You crush your exercise goals like a boss, paleo has long been your way of life and you strive for perfection in mostly everything you do. On the outside, you are glowing with health, vitality and success. On the inside, however, it’s a different scenario. Your period has been missing in action for longer than you’d care to remember, your energy levels are low, you have no libido and you often feel cold.
Sound familiar? You may be suffering from a condition called hypothalamic amenorrhea (HA), a common endocrine disorder in which the hypothalamus – a tiny yet important control centre in the middle of your brain – signals for your reproductive system to shut down.
HA is undoubtedly on the rise in today’s fast-paced, body-obsessed world. We are absorbed in the busyness of everyday life, in our high-stress jobs, active social lives and family commitments. Throw in a little personal or societal pressure to be thin, fit and ‘healthy’ and you have the recipe for HA.
Kate Callaghan, aka The Holistic Nutritionist, says this modern lifestyle can wreak havoc on our hormonal health. And she would know – as well as being an HA expert and the go-to for women all around the world who wish to regain their cycles, she has personally experienced the condition.
“I had always been a very active person and interested in health, nutrition and eating well,” she says. “I was a group fitness instructor from the age of about 17 and, at times in my 20s, was teaching up to 16 classes per week. I also was not fuelling my body appropriately – not enough calories, and not enough carbohydrates. I was a major stress-head and I always had to be busy.”
When Callaghan and her husband began trying for a baby, the real consequences of her ‘healthy’ lifestyle became apparent.
“I didn’t have the fuel required for healthy reproductive function, let alone creating another human,” she says.
“My brain stopped communicating with my ovaries, my sex hormone production came to a stand-still, and I lost my period. I was infertile and, due to my low oestrogen levels, my bones were deteriorating. I was also putting my heart health at risk, not to mention I really didn’t feel that great, despite what I may have looked like: no libido, no energy, poor memory, moody and daily brain fog.”
Doctors told Callaghan she wouldn’t be able to fall pregnant without medication; however, she sought a natural solution to reboot her system.
“I set about making the necessary changes. I ate more – especially carbohydrates – I cut way back on exercise and was diligent in managing stress,” she says.
It worked. Seven months later her period returned, and she conceived naturally a few months later.
What is hypothalamic amenorrhea?
‘Amenorrhea’ is the term for absent periods, and ‘hypothalamic’ refers to the hypothalamus, a pea-sized gland in the brain responsible for controlling the hormones needed for ovulation and menstruation. It’s also responsible for certain metabolic processes, fatigue and thirst, as well as regulating body temperature and circadian rhythms.
Exercise, famine, stress and not enough rest can disrupt your hypothalamus, preventing it from producing adequate hormones for ovulation and menstruation to take place. This is because our bodies were smartly designed to only conceive when energy stores are high enough to grow a baby.
If you’re not eating or resting enough, or exercising too much, the energy stores in your body will be lacking, explains Callaghan.
“Your body will then prioritise how it uses its resources to keep the essentials functioning – your heart beating, your lungs breathing, your brain ticking along. Reproduction is not one of those vital functions, as we can survive without it.”
Kate Callaghan, aka The Holistic Nutritionist
Who’s at risk of hypothalamic amenorrhea?
HA is more common in athletes (particularly runners, gymnasts and dancers), dedicated gym bunnies and women who are underweight or have eating disorders, but it also presents in women who have a ‘healthy’ or even ‘overweight’ BMI and exercise moderately.
“Type A personalities and perfectionists are more susceptible to HA,” says Callaghan. “We’re always striving to achieve everything. This keeps our body in ‘fight or flight’ mode, whereas we need to be in ‘rest, digest and reproduce’ mode for our reproductive system to flourish.”
What are the effects of hypothalamic amenorrhea?
Infertility is the most obvious effect of HA – without periods and ovulation, conception is out of the question. So how did super-skinny, high-achieving celebrities such as Victoria Beckham and Amal Clooney get pregnant? The answer is that every woman’s body is different. They may have adequate levels of body fat for healthy hormone production; they may have also had fertility treatment.
Even if you’re not looking to start a family, HA can cause serious long-term health issues. As well as dry skin, nails and hair, low energy and low libido, it can lead to cardiovascular problems and depression. It’s also a one-way ticket to osteoporosis; the rate of bone loss in a woman with HA is five times greater than it should be.
“The longer a woman experiences HA, the worse off her bones will be,” says Callaghan.
How to recover from hypothalamic amenorrhea
Fortunately, with some diet and lifestyle changes, it’s possible to successfully treat HA. Callaghan says the key components to regaining your cycles are eating and resting more, exercising less and managing stress.
“It sounds simple, but in reality it’s quite difficult as it involves a massive shift in mindset and huge lifestyle changes,” she says. “Figure out why you want to get your period back: what is your motivation? This will help you stay on track for the long haul.”
Exercise less: Replace those high-intensity, fat-burning workouts with more restorative activities like yoga. Running and other intense cardio are off-limits while you’re in recovery; you may be able to gradually reintroduce these later.
Eat more: Eat more calories than you expend. Enjoy a range of food groups and focus on eating high-energy and nourishing foods like full-fat dairy, organ meats (eg liver, heart), eggs, fermented foods and quality protein and carbs. Consult a dietitian for individual advice.
Manage stress: Psychological stress alone can pause your periods. Techniques such as meditation, visualisation and cognitive behavioural therapy can help.
Get more rest: Go to bed earlier, sleep in later, take that afternoon nap.
Embrace recovery: You’ll most likely experience weight gain after making the above lifestyle changes, but the benefits to your health and wellbeing outweigh the negatives.
“Letting go of old habits and completely changing your lifestyle is extremely challenging,” says Callaghan. “However, your body will thank you for it, not only in the short term but in years to come.”
What are the signs of HA?
– You don’t get periods
– You have a low body weight and/or body fat (note: it’s still possible to have HA at any BMI)
– You have dry skin, eyes or hair
– You feel stressed or burnt out
– You have low energy and low libido
– You have poor quality sleep
– You feel the cold easily and have a low body temperature
– You often catch colds and viruses
What are some HA triggers?
– You are not eating enough calories to adequately fuel your body
– Your stress levels are high, or you have experienced a stressful event or change
– You have experienced a significant weight loss (recently or historically)
– You are a dedicated exerciser
– Genetics can also play a part in HA (this explains why one woman will lose her period, while her friend with a similar physique and lifestyle won’t).
For more information, head along to www.theholisticnutritionist.com
Words: Rebecca Williamson
