A diagnosis of hypothalamic amenorrhea can be scary, but there are ways to recover. Once you begin the process of getting your period back, there are signs that you can look out for that will show you are on the right path.
As a Certified Sports Dietitian, I help a lot of athletes with hypothalamic amenorrhea (HA) regain their menstrual cycle and return to participating full-time in their sport! In this blog, we are going to discuss what HA is, the symptoms of HA, HA recovery, and some HA recovery signs that can signal you on the path to recovery!
What is Hypothalamic Amenorrhea (HA)?
Hypothalamic Amenorrhea or HA is when a female loses her period for three months or longer. This can occur for a variety of reasons, but it is often a combination of causes. Common causes include intense exercise, hormonal imbalances, and underfueling.
When a female’s body stops menstruating it is a sign of decreased health. When your body is no longer able to sustain a pregnancy due to malnutrition or increased energy expenditure, the body shuts down the nonessential functions to prioritize fueling your brain, heart, lungs, and digestive system so you can survive.
When the body stops menstruation it also comes with an imbalance of hormones. In HA, our hypothalamus, which is a part of our brain that secretes hormones, is working at a lower level than it usually does when our bodies are healthy. It may stop secreting hormones that are needed for menstruation altogether.
Symptoms of HA
Besides missing your period, you will experience different symptoms when you have HA. These symptoms could include:
- Anxiety and Depression
- Low energy
- Trouble sleeping
- Hair loss
- Low sex drive
How Can I Recover?
The only way to recover from HA is to level out your energy imbalance. This can come from a few strategies but they boil down to two things: decreasing your activity and/or increasing your food consumption. Decreasing your activity may not be easy as an athlete, especially if you are in season.
Here are some ways you could increase your food intake when decreasing training is not an option:
- Incorporate 2-3 snacks a day. You should be eating every 2-3 hours.
- Focus on calorie-dense foods (carbs and fats) that can give you a boost in calorie intake. Some of my favorite energy-dense foods include
- Peanut Butter
- Liquid energy (full-fat milk, sports drinks, 100% juice)
- Eat before, during, AND after training. Training is a large reason you need more energy than your non-athlete friends, so taking that opportunity to get more calories is essential and will improve performance.
- Drink beverages in addition to water (juice, smoothies, sports drinks) to add calories in an easily digestible way.
How Do I Know I am Recovering?
Although you may have been trying for long periods of time to regain a normal menstrual cycle, it is important to not give up! Recovery is a process and there are signs that you may be recovering even if your period has not returned.
HA Recovery Signs
There are a couple of signs that can be celebrated when you are trying to get your period back and it shows that your body is returning to the normal hormone levels and activating bodily functions again.
One is increased hunger (because of an increased metabolism). When you begin to eat more foods, your metabolism speeds up which in turn utilizes the new energy it has available, making you hungrier. It may feel like you are hungry all the time, but this is just a sign that your body is getting its hunger cues back and is telling you when it is time to eat!
Another is an improvement in other symptoms related to HA. This could mean you have more energy, you are sleeping throughout the night, or you aren’t as anxious. All of these symptoms have to do with a hormonal imbalance, so any improvement shows that the body is slowly getting back to normal.
The last one is the addition of cervical mucus. When you had a normal cycle, you may have noticed discharge was normal throughout your cycle and it will disappear once you lose your period. When you begin to gain cervical mucus back, it is a sign of recovery!
Receiving a diagnosis of Hypothalamic Amenhorrea may be scary, but you are able to get your cycle back! Hypothalamic Ammenhorea is when you lose your period for three months or more and is due to a hormonal imbalance, long periods of intense exercise, or underfueling.
There are symptoms other than losing your period and those can include fatigue, hunger, anxiety, and depression. These symptoms are all involved with the secretion of hormones being lower than usual.
When you begin to recover from HA, there are certain signs you could look out for. Some of those HA recovery signs are increased hunger, improvement in symptoms that aren’t your menstrual cycle, and a return of cervical mucus.
Symptoms of underfueling and fueling strategies are things that I discuss with my athletes in the Performance Fueling Club (PFC). PFC is an online sports nutrition coaching program that helps athletes with flexible on-demand content and live nutrition coaching with a sports dietitian.
If you are looking for guidance on proper fueling, I encourage you to sign up today. We currently have open enrollment, and I would love to help support you in getting to your goals!