Coming off the pill eight months ago was an eye-opening decision, revealing the fact that my reproductive system had completely shut down. Years of food restriction, chronic stress, and over-exercising had their toll on my body, and I was now suffering from the consequences.
Celebrating your period might seem a bizarre concept. But, after seven tiresome months of attempting to balance my hormones and regain my cycle, I have begun to see my monthly bleed as a blessing rather than a curse. I take it as a sign that my body is well nourished and that my lifestyle is finally supporting my body, rather than depriving it of what it needs.
I am quite an expert in the reproductive system, having studied it in-depth whilst at university. However, until recently, I was clueless about my own menstrual cycle and hormones, never stopping to consider the impact my lifestyle choices were having on my reproductive health.
I had mistreated my body for years, restricting food intake, over-exercising and keeping my body in a perpetual state of stress. Over time I became seriously underweight, fatigued and developed severe irritable bowel disease (IBS). My body was in a constant state of stress that impacted every aspect of my life. I could not eat; I could not sleep; I could not even go to the loo.
The pill had become the perfect alibi, allowing me to blame it for some of my symptoms whilst being blissfully ignorant to the fact my reproductive system had, in fact, shut down.
Two years ago, I took back control of my life, teaching myself to prioritise my health and well-being rather than obsessing over my weight and how I believed my body should look. Slowly, I healed my relationship with food, removed any undue stress from my life and began to focus on my mental health.
Strangely, however, my IBS symptoms got worse. I constantly suffered from severe stomach pain, fatigue, dizzy spells and bloat. Nothing helped alleviate the pain, and I began to surrender to the thought that I would have to live with the symptoms for the rest of my life. That was until I came across a scientific article that suggested a high correlation between the severity of IBS and women taking the progesterone-only pill.
I had one of those “ah-ha” moments, you know when a light bulb goes off in your head, and suddenly everything makes sense? I had recently been transferred to a progesterone-only pill, so could this explain the deterioration in my IBS?
After some further digging into the literature, I was convinced that the pill was at the root cause of my severe symptoms and following a discussion with my doctor, I stopped taking it.
Incredibly, my severe IBS symptoms vanished in a matter of weeks and now only flare up when I am stressed or have eaten the wrong thing– for me, this is dairy and gluten. It was a bittersweet victory, as I was faced with a whole new dilemma – my period was nowhere to be seen.
After three indifferent months, I decided it was time to visit my doctor, who performed a blood test and internal scan before diagnosing me with hypothalamic amenorrhea (HA; otherwise known as functional hypothalamic amenorrhea or the female athlete’s triad).
I was alarmed to hear her say, “It might take a while for your period to come back naturally, so I’d recommend you go back on the pill to balance out your hormones”.
It is essential to explain; the pill does not regulate your periods or cure an underlying hormonal imbalance. Many women (including myself) can go years or even decades without addressing the root cause of their hormonal imbalance, which tends to resurface after coming off the pill.
After stating to my gynaecologist that I wanted to get to the root cause of my absent period rather than mask it with the pill, I decided to take things into my own hands and alter my diet and lifestyle to balance my hormones.
How I Balanced Out My Hormones And Regained My Period
Before I begin sharing my recovery from HA, I want to add a little disclaimer. The information provided below is from my own research and is for educational purposes only. It is not medical advice. If you are at all concerned about your reproductive health, ensure you seek advice from a medical professional.
If you have been diagnosed with HA, there are likely lifestyle changes you can make to rebalance your natural hormonal levels and regain your period. To some of you, it might be glaringly obvious, maybe you are on a highly restrictive diet or been hitting it too hard in the gym, or to others like me, it might require digging deeper. Ask yourself these questions:
- Am I undereating?
- Is my diet balanced?
- Am I over-exercising?
- Am I overly stressed?
Understanding what factors are putting undue stress on your body is key to finding the root cause of your hormone imbalance. It could be an accumulation of several of the above factors or it could be a large imbalance in just one factor.
Am I Undereating?
