Let me paint the picture…You’re in your late 20’s or early 30’s. You’ve spent the last decade preventing pregnancy. Most likely by using some form of birth control. Now, you’ve found your partner, maybe gotten married, and finally ready to start trying for a baby! You stop your birth control only to find that your natural cycle isn’t returning. Or maybe you were never on birth control, but always had wonky cycles. It wasn’t a big deal…until it was, and now you’re struggling to get pregnant. 

I’ve seen this exact scenario play out SO many times, and it’s heartbreaking. I wish we were taught about our cycles when we GOT our cycles. But alas, that’s not the case for so many women! 

Why Is Your Period Missing?

Missing periods, or amenorrhea, can happen for many reasons, often reflecting an underlying imbalance in the body. Here are some common causes:

• Stress: Both physical and emotional stress can suppress the hormones that regulate your cycle. This can include stress from work, relationships, or even undereating or excessive exercise.

• Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt your menstrual cycle. These imbalances often affect hormone levels, which can impact ovulation and regularity. With hormone imbalances, I often see clients having a cycle, but their cycle is usually very irregular or long. 

• Low Body Weight or Low Body Fat: If your body weight or body fat is too low, the body may "pause" reproductive functions, interpreting the low energy availability as an unfavorable environment for pregnancy.

• Medications: Some medications, including hormonal contraceptives, can disrupt or delay the return of natural cycles even after stopping them.

If you are someone who is struggling more with a hormonal imbalance- you have a cycle, but it’s super irregular- I encourage you to check out THIS blog post on NEXT steps to have regular and predictable cycles.

If you are someone who hasn’t had a cycle for 3-6 months, this next section is for you. 

Hypothalamic Amenorrhea: When Your Body Is Trying to Tell You Something

One specific cause of amenorrhea is hypothalamic amenorrhea (HA), a condition that affects many women trying to conceive. HA occurs when the hypothalamus—an area of the brain that regulates hormones—reduces its production of gonadotropin-releasing hormone (GnRH), which leads to a drop in the hormones needed for ovulation.

HA is often triggered by a combination of stressors, including:

• Under-eating or Low-Calorie Intake: If your body doesn’t have enough energy, it shifts away from reproductive functions. This can happen when calorie intake is too low to sustain the body’s basic needs. This often leads to a low body fat percentage. 

• Excessive Exercise: While physical activity is generally beneficial, too much can signal to your body that it’s not a safe environment for reproduction.

• Psychological Stress: Ongoing stress activates the release of cortisol, which can disrupt the hypothalamus and suppress reproductive hormones.

• Some combination of the above! 

A diagnosis of HA is made when the following parameters are met: 

• No cycle for 3 months with those who previously had normal cycles OR no cycle for 6 months for those who previously didn’t have normal cycles

• No other condition is found: Normal prolactin and thyroid function, no PCOS or pituitary issues, etc. 

Tips for Recovering Your Period and Regulating Your Cycle with HA: 

If you’re experiencing HA and want to restore your cycle, here are some practical steps to start with:

1. Increase Your Caloric Intake: Fueling your body with sufficient nutrients is crucial for recovery. Focus on adding balanced meals with protein, fats, and carbohydrates at each meal to signal safety and nourishment to your body. Whole foods like eggs, avocados, sweet potatoes, regular potatoes and fatty fish are especially beneficial. If you’re someone that finds yourself eating TONS of fruits and vegetables, salads, and dense meals, try replacing some of these with foods higher in calories. A good example is adding rice and potatoes vs a side of just roasted veggies. Using higher fat milk instead of nut milks. 

2. Reduce Exercise Intensity and Volume: HA often stems from high-intensity exercise. Switch to gentler forms of movement such as walking, yoga, or Pilates, and allow for more rest days each week. It’s essential to give your body time to repair and restore energy for reproductive function.

3. Reduce or Eliminate Stimulants: Caffeine, alcohol, and other stimulants can increase cortisol levels, which may further stress the body and keep you from getting your period back. Try reducing or avoiding stimulants gradually, replacing them with calming herbal teas or nutrient-dense smoothies for sustained energy. You can also choose a decaf or half-caf options if you’re someone who loves their morning coffee! 

4. Identify How You Got Here: Self-reflection can help uncover behaviors or beliefs that contribute to HA. Here are some journaling prompts to explore your relationship with food, exercise, and body image:

• What beliefs do I hold about food, weight, or exercise?

  • Are there foods I avoid because of specific rules I set for myself?

  • Do I feel pressure to maintain a certain body weight or size? If so, why? 

  • How does my body feel when I rest or eat more freely? What feelings come up when I consider making changes?

5. Support Your Mental Health: Chronic stress affects the hypothalamus, so try incorporating relaxation techniques. Meditation, journaling, and deep breathing can lower cortisol and support hormone balance.

6. Sleep Well: Aim for 7-9 hours of restful sleep per night. Sleep plays a critical role in hormone regulation, so make it a priority.

7. Practice Patience and Kindness: Recovery from HA can take time. Regularly remind yourself that your body needs this time to restore its natural rhythm. Celebrate small victories along the way, like increasing calories or taking a rest day, and know that each step is a positive investment in your health and fertility.

Remember, your body wants to find its natural rhythm and prepare for a healthy pregnancy when the time is right. Taking steps to nourish and nurture it now can make all the difference in your fertility journey!!

If you’re interested in a personalized approach to recovery and fertility, I’m here to help. Reach out, and let’s create a plan that supports both your body and your dreams of conceiving. 💜