Hypothalamic Amenorrhea

You might have heard the term, heck, you might have been diagnosed with it and your still confused about what it actually means.  The condition Hypothalamic Amenorrhea is fast becoming a major health issue for women near and far.  Hypothalamic Amenorrhea (HA) is a result of the hypothalamus shutting shop on your hormones.  For whatever reason, it decides it isn’t going to tell the pituitary the right message for ovulation to occur meaning you don’t ripen and release a follicle each month for ovulation and therefore you don’t get a period either (because let’s remember that a period will always follow ovulation. Always!) So if you are having a regular period, it can be almost guaranteed you’re ovulating, it’s just a matter of when that might be in your cycle.

Why does HA happen?

Most commonly it is a result of weight loss, drug use, use of medications like the pill, excessive exercise and of course STRESS – but back up the shopping trolley for a second; ALL these factors are simply stress in one form or another that the body can’t handle. In my experience, in almost all cases of HA there is a strong emotional element that very often not even the patient is aware of.  Some type of childhood trauma, even a long term belief we may have running in our sub-conscious that is simply getting in the way. Your body is clever you know, it can only deal with so much, and in times when it all gets too much it simply switches off the buttons to those organs you can live without. In any case, HA is certainly a treatable condition. How long healing takes is the biggest uncertainty.

I love the way Chinese Medicine (TCM) comes along to explain HA.  There isn’t actually a singular diagnosis from a TCM viewpoint but rather several reasons as to how HA results.  The most common and my most favourite is due to what is known as Liver Qi Stagnation – that is, when the energy of the liver becomes ‘stuck.’  This is most commonly a result of pent up emotions, prolonged frustration, irritability or depression.  This may also be commonly seen after long term breast feeding or the use of the pill (or other synthetic hormones like those in the mirena, implanon or nuva ring.   When the liver becomes stagnant, it can weaken the digestive system (spleen and stomach) also.  In a nut shell, everything seizes up.  I absolutely love how hundreds of years of observation lead to an accurate diagnosis based on TCM theory. Because after all, in HA the body literally has become stuck, we know the signals that fire off ovulation just aren’t being triggered.

It’s important to point out that women with HA are generally very deficient.  Their gut health is almost always compromised meaning they can’t adequately absorb enough nutrients from food and drink to replenish their hormones.  This is truly the crux of the issue and starting here is an absolute must.

How is HA treated?

There is no actual ‘treatment’ for HA with western medicine.  The pill is used to ‘blanket’ the symptoms and in theory protect a women’s hormones.  Sadly this is all too good to be true since the long term implications of the pill include severely robbing the gut of it’s vital flora and diminishing the vitamin and mineral stores.  Women who have HA and would like to conceive are most likely prescribed drugs like clomid to induce ovulation.

There’s a massive problem with this picture.  None of the above actually addresses the crux of the greater issue.  Why is the Hypothalamus playing games?  What is the body trying to tell you?  This is where true treatment begins, when we can really sink our teeth into the actual problem rather than skirting around the outside treating symptoms.

The gut health is the first place any woman who is experiencing hormone issues must start.  There’s no point in loading up at your local health food shop with a truckload of wonderful supplements if you can’t assimilate them.  If you want more on gut health, head here.

Secondly we need to replenish our vitamin and mineral stores and pep the body back up to where it wants to be, to once again have your hormones flourishing.  This may mean seeking guidance from your health professional alongside a whole-food diet as I outline in Well & Good.  Equally there is so much info on the site here about how you can go about doing that.

Managing stress is an important piece of the puzzle.  It’s one thing to know you are stressed, it is another to actually do something about it.  Hate your job?  Girlfriend it’s time for a change. Holding onto toxic friendships? It’s time to break up.  Stress can be a swag of things from eating really crappy food right through to period pain.  Your body doesn’t know the difference, stress is stress in any shape or size.

And finally, those emotions.  They are the hardest to tame but the centre of our universe.  They are what infiltrate our thoughts, our believes and our mindsets.  Very often, we don’t even know the trigger, let alone how to treat it.  As a second part to this blog, I’m going to dig into the topic of emotions.  So many of you are begging for some guidance. You’re telling me this is the most difficult part of it all and I not only hear you but I completely agree.  If you want to action it right now, maybe get a hold of Debunking Stress.  But I will be back with more about managing emotions in the weeks to come. Emotions can be so tricky to get a grasp on but once you do, it will be the game changer.

Know that like all hormone conditions, HA is treatable.  It takes time and diligent care.  But as you begin to implement change into your life, you’ll begin to see evidence of your body waking up to show you that you are most certainly on the right track.  It is a matter of being patient, being kind to yourself and observing your body, setting yourself up to thrive.

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  • March 16, 2015 By Anna 7:48 pm

    Hi Nat, great article. Do you think this is something that also effect males? As in issues with the pituitary stopping production of LH, FSH and testosterone?
    If so would you think the same solutions apply as u outlined above?
    Thanks heaps 🙂

  • March 18, 2015 By Laetitia 1:32 am

    Hi Nat,

    I’ve been reading your blog for some time now and I’ve always enjoyed your articles. Coincidence today: you finally publish what I always wanted to read about HA the very day I get my period after 3 years without… time to celebrate!
    Thanks for helping so many women out there.

    Greetings from France! Lx

  • March 20, 2015 By Jess 3:16 pm

    Hi Nat!

    I am so glad you decided to shed light on this topic! I had HA after coming off the pill and my traditional doctors told me “not to worry.” After 13 months without it, and going gluten/dairy/alcohol free for 6 weeks and seeing a NST therapist , my period returned! I am now very careful with my exercise regime and I can tell when I am stressing in everyday life, as my period will disappear. Its all about listening to our bodies!

    Keep up the good work,

    Much love xx Jess

  • March 20, 2015 By Cassie 4:16 pm

    Thanks Nat,

    Wow! Very interesting.
    I believe I had an episode of HA during a particularly stressful time when I was 21.
    I had just come off the pill (after being diagnosed & treated for CIN I) and experiencing the loss of my niece 36 hours after she was born.
    I wasn’t ovulating/bleeding (for ~6months despite natural treatments from a naturopath). I was sent for blood tests that showed my Oestrogen level was <100.
    Everything you mentioned here (the pill, stress and emotions) were involved.
    I ended up going off everything (even natural supplements) and gave my body time to work itself out, took a month or so to start having cycles again.
    Totally agree with Jess; we need to listen to our bodies, be gentle and kind.

  • March 20, 2015 By Elise 5:19 pm

    Hi Nat,
    Thank you so much for this post. It has nearly been a year since I have come off the pill and I still have not gotten a period back. I went to the doctors and they thought it was PCOS and put me on metformin as I have cysts on my ovaries but blood tests confirmed it wasn’t PCOS. I have now come off Metformin.

    I have tried eating right and improving gut health but this really in turn stressed me as well (being a control freak). Do you think my periods will return in time or can it be the case that they never return? Doctors have now recommended Clomid.
    Your help is so appreciated!

    • June 4, 2015 By Hannah 10:45 pm

      Hi Elise,

      I have not had a period for 12 years, have tried to reduce stress, exercise and put on weight. I am now at a point I would like to try anything and am therefore interested in giving climid a go, however i am having difficulty finding a doctor or specialist in australia who will support this in the absence of not wanting to conceive. I am interested in any research on the usefulness of clomid to induce normal menstruation or any practitioners who believe this is worth a try? Any other thoughts, tips, info appreciated – anyone?!

      Thanks so much, hannah

  • March 20, 2015 By Mia 7:33 pm

    Man you’re awesome – I love how succinctly you can explain a condition and that at the same time it seems I am just talk to one of my girlfriends. The world needs more Kringo’s.

  • April 1, 2015 By Lee 11:42 am

    Hi Nat,

    I am currently studying overseas (and about to go traveling), and was wondering what type of probiotic strain you would recommend getting if you have hypothalamic amenorrhea? I read your post on probiotics and the various types of strains and was wondering what type I should particularly try and get my hands on (that is if I can find one without needing refrigeration). I saw a naturopath not long ago who told me I have slight chronic fatigue (if that makes any difference in deciding). I am also well aware that I am most likely extremely deficient in vitamins, as well as my hormones being out of whack, but being away I am just taking Vitamin D, (and vitamin C here and there) as I’m not getting a lot of sunshine where I am at the moment. I plan on seeing someone a qualified in this field when I return to Australia, but in the interim I’m not sure if you can offer any other recommendations whilst being away?

    Kind regards

  • April 23, 2015 By Sally 4:33 am

    Fascinating article! Thank you for explaining in such detail. Sharing with my private FB group.

  • Trackback: My experience of overcoming Hypothalamic Amenorrhea (loss of periods) and becoming pregnant - Wholeheartedly Healthy

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