Even a small calorie deficit can have an impact on your menstrual cycle. Your body requires adequate nourishment to support your reproductive system, so a calorie deficit (i.e., imbalance in the calories in vs calories out), is one of the main causes of HA in young women. When there is poor energy availability, the body prioritises activities necessary for survival (i.e., basic cellular function) over less crucial functions (i.e., growth, body fat stores or reproduction). When this deficit is overcome, reproduction and thus menstruation should return to normal.
There is often the misconception that women suffering from HA have to be underweight. This is not the case. Initially, when we reduce our calorie intake below that required to support all of our body’s physiological requirements, we will lose weight. However, a long-term calorie deficit leads to physiological adaptions to conserve energy and promote survival, including a reduced metabolic rate, suppression of the thyroid, reproductive and growth hormone axis and reduced inflammatory response. Therefore, women may be weight stable and not excessively low in body mass or body fat levels, yet have impaired physiological functions. This is what happened to me.
I honestly thought I was eating enough and it was only after monitoring my food intake over several weeks, I realised that I was under-eating in respect to what my body was burning. In an attempt to alleviate my IBS symptoms, my diet had inadvertently become restrictive, with all high-FODMAP foods, gluten and dairy not on the menu. Although I was eating three big meals a day, they were not calorie-dense. My plates were extremely green and full of veggies, which although very nutritious, did not provide me with an adequate amount of energy. There truly is “too much of a good thing”.
Eat more. That is Easy.
Think again. To some of you the concept of chowing down more food might seem like nothing or maybe even a blissful idea, but to an eating disorder (ED) recoverer like me, this can seem a daunting task.
When I was diagnosed with HA my mind and body were the strongest they had ever been, but I soon realised my journey to find peace with food was not quite over and in those last few months, I knew I needed to let go of my control and learn to eat intuitively.
If you are struggling with an ED or other lifestyle changes yourself, please reach out to a professional or friend. Having support really helps keep you on track and remind you why you deserve to live your happiest, healthiest life (I’ve attached some helpful contacts for support in a drop-down at the bottom of this article).
With time, I learnt to listen carefully to what my body needed and provided it with the nourishment it required. I began eating an additional 1000kcal a day, placing my body in a calorie surplus, rather than a deficit, in an attempt to jump-start my reproductive system.
Yes, I put on some weight but that was OKAY and exactly what my body needed to rebuild and reboot my reproductive system. The positive effects were endless, I was the strongest, most productive and energised I had ever been, plus I suddenly had boobs, which was an added bonus!
Is My Diet Balanced?
It is not just about eating enough calories, it is also about eating the right things. What you eat has a huge impact on your hormones and thus the menstrual cycle. The “fertility diet”, emphasised by higher monounsaturated to trans-fat ratio, vegetable over animal protein, high-fat over low-fat dairy, a decreased glycaemic load, and an increased intake of iron and multivitamins, has been associated with lower rates of infertility due to ovulation disorders.
Therefore, in addition to ensuring you are eating enough food, making sure that you are also eating the right macro- and micronutrients is imperative to a healthy, balanced reproductive system.
When I had my ED, I feared calorie-dense foods and avoided them like the plague. Therefore, foods like avocado, nut butter, sweet potato, oil and processed foods were “off-limits”. It saddens me to look back and see the negative attitude I had towards food and I am proud of myself for having transformed my mindset. The truth is that foods like avocado and sweet potato are some of the most nutrient-dense foods in the world and therefore are vital to a healthy, balanced diet.
Avoiding calorific foods often means limiting the amount of fat in your diet. Getting enough healthy fats in your diet (think avocado, eggs, dark chocolate, nuts, chia seeds, extra virgin olive oil, coconut oil and full-fat yoghurt) is essential for hormone balance. Your sex hormones (estrogen, progesterone and testosterone) are made from cholesterol which is found in fat. Therefore, if you are following a low-fat your hormone production will suffer as you will not have the necessary components to make an adequate amount of hormones. Dietary fat is also essential for the absorption of fat-soluble vitamins (i.e., vitamin A, D, E and K), which, if deficient, can also be a contributing factor to hormonal imbalance.
