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Understanding Hypothalamic Amenorrhea (HA)

by | Feb 6, 2024 | Binge Eating, Blog, Eating Disorder Recovery, Healing, Health | 0 comments

If you’re missing your period, you might be dealing with hypothalamic amenorrhea (HA). HA is a common side effect of struggling with disordered eating. Despite being less discussed than some of the other impacts of disordered eating and eating disorders, HA is a common issue that significantly impacts life.

It’s important for you to understand what HA is, what causes it, and how to begin recovering. This article will give you a comprehension overview of what HA entails, its signs and symptoms, and navigating the healing process.

Hypothalamic Amenorrhea Basics

Hypothalamic Amenorrhea is when the menstrual cycle disappears due to the body feeling unsafe for pregnancy.

Physiologically, HA happens due to disruptions in the hypothalamus (a pivotal part of the brain responsible for regulating periods and lots of other processes).

Factors like high physical activity, elevated stress levels, weight loss, or being at a low body weight for that person can impact the hypothalamus. Long-term impact on the hypothalamus stalls the release of menstrual cycle-related hormones, such as estrogen.

It’s important to note that HA presents as a missing period. But the root cause is actually missing ovulation due to disrupted hormone production.

Disordered eating behaviors, such as limiting carbohydrates or fats, compensating for food intake through exercise, or exercising despite exhaustion, also stress the body, contributing to HA. It’s a paradox that those who are engaging in the most “healthy behaviors” are most likely to experience period loss.

Signs + symptoms of HA

HA goes beyond the absence of periods; it serves as an indicator of underlying issues.

The hormonal imbalance in Hypothalamic Amenorrhea can be due to:

  • Too little food intake or missing food groups
  • Too much exercise
  • Too much stress

The health impact of missing cycles becomes worse the longer you have HA. THerefore it’s important to detect HA and begin recovery.


Common signs include missing periods and ovulation, low energy levels, mood swings, decreased bone density, feeling cold, and disrupted sleep patterns.

Diagnosis of HA:

Diagnosing HA can involve a comprehensive evaluation of medical history, hormonal blood tests, and bone density scans. Given its association with food and exercise habits, honesty about any disordered eating is vital for an accurate diagnosis.

How to begin healing your Hypothalamic Amenorrhea (HA)

Recovery from HA involves more than reinstating regular menstrual cycles; you must address the reasons that led to it in the first place.

The healing process encompasses regaining a healthy menstrual cycle, restoring hormonal balance, improving bone health, enhancing overall well-being, and fostering a healthier relationship with food, exercise, and the body.

Nutrition for Hypothalamic Amenorrhea recovery:

Consistent and adequate eating serves as the foundation for HA recovery and repairing one’s relationship with food.

This includes having at least three meals and potentially three snacks daily, with meals spaced no more than 3-4 hours apart.

Adequate intake of carbohydrates and fats is vital for proper hypothalamic function, especially considering the energy deficit experienced with HA. Starting gradually or seeking support from an HA specialist can help manage this transition.

Exercise modifications:

Reducing the intensity of workouts and prioritizing gentler forms of movement can aid the body’s recovery without adding stress.

Adjusting exercise schedules, potentially reducing workout frequency e.g. from five days to two days per week, might be necessary. In some cases, pausing or engaging only in low-intensity exercises might be needed, depending on individual responses.

Stress management:

Incorporating mindfulness, meditation, and relaxation techniques into daily routines is essential.

These practices gradually signal safety to the body, allowing the resumption of the menstrual cycle. Developing new coping mechanisms beyond using food and exercise to manage stress is beneficial during HA recovery.

Weight restoration:

HA affects people of all body sizes. Attaining a healthy weight specific to one’s body and not based on BMI is integral to recovery.

Overcoming the fear or uncomfortableness of your body changing is key to a long-term happy relationship with food and your body.

Further Resources

Recovering from HA can be challenging, but numerous resources offer support.

Some valuable ones include:

  • “No Period. Now What?” by Dr. Nicola Sykes, an esteemed resource highly recommended for understanding and implementing recovery strategies.
  • The Ease With Food Podcast, a podcast focusing on disordered eating recovery and often featuring episodes discussing HA recovery in a holistic and practical manner. Hosted by Shannon Western.

Remember, you’re not alone in this journey towards healing from HA. There’s ample support and guidance available to help navigate this process successfully.

This blog post was written by Shannon Western, Registered Nutritionist, ACCPH therapist, and founder of Ease Nutrition Therapy. You can find Shannon and her work on www.easenutritiontherapy.com Go and read more about her work!

Looking for further support to heal your relationship with food? Work with me 1:1.

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Hey there, I´m Linn

This is my little corner of the internet where I share things related to our complex relationship with food, eating and our bodies.

I believe that eating ought to be nourishing and joyful instead of filled with fear, guilt and shame.

Your body, and all of you, is worthy of care and  food or eating should never need to be earned or justified.