How to Get Your Period Back

As an athlete, you may have heard of others or have experienced yourself losing a normal menstrual cycle. Although it may not sound terrible, it is something that needs to be taken seriously and worked to be fixed. 

Getting your period back after you have lost it is a process, and I am here to help you figure it out. In this blog, we are going to talk about how to get your period back, the importance of having a period, and what is actually happening with period loss.

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 (not eating enough).

When a female’s body stops menstruating, it is a sign of decreased health and an energy imbalance. When your body is struggling to find enough energy to live normally, it shuts down the nonessential functions to prioritize fueling your brain, heart, lungs, and digestive system so you can survive. 

An imbalance of hormones also comes when the body stops menstruating. The word “hypothalamic” comes from our hypothalamus, a part of our brain that secretes hormones. In HA, your hypothalamus is not secreting hormones at a level that is needed to signal for menstruation.

Stages of the normal menstrual cycle (source)

Why Did I Lose My Period?

Your period is regulated by hormones in your body, which come from the hypothalamus. The main hormone that is affected is gonadotropin-releasing hormone (GnRH) and that comes directly from the hypothalamus. When GnRH is released it leads to the secretion of other hormones such as follicle-stimulating hormone (FSH), estrogen, and luteinizing hormone (LH). These are all necessary for a regular menstrual cycle so when your hypothalamus decreases the secretion of GnRH, the other hormones become imbalanced. 

You may be confused as to why your hormones are out of balance, but there are causes for this decreased secretion. When you are in an energy imbalance, meaning energy intake is not matching your energy output, can cause an imbalance of hormones because your body begins to shut down nonessential processes. 

Graphic from New England Journal of Medicine

Other Symptoms of HA

You won’t just lose your period when you have HA, there are many different symptoms that you may encounter. These signs can also show that underfueling is taking place and that HA may become a problem if not resolved. 

Other symptoms of HA include: 

  • Anxiety and depression
  • Low energy
  • Trouble sleeping
  • Hunger
  • Hair loss
  • Low sex drive

How Do I Get My Period Back?

Learning that you have this condition may be scary, but there are ways to recover! Focusing on these things will help you get onto the road to a normal menstrual cycle. 

Food

Proper fueling is a vital step in getting your period back. Since your body has begun to conserve energy by shutting down your menstrual cycle, it is important to increase your energy intake to match your training volume so your body can start up the systems that have been shut off. 

Exercise

If you are struggling to get your period back, a decrease in training volume may be necessary. This does not mean that you must stop exercising altogether but making sure that you are eating enough to match the intensity is vital for recovery. 

Mental Health

Mental stress also plays a big role in the release of your hormones. Making sure that you are mentally in the right place is the first step in being able to take steps in the recovery journey. Healing relationships with food and exercise may also be necessary before you begin incorporating more food or decreasing exercise. 

Getting Support from Professionals

Getting your period back isn’t easy, and it helps to have a support system around you that can help you. These professionals may include Athletic Trainers, Psychologists, and Sports Dietitians like me

Should I Get on the Pill? 

When you lose your menstrual cycle a solution that may be suggested is to begin taking oral contraceptives to “get it back”. This is NOT the case. When you are taking an oral contraceptive the period that you have on the pill is a “withdrawal bleed”, meaning it is your body withdrawing from the hormones you are taking, giving you a “period”. 

You will not receive the normal circulation of hormones and unfortunately, this is not an effective way to get your period back. Taking the pill, is simply just a masking tool that is not addressing the true causes. 

Conclusion

Losing your period is scary, but there is a way to get it back! Hypothalamic Ammenhorea is the absence of a menstrual period for three months or longer. This can be due to intense exercise, underfueling, or a hormonal imbalance. 

The hormones that control the menstrual cycle are GnRH, LH, FSH, and estrogen. All of these hormones are necessary and an imbalance in them will cause a disrupted or abnormal menstrual cycle. 

There are ways to recover from HA, and it starts with being in a position where you are mentally ready to make changes. This is the most important step in the journey! It can be scary to hear that you have to gain weight or eat more but it’s what your body needs!

From there, an increase in food intake or a decrease in exercise intensity will help to balance your energy balance. Surrounding yourself with professionals who are eager to help you is also important. Some professionals may suggest oral contraceptives, but this is simply a band-aid that is not healing the root cause. 

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! 

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