What is hypothalamic amenorrhea (HA)?  It is a condition in which you are not menstruating for several months, correlated to your hypothalamus, a section in the brain which is next to the pituitary gland. The hypothalamus is the main controller for our hormones, meaning it controls the hormones our ovaries produce, the hormones our thyroid produces, and the hormones our adrenals produce. This means that out of those three sections, is struggling, hence some people may have adrenal fatigue, or thyroid problems, or ovarie issues, all in which can affect the hormones the hypothalamus produces, triggering HA. Yet, its not the fact that one of those organs are not working, it is the actual hypothalamus that is not producing those hormones, supplying the organ that requires it. The organ is not “broken” per se, it is that our bodies are suffering someway or somehow, having our hypothalamus send signals to these body parts in saying not to produce x, y, or z hormone. It is important to note that not all women who are missing their period are suffering with HA. There are several reasons for a missing period such as PCOS, obesity, a chronic disease such as diabetes or celiac, and more.
Now, what can cause HA? A series of issues such as eating disorders (low body weight, malnutrition), female athlete triad (over exercising or low body fat%), stress, a deficiency of leptin or some other medical conditions. All of these conditions put some sort of “stress” on the body, hence the body’s initial reaction, when it feels like it is under too much pressure, and potentially in danger, is to stop a bodily function in order to preserve energy to survive. There are four types of stressors: mental and emotional stress, physical stress in the forms of wearing out the body, and lastly a secondary form of physical stress in which affects our body’s circadian rhythm. For those who have never heard of circadian rhythm, it is the natural process that our bodies go through that regulates our sleep and waking cycle, our body temperature, and the cycles in which our hormones are secreted.
Symptoms of amenorrhea include frequent headaches, iron deficiency, abnormally low blood pressure, hair loss, weak nails, vision problems, acne, lack of energy or unbalanced hormone levels.
Losing one’s period should never be taken lightly, for it has a list of side effects that can occur. For instance, due to the lack of estrogen in the body, one can develop premenopausal symptoms at an early age such as night sweats, lack of sleep, and moodiness. Conversely, a greater danger that can occur is the loss of bone density. Estrogen is essential in maintaining healthy levels of calcium in the bones, and when estrogen is absent, bones begin to degrade, losing the calcium in them, despite how much vitamin D, calcium, magnesium, and all the other essential vitamins and minerals that are required for bone health the individual may be eating.
So what can someone do when they lose their period?
Firstly, try and pin point the main reason why. Are you under eating? Are you underweight or suffering from an eating disorder? Are you over exercising? Do you have a nutrient deficiency? Have you developed a chronic disease? Are you under a lot of stress? It is always recommended to get a blood test first to rule out any nutrient deficiencies, illnesses, disorders, etc. before tackling on more tangible things that one may be able to control a little more.
If you are under eating, the best way is to start eating more, yet some people struggle with this, which in this case it is always recommended to go see a nutritionist or a dietician. Conversely, when it comes to over training, there is a fine line between managing the issue and making the individual more stressed out. Many tend to recommend cutting exercise out all together in order to resume menses, but is that really the answer when we know that individuals suffering with this will become even more stressed, anxious, and neurotic over the lack of movement? Same thing goes with those suffering from eating disorders. Is it really the best approach to force feed them with food that will not benefit them nutritionally and confine them to a bed as well as not help them work through specific challenges?
Coming from a history with an eating disorder, I know it definitely did not help me, and in fact, had me relapse one too many times. My body was in a constant state of inflammation due the stress levels I was experiencing, hence did not help with my gut issues, my hormone levels, my energy levels, and so forth.
The best solution for this is, indeed, to cut down on the toxic behaviour, yet give the individual some room to still feel comfortable with the process in restraining themselves from what is stopping their period.  So, instead of cutting exercise out completely, advise the individual to exercise half as much or change the type of activity they are doing. High intensity interval training, cardio, cross fit, or anything along those lines should be eliminated or decreased, and alternated with forms of strength training, yoga, light cardio, pilates, and so forth. These forms of exercise are less strenuous on the body, and might even be beneficial for the individual in building bone density.
If eating was a problem, identify their caloric needs and try to fit in foods that they may enjoy, rather than not, and slowly increase from there, all the while allowing them to still move to a certain degree so the feeling of fullness and discomfort does not over power them. They key to both of these tactics is to encourage sufferers in hopes of seeing improvements in their energy levels, blood work, and the lessening of some symptoms.
Opt for a more whole foods diet composed of dark leafy greens, lots of fruit, vegetables, whole grains, nuts, seeds and legumes, all in which are rich in vitamins and minerals. Focus on ingesting good sources of omega-3 fatty acids in particular, for fat is an essential macronutrient for women’s overall health. If there are any nutritional deficiencies that may be hindering one’s flow in resuming, is it recommended to reach for calcium, magnesium, vitamin D3, vitamin K2, and boron. This is to preserve one’s bone health.
As for natural remedies, sadly, there are none, yet there are some medicinal herbs that can aid balancing out one’s hormone levels, all the while in following the necessary protocol in recovering from their amenorrhea.
Chaste tree, or also known as vitex has high prolactin levels which may help the pituitary gland’s function by reducing overall prolactin levels. Individuals who are producing too much will show signs of H for it inhibits the GnRH and gonadotrophin, as well as other hormone to secrete from the pituitary gland, hence vitex will counter act that and reduce it.
For herbs that have estrogen-like effects, black cohosh and licorice are some that can help stimulate our body in producing its own. Lady’s mantle and vervain do the same and have been recognized in help starting one’s flow again. Lastly, kelp and oatstraw are others for they are rich in minerals and may even reduce stress, which can promote a healthier thyroid. Remember to always consult a medical practitioner before starting any of these for they are potent and may interact with other forms of medication.
Recovering from HA is possible, despite the years one has suffered with it, but the sooner one acknowledges the issue, the faster ones menses will come back.