Recently I spoke with Cynthia Donovan, a Registered Dietitian-Nutritionist with over 10 years' experience in the field serving women with Hypothalamic Amenorrhea (or HA), on my podcast "Curious About Recovery". She shed some interesting light on the topic for me.
Listen to the episode on Spotify here.
Cynthia helps women regain their period in a wholistic and nurturing way. Getting your period back is about fully enjoying your life and improving your health — the mental space to enjoy the things you love, closer relationships, and so much more.
A missing period is commonly seen in women with eating disorders, especially those who are restricting food whilst also engaging in vigorous exercise routines.
My personal experience with not having a period during the eating disorder, and then getting it back, was a process of deep healing for me. With my period happening on a regular basis, it opened up a deeply intuitive softening of my spirit. During those (rather unpleasant) times of the month, I would go through the motions of a changing body and learn to love myself through them. It opened up a whole new way of connecting with my body, and leaning into the impermanence of physical or emotional sensations.
Getting my period back helped me reintegrate my feminine self and set aside time to listen to my body from deep within, despite the discomfort that arose. I pray that your reconnection with this beautifully natural and necessary phenomenon will bring you the same soul-connection I experienced.
In this post, I share a bit more about what HA is and some of the insights from my chat with Cynthia. If you'd like to go deeper, listen to the full podcast episode here.
What is HA?
Your hypothalamus is the control centre in your brain that helps to regulate many bodily responses. It is responsible for releasing hormones such as GnRH (gonadotropin-releasing hormone) which partners with FSH, LH and oestrogen — all involved in your menstrual cycle. If the hypothalamus stops producing GnRH, your period stops.
Having a period is one of the most natural things a woman can experience. If this is absent, it could lead to other health issues like osteoporosis, hair loss, heart disease, or infertility. Most importantly, HA could be a sign that your body is under too much stress from malnourishment or over-exertion. This is why Cynthia's go-to for getting your period back is: eat more, exercise less.
But this isn't an easy thing to consider when in recovery from an eating disorder, and you may need support to help navigate the psychological, emotional, and physical changes you might undergo during this process.
What causes HA?
Hypothalamic Amenorrhea is mostly due to poor nutrition, inadequate food intake, excessive exercise, stress, or a combination of these — which you may experience if you are struggling with an eating disorder. This can lead to depression, anxiety, fatigue, abnormal hunger cues, insomnia, hair loss, reduced libido, headaches, and more. Your doctor will usually diagnose HA through a series of blood tests, so if you suspect you may have HA, please speak to your GP or gynaecologist.
The good news is that HA is treatable most of the time, mainly through lifestyle changes. Getting adequate nutrition and assessing where the body is under undue stress is the key starting point — but it's important to work on this with a professional.
The pill can mask a missing period
If you are on a hormonal contraceptive, there is no guarantee that the bleed you experience is actually a healthy period. It's a synthetically induced bleed. It's also important to know that a missing period is not normal and should be taken as a vital sign — just as much as blood pressure — by doctors and practitioners.
HA can happen at any body size
HA was originally thought to only occur in thinner women, but that is not the case. Even though the occurrence is seen often in lower weight people, it's a problem with the hypothalamus, of which weight is not a direct cause, even though it might be a factor.
You can still feel good with less exercise
Exercise can form part of a balanced lifestyle and does release endorphins — but you may need to reduce your frequency or intensity considerably while trying to recover your period. For more ways to support your wellbeing during this time, visit Cynthia's website here.
HA is a very real condition that can lead to many health concerns. If you are navigating an eating disorder alongside this, you may need to work on more than one area at once. But you are not alone, and you can feel fully supported in this journey. Don't hesitate to reach out — I'd be happy to help or point you in the right direction.