4 Things Hypothalamic Amenