gyn, and got put back on BC. The first time I stopped it I was diagnosed with “atypical” PCOS after an ultrasound showing cystic ovaries. BMI is 23. No hormonal issues and no other symptoms. My gyn just told me that there is nothing wrong with birth control and it’s better to have an induced period then none at all. Now, 7 years later I’m still taking it. I am at the point where I want to start a family and I am TERRIFIED of infertility related to the amenorrhea. Well, I literally just finished my last pack…BYE birth control! I wanted to say thank you for being so open about your struggles and giving everyone else going through the same thing hope. <3

  12. Thank you so much for sharing your journey. I appreciate your authenticity. I’m wondering if you would be willing to share how you introduced exercise back into your life in a healthy way. I have also been advised to stop exercise for a period of time to regain my period, and I’m curious what you found effective to incorporate it again.
    Thank you!

  13. Hi Brittany, my name is Irena and I’ve been dealing with amenorrhea for little over 2 years now, since coming off the pill after 8 years on it. I have been underweight my whole life and also restricting myself all the time. Four months ago I decided to go all in and stopped caring about what I eat. I also started gentle yoga. I gained about 20 pounds but I still didn’t get a period. I did 3 months of clomid and was having periods every month, but my cycles were too short – only 24 days. Fertility specialist is going to be my next step. I am 28 and all my hormones are fine, except amh which is lower than it should be but not crazy low. I just don’t see a solution…

  14. Congratulations Brittany! I can imagine how happy, elated and relieved you must have felt! 😀

    Two of my best friends went through something similar: after coming off the pill they both had HA: one of them for about 2-2.5 years, the other for 6-7 months. Their story also had a happy ending: my friend who wanted to have kids (and didn’t have her period for more than 2 years) gave birth to a little girl 1.5 years ago (she also credits acupuncture as one of the most significant treatments in her healing), and the other one got it back when she changed her diet and workout routine (and incorporated yoga and relaxation into her daily activities to reduce stress).

    Congrats once again, and here’s to more dancing! 🙂 (I’ve read that dancing is one of the best workouts a woman can do since it moves the whole body, relaxes it, produces endorphines, so it’s great overall).

  15. Oh my days this spoke to me. I haven’t had a period in aaaages (came off my pill in March and still nothing!) so I’m going to go back and read through all your posts.

  16. Congratulations! I can’t tell you how grateful I am that you’ve shared your story. I’ve been in a similar situation where I went off birth control in December 2015 and haven’t had a period since. I’d done some research about HA early on and many people who’ve overcome it identified eating more and exercising less as one of the factors in their recovery. I started working out a little bit less, eating a little bit more, and gained a little bit of weight, but wasn’t committed to letting go of everything just yet. After following your blog over the last year and hearing about your success, I’m ready to go all in. No more counting calories and cardio for me. Thank you so much for being such an inspiration!

  17. Thank you so much and congratulations! So many times I just forget that i don’t get my period and it’s mostly because I have tried so many things to no avail. Can you explain more about the herbs you took?
    xoxo

  18. Thanks so much for sharing! I think it’s amazing that you can provide a platform for the numerous women going through this experience (there are so many more than we think/know). With all the pressures to be the perfect shape, size, wife, mother, business-women and ect there’s no wonder there’s been an influx of HA. And hearing, ‘you need to gain weight,’ is one of the most challenging things for a woman to hear and implement. Thanks so much for sharing and so happy to hear you’ve got your period back — so happy for you! xo-Lindsey

  19. Ohome my Gosh I am so HAPPY for you I have been praying for your health and well being. And yes weight is just a number being comfortable in your own body takes some time and getting used too. I can’t imagine all you have been through but thank God it has worked for you. Hugs

  20. So happy for you! One more thing to be thankful for. It’s amazing how emotional you can feel just by reading someone’s blog for years. I think it’s important for people to note how long the process took, we are so used to an instant fix and our bodies need time…

  21. I had HA years ago for about 5 years. Now I have 2 children, my daughter was just born last week. I got pregnant easily both times despite this all.

