Let me paint the picture…
You’re in your late 20s or early 30s. 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 you’re finally ready to start trying for a baby.
You stop birth control only to find that your natural cycle isn’t returning. Or maybe you were never on birth control, but you’ve 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 for so many women, that’s just not the case.
Why Is Your Period Missing?
Missing periods, or amenorrhea, can happen for many reasons and often reflect an underlying imbalance in the body. Here are some common causes:
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Stress
Both physical and emotional stress can suppress the hormones that regulate your cycle. This includes stress from work, relationships, undereating, or excessive exercise. -
Hormonal Imbalances
Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt your menstrual cycle. These imbalances often affect ovulation and regularity. With hormone imbalances, I often see clients still having a cycle—but it’s usually very irregular or long. -
Low Body Weight or Low Body Fat
If body weight or body fat is too low, the body may “pause” reproductive functions, interpreting low energy availability as an unsafe environment for pregnancy. -
Medications
Some medications, including hormonal contraceptives, can disrupt or delay the return of natural cycles even after stopping them.
If you’re someone who does have a cycle but it’s very irregular, I encourage you to check out THIS blog post for next steps toward more predictable cycles.
If you haven’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 responsible for hormone regulation—reduces its production of gonadotropin-releasing hormone (GnRH). This leads to a drop in the hormones required for ovulation.
HA is often triggered by a combination of stressors, including:
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Under-eating or Low-Calorie Intake
When the body doesn’t have enough energy, it shifts away from reproductive functions. This often leads to low body fat percentage. -
Excessive Exercise
While movement is beneficial, too much can signal that it’s not a safe time for reproduction. -
Psychological Stress
Chronic stress increases cortisol, which can suppress reproductive hormone signaling. -
Some combination of the above
Diagnostic Criteria for HA
A diagnosis of HA is typically made when:
- No cycle for 3 months in someone who previously had regular cycles
OR - No cycle for 6 months in someone who previously had irregular cycles
- No other condition is found (normal prolactin and thyroid labs, no PCOS or pituitary issues, etc.)
7 Ways to Recover Your Period With Hypothalamic Amenorrhea
If you’re experiencing HA and want to restore your cycle, here are practical steps to start with:
1. Increase Your Caloric Intake
Fueling your body with enough energy is critical for recovery. Aim for balanced meals with protein, fat, and carbohydrates at each meal to signal safety and nourishment.
Whole foods like eggs, avocados, sweet potatoes, regular potatoes, and fatty fish are especially supportive. If you eat large volumes of fruits, vegetables, salads, or low-calorie foods, try swapping some of those for more calorie-dense options—like rice or potatoes instead of just roasted veggies, or full-fat milk instead of nut milks.
2. Reduce Exercise Intensity and Volume
HA often stems from excessive or high-intensity exercise. Transition to gentler movement like walking, yoga, or Pilates, and allow for more rest days. Your body needs energy availability to prioritize reproduction.
3. Reduce or Eliminate Stimulants
Caffeine, alcohol, and other stimulants can elevate cortisol and prolong HA. Try gradually reducing intake and replacing stimulants with calming herbal teas or nutrient-dense smoothies. Decaf or half-caf options can be helpful if coffee is part of your routine.
4. Identify How You Got Here
Self-reflection can uncover habits or beliefs contributing to HA. Consider journaling on these prompts:
- What beliefs do I hold about food, weight, or exercise?
- Are there foods I avoid due to rules I’ve created?
- Do I feel pressure to maintain a certain body size? Why?
- How does my body feel when I rest or eat more freely?
5. Support Your Mental Health
Chronic stress directly impacts the hypothalamus. Practices like meditation, journaling, deep breathing, and nervous-system regulation can lower cortisol and support hormone recovery.
6. Prioritize Sleep
Aim for 7–9 hours of quality sleep per night. Sleep is foundational for hormone regulation and recovery.
7. Practice Patience and Kindness
Recovery from HA takes time. Celebrate small wins—eating more, resting, choosing gentler movement. Each step is an investment in your health and fertility.
Your body wants to find its natural rhythm and prepare for a healthy pregnancy when the time is right. Nourishing and supporting it now can make all the difference in your fertility journey.
If you’re interested in a personalized approach to HA recovery and fertility support, I’m here to help.
Reach out, and let’s create a plan that supports both your body and your dreams of conceiving.
- Kylie
