How I Got My Period Back: Healing from Hypothalamic Amenorrhea
This article is based on a podcast episode and YouTube video I did on The Hypothalamic Amenorrhea Podcast. If you'd like to listen to the episode OR learn more about myself and my services, as well as The HA Society, a membership that I run for women with HA, click here.
Hey guys, the day has come where I share in some detail, my HA story.
This is important for me to do because I talk to a lot of girls about hypothalamic amenorrhoea and many have questions about my history with it.
First of all, to explain, hypothalamic amenorrhoea or “HA” is the absence of a period in someone who should have a period, and has before had a period. Not to be confused with primary amenorrhea where you’ve never had a period.
My Life Prior to Hypothalamic Amenorrhoea
My background is really, really important in this story because it helps other girls to find themselves represented. There are a number of people sharing their HA stories out there, but the thing that helps people the most is to hear a story where they can RELATE. To see yourself in that story.
I’ve heard so many stories of women with a past history of a diagnosed eating disorder or a really high level of athletics – specifically in the endurance sports realm but for me, those stories didn’t resonate.
I was SO confused - why do I have the same diagnosis, but I don’t have the same story? CONFUSING.
SO, I grew up a very normal girl in a very normal family-life setting. I matured at a normal rate and had a fun, carefree life in a first world country. Things were good for me. (1)
I got my first period at 13 and rarely had issues with my period at all.
Like many women, I also grew up thinking that you could get pregnant on any day of the week and all that rubbish, so I was pretty uneducated on period health.
I played some sport, maybe once or twice a week. The older I got, the less and less I played. My passions were in computers - building websites and art - creating graphics.
Then I finished high school, went to business college, and entered that world.
Then I Started Working Out
Around 18 or so I started to notice my body change. Gaining weight was easier and I felt a little more...now looking back, just curvaceous and matured than my girlfriends. I “needed” to start working out. (2) I was only 18 but I could look 16 I guess....
My AnyTime fitness membership turned into a CrossFit membership, which became a weightlifting membership. And I fell in LOVE with weightlifting.
My Story Didn’t Seem to Fit the HA Mould
My focus was more on strength and my period health didn’t decline with endurance training, but it did with weightlifting. This seems to be less common, maybe? I don’t know. If this sounds more like you PLEASE let me know in the comments of this video.
I dove into weightlifting and focused on it. To be clear, I wasn’t even that strong. It’s not like I excelled and became some superstar with a bunch of pressure on her. I just liked it a lot and wanted to get better, so I showed up. I showed up a lot, like 5-6 days a week for multiple hours at a time.
PS I wrote a whole article about not fitting the HA mould, so if that’s something that hit home for you take a read.
Then I Started Dieting
My body wasn’t really changing much even with all this exercise, so I started to focus on dieting. I had focused on food sources, eating paleo, but never on cutting calories or tracking macros.
In fact, I used to eat meals like half a chicken and roast vegetables for lunch haha. But then I started tracking macros and was a little too unaware of the dangers of a low fat diet. So I was eating extremely low fat. (3)
Then My Period Disappeared
With the combination of weightlifting and dieting, my period disappeared. The exact time is unknown because I had no idea about period health and if anything, I was quite pleased with myself. Being so active that I didn’t menstruate - how cool.
I would openly share that I didn’t have one. No one ever ONCE worried about that. I shrugged it off like I knew what I was doing.
Then I Started a Business and Worked 7 Days a Week
Meanwhile, my priorities in my career had changed too. I’d worked some amazing corporate jobs but wanted a change and was in love with making coffee. So I switched to hospitality and opened up my own shop.
So now I was working 6-7 days a week, getting up at 4am and working until 3.30pm. Then going to training from 5.30pm to 7.30pm. Eat, sleep, repeat. (4)
The business was a success, too. I poured my heart and soul into it.
Eventually, I Asked a Doctor About My Missing Period
So, somehow, for some reason, I decided it was time to ask the doctor why I don’t have my period. I was there to see him for something else, but I also asked him about that because I knew I didn’t actually understand where it was.
Although the doctor didn’t tell me his specific thoughts, he actually prescribed me a vacation and to chill out. He had a hunch that I had Hypothalamic Amenorrhea I suppose, but that’s honestly all he said. He also gave me a hug which was interesting. He felt sad for me and I had no idea why. (5)
It only registers now, in hindsight. I actually did take his advice anyway and went on a vacation to the USA (I was living in Australia, did I mention that?)
On that vacation, I met my now husband. So I closed my business down in Australia and started the VISA process to move to the US.