  22. I’ve been in your shoes and I also agree with so many of the items you noted that impacted your cycle. My game changers, regular chiropractic care, adding in acupuncture, no longer distance running and adding in yoga/weights, forgiving myself and reducing stress, and using an essential oil blend that effected my progesterone levels.

    I fought this for over five years. I am now 32 and have a regular (for me) cycle of about every 40 days. To anyone else struggling, !2?34 give up!

    • Hi, I was wondering what essential oil blend you added in and how you used it? How long did it take you to recover your period with these things?

  23. Congratulations Brittany! I’m currently on month 16 of no period and am at a loss. I also think that I need to look at cutting down on exercise, but like you, I’m at around 21 BMI which seems normal. Do you have any ideas about re-integrating workouts back into your routine? Are you planning on maintaining your current weight or is it not as big of an issue once your period is back?

    • Hi Laura, I just wanted to let you know I understand what you are going through. I didn’t have my period for 18 months after stopping birth control and I had no other complaints. I work out 3 x a week (weights) and didn’t stop exercising but a few weeks ago my breast felt tender on the side and I had a little cervical mucus and out of the blue my period returned a week ago! Keep hope! My doctor said I would probably never cycle without hormonal therapy. Clearly some women need more time after quitting the pill.

  24. Wow! I’m dealing with this (well not official HA, but post pill amenorrhea) and just came across part 1 last night while searching the internet…how crazy that you have an update right now! I’ve followed your blog for a while but have backed away from health/wellness blogs recently. Anyway — I am so, so, so happy for you. YAY!

  25. You know, this is such a coincidence because I just recently started following your blog, and also, I just got my period back after an eleven month absence! So I know EXACTLY what you mean when you say that you were doing a happy dance. I never thought I’d be THRILLED to get my period, but I was. My amenorrhea was due to a concussion, and if you’ve never heard of that, you wouldn’t be the first one! It’s a pretty new finding. So glad you found what helped you heal!

  26. I second the recommendation for acupuncture for overall life balancing but also fertility. I’ve conceived both of my babies through IVF with the help of acupuncture. I’ve had failed cycles when I didn’t do acupuncture so I know it’s a huge factor! So happy for you! Thanks for sharing your story.

  27. Thank you so much for sharing your story. As someone who has struggled with HA also, I’m curious to know how you plan on re-integrating workouts into your routine?

  28. Any suggestions for the opposite? I have abnormal uterine bleeding. I bleed everyday. I had a 40 day period using a night time pad hourly and regularly changing my clothes when that wasn’t enough. I’m on birth control now to reduce blood loss and while it has dissipated significantly, I still bleed daily even though majority of the time it is minimal. That being said, It is still enough to prevent me from being able to swim and as for sex, what is that?!? Lol

    • Be sure you don’t have any uterine growths. I was told it was normal and to use two tampons at a time!! Just think of trying to do that?? I had a myoma which was so low down in the uterus the tests could not find it until it grew large enough to abort itself.I became severely anemic and at high risk for heart attack. Maybe it is normal for you but this problem went undiagnosed for over a year for me. Just be sure you are taking care of yourself, It is pure exhaustion dealing with the bleeding.

  29. Brittany, First, I am so happy for you!! That girl in the Red Dress Emoji is sweating she is dancing so much!!! You offer so much to all of us I just hope our support and encouragement has lended to your support group. Sending you well wishes and light period cramps 🙂 All my best and can’t wait for you to do a Takeover Tuesday on Coffee Chat Girl when it launches soon. Hugs sugar, Robyn

    • I don’t think it was specifically adding back in foods with gluten, but more taking away all the diet restrictions. But I’m guessing that I did eat more carbs once I added back in gluten than when I was 100% gluten-free. I do know that low-carb diets aren’t the best when trying to regain your cycle. Having ample carbs and fats helps!!

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