When reflecting on my diet, I realised that although I had upped my daily food intake over the last few years, I had not mustered up the courage to introduce an adequate amount of fat. Therefore, the first step I took to restore my period was to begin adding an adequate amount of healthy fat (i.e., avocado, nuts, fatty fish, eggs, olive oil and chia seeds) to my diet, which also helped me increase my daily calorie intake.
Consuming a large quantity of sugar, including simple carbohydrates (i.e., bread, cakes, white rice) can also play havoc on your hormones. When we consume large quantities of sugar, our glucose levels spike which causes an increased production of insulin to process this glucose. In turn, this can lead to sky-high levels of reproductive hormones like estrogen and testosterone. Therefore, try cutting out simple sugars and replacing them with complex carbohydrates like whole grains and vegetables.
Am I Over-Exercising?
To help combat a calorie deficit, altering your exercise routine to focus on low-intensity exercise is advised. I do not agree with cutting out exercise completely, because I believe that the positive effect it has on your mind and body far outweighs any side-effects. However, by replacing high-intensity exercise (especially cardio) with low-impact exercises, such as Pilates, yoga or walking, you will decrease the amount of energy you are burning, whilst still combatting your stress levels.
During my recovery from HA, I refrained from undertaking any HIIT classes, running or cycling. I instead turned all my attention to improving my yoga and pilates practice. When my periods began to regulate again, I slowly began to incorporate some jogging and HIIT back into my workout routine (limited to 2-3 times a week), whilst ensuring my diet was supporting the extra activity.
Am I Overly Stressed?
Stress can wreak havoc on our hormones and is in fact one of the main causes of hormonal imbalance in women. External stress can come from a variety of sources, including excessive exercise, lack of sleep, drinking too much caffeine or alcohol and spending too much time on electronic devices.
Most of us cannot remove all stress from our lives but we can put things in place to minimise daily stressors we may encounter. Practicing mindfulness, getting enough sleep and creating a daily routine are just a few methods to help combat your stress levels.
A missing period is not something to be ignored as it means that your reproductive system is not working. It might seem convenient not getting your period – no cramps, bloating or fatigue. But the health repercussions from not menstruating are detrimental, increasing your chance of developing osteoporosis, cardiovascular disease and infertility.
HA is one of the reasons your period may have gone missing.
Every time we ovulate, our bodies presume we are trying for a baby. Pregnancy is one of the most energetically costly things we can put our bodies through and our bodies know that. Therefore, they monitor our energy availability and stress levels closely to determine whether ovulating this month would be in our best interest. If they decide that it isn’t, they will shut down your reproductive system to conserve energy.
My journey to recovery from hypothalamic amenorrhea was by no means straightforward and there were times where I thought all my hard work was for nothing. However, my months of perseverance and hard work paid off and along the way I learnt some valuable lessons, including what it truly means to be in-tune with your body. Now, when I get my period, I jump up with joy – reminding myself that although annoying, it is a sign of fertility and good health.
Luckily, through some basic lifestyle changes HA can be reversed and normal menstruation returned. By increasing your body’s energy availability and decreasing your internal stress levels you will begin to support your reproductive system, rather than deprive it.
The side effects of recovery?
- Increased energy levels
- Increased performance
- Better mood
- Increased metabolism
- Increased bone density
- Improved sleep
- Improved cognitive performance
Getting your period doesn’t seem as awful now, does it?
If you’d like to learn more about your menstrual cycle and HA then I’d highly recommend having a look at these books and websites. Don’t forget, knowledge is power. The greater understanding you have about your body, the more control you can have over your health and wellness. Read, read, read!
- No period – now what? – by Nicola J. Rinaldi.
This is a MUST READ for anyone suffering from HA. It covers everything from the science behind HA, diagnosis and treatment, all in one book.
- In the Flo – by Alisa Vitti
I hope you found this article helpful. If you have any questions, please buzz me a message or leave a comment below. If you haven’t already, please sign up for my newsletter to get your hands on my FREE GUIDE to a Healthy Menstrual Cycle.
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