I Became More Curious About Recovery from Hypothalamic Amenorrhea
Leading up to my official move, I did an extended stay visit for a whole month. While Jake was at work all I could do was chill on the internet, walk to a nearby coffee shop, eat Christmas food and wait for Jake to finish work so we could hang out. I wasn't able to work out much and I wasn't really proficient enough in working out at home alone so I just didn’t.
I Got A Period
That’s when I connected my first dot: chilling out = period. That’s what the doctor was saying. But I had to go home and go back to work and start weightlifting again so it disappeared.
This made me think that I knew I could get my period back if I wanted it. But I didn’t really know why I wanted it yet so I didn’t pursue that.
Then I finally moved to the States. I was still weightlifting a lot there, I found a cool gym, and actually, I trained even more because I wasn’t legally allowed to work in the US yet. BUT, after about 5 weeks, I GOT ANOTHER PERIOD.
So I connected another dot. Ok, chilling out, not stretching myself over multiple passions, and instead living the life of a brooding author who just writes by the beach = period. (6)
I was at a coffee shop on the coast of California when I got really sick really suddenly. I thought I’d need my husband to come and pick me up it was that bad. Then I felt it and something in that moment made me a lot more curious.
I did a touch of research but honestly, I found nothing. No decent information around this on the internet. And then I started working full time and continuing to work out and diet, so I lost my period again.
I Saw An OBGYN Who “Diagnosed” Me With HA - Sort of
Around the same time, I was overdue for my annual women's health check so I went and did that. I told him I didn’t have my period and he was like “WOW LADY. It’s important you have it so here take these progesterone pills” (I’m paraphrasing)
I didn’t want to take the pills because I believed in a holistic approach but I did choose to take his caution about the dangers of not having a menstrual seriously.
He made me officially curious to learn about it. I mean, what if I was dying? What if tons of blood was pooling up in me, drying out and going to infect my uterus? What if I was infertile?
It was time to really dive into the rabbit hole of my missing period.
The Really Hard to Handle Part
My research took me longer than I feel like it should have because I was in denial for a long time that all of this information even applied to me. I was “never” “really” lean. I felt like I always “had weight to lose” or something like that.
I didn’t see or hear myself the stories of other women with HA and so I wasn’t comfortable following their recovery protocol.
I did believe that I had HA when PCOS and brain tumors were ruled out (yep)...but I didn’t believe that the healing protocol for those girls - to relax and eat - applied to me.
Here’s the crazy thing. I experienced first hand that chilling out and eating enough calories will give me my period. Yet I still didn’t believe that I deserve to treat myself with rest and nourishment. I just didn’t believe it. I still battle with that today.
So naturally, I wasn’t ready to make many changes to my lifestyle at that time. I needed to be sold on why I need my period and why I was probably under-fueled despite all of the advice of the health and fitness magazines and companies marketing.
As I was learning, I tried all of the small things I was willing try:
multivitamins
bone broth
sleep/naps (which I can’t do)
None of which did anything.
I Became More Obsessive About Recovery
After many months of learning, I was now better educated. I needed my period for a plethora of important reasons and it was time to get it back. BUT it was a really long process and I still had this challenging internal belief that I did not deserve recovery and was not worthy of undertaking the process of recovery from Hypothalamic Amenorrhea.
I battled through it anyway with the support of my husband, some clutch podcasts, and telling my friends all the things I’m afraid of if I try this whole recovery thing. (7)
Pseudo Recovery of Hypothalamic Amenorrhea
Eventually, I settled on my own customized version of ‘all in’. The process of stopping exercise and eating all of the things.
My version was moving from weightlifting to walking, yoga and tiny bits of bodybuilding type exercise. It was quasi-recovery. I was talking like MILES. I was doing 1-2 yoga sessions a DAY. You have to understand that for me this felt like nothing.
But in reality, it was still the ritual of continued productivity. It was me trying to make my recovery productive and it was me trying not to gain weight with the hopes that the reduction in the intensity of exercise would help me.
Persevering Anyway and Finally Getting a Period
So there I was, doing my best. Battling all of the time between “am I worthy of this” “am I doing this right?!” “no - run back!” and feeling like people won’t understand me or believe me.
But I did the work and I did eventually stop the fake-recovery behavior. Look, it just wasn’t that easy to go cold turkey and I think that's the case for a lot of girls. I gradually reduced my exercise and I don’t blame myself. I wanted to know if I could do this with the least amount of change possible i.e the process of elimination.
Another challenge to going “all in” for me was that there were times where I felt like I was telling people some false story about a fake diagnosis. I thought people would not believe that I was an over-exerciser under-eater because I didn’t look like the type of person that would. I feared they would think it was an excuse for ‘letting myself go’.
That's how my art Instagram account started. I used illustration to help me work through this period of my life and as a way to educate people on what was happening because I knew there were others.
This helped and was easy for me to start because during my entire journey I met many women just like me with dysfunctional periods that didn’t really understand what was happening. I wanted to share my story to help them too and that’s why I have a YouTube channel now, too.
Hypothalamic Amenorrhea Relapse
I only got two periods in a row and it was gone.
After two periods I thought that I could go back to exercising, maybe even cutting down how much I was eating again...
I had come a long way with my self acceptance and acceptance of this situation, but exercising and dieting was pretty hardwired in me. It was like a smoker relapsing a little. I always wanted to go back. And I thought “ok, if I start working out but continue eating enough and am super aware of my nutrient intake I’ll be golden”.
But nope, that very next period was goneskies. I was convinced that “all in” had failed me and I was more broken - but I do see that looking back I relapsed and had gone back to my old habits.
So I enlisted the help of a Nutritional Therapy Practitioner.
We worked together on my protocol and I think that because I had paid money and she basically gave me PERMISSION to rest and eat, it was the validation and motivation I really needed. I needed that third-party person, whose opinion was educated, to tell me that it’s ok for me to do this and this is what I need.
I worked with her and I got my period back again quickly after. The main difference working with her was that I felt accountable to rest and eat and she also had me take certain supplements, stress reduction and be more mindful of my intake of things like caffeine.
Today I Am Recovered From Hypothalamic Amenorrhea
But I still miss periods easily. I will consider myself 100% recovered when I have a full year of periods I think.
I slip back into HA really easy right now if I have a week or two of skipping breakfast, feel extra stressed, don’t sleep enough, or try to push the intensity and/or frequency of my workouts.
It really sucks to be so delicate and have to take it so easy to be healthy. I’m not used to being told that dieting and working out isn’t what I need to do. I KNOW it’s not and I preach it every day to help others not fall into this trap, but I’m still not used to it.
As I rested, I had to find a way to fill the new void in my life. I had more time to draw and write. To connect with friends and others. To put even more creative energy into my work and my team and get my sex drive back. That thing was missing for a long time. With time I started to see how great this new way of living can be.
Sometimes it’s hard, I’d love to be an athlete. But it’s also ok when I think about all the other things I could do with that 2-3 hours a day and all the energy that I’ve gotten back. (7)
Now I Help Women Recover Their Periods
After helping tons of women through The HA Podcast, starting The HA Society, a community for women with HA and using my background in nutrition and fertility to work with women to recover their missing cycles every day, I can proudly say that my journey was well worth it.
References:
Smith, A. J., O’Sullivan, A. J., & Hawley, J. A. (2018). Growth hormone and insulin-like growth factor-I in the transition from normal menstruation to reduced ovarian function and premature ovarian insufficiency. Frontiers in Endocrinology, 9, 602.
Reference: Nattiv, A., Loucks, A. B., Manore, M. M., Sanborn, C. F., Sundgot-Borgen, J., & Warren, M. P. (2007). The female athlete triad. Medicine & Science in Sports & Exercise, 39(10), 1867–1882.
De Souza, M. J., Nattiv, A., Joy, E., Misra, M., Williams, N. I., Mallinson, R. J., ... & Warren, M. P. (2014). 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. British Journal of Sports Medicine, 48(4), 289–289.
Reference: Hoch, A. Z., Papanek, P., Szabo, A., Widlansky, M. E., & Schimke, J. E. (2007). Association between the female athlete triad and endothelial dysfunction in dancers. Clinical Journal of Sport Medicine, 17(4), 283–289.
Reference: Gibson-Helm, M., Teede, H., Dunaif, A., & Dokras, A. (2017). Delaying diagnosis and management of polycystic ovary syndrome is associated with a worse phenotype in adolescence. American Journal of Obstetrics and Gynecology, 216(6), 580.e1–580.e6.
Reference: Sundgot-Borgen, J., & Torstveit, M. K. (2010). The Female Athlete Triad: Are elite athletes at increased risk? Medicine & Science in Sports & Exercise, 42(3), 533–541.
Reference: O’Connor, L. E., Puetz, T. W., & Dishman, R. K. (2011). Effects of physical activity on anxiety, depression, and sensitivity to stress: A unifying theory. Clinical Psychology Review, 29(4), 547–557.
Nattiv, A., Loucks, A. B., Manore, M. M., Sanborn, C. F., Sundgot-Borgen, J., & Warren, M. P. (2007). American College of Sports Medicine position stand. The Female Athlete Triad. Medicine & Science in Sports & Exercise, 39(10), 1867–1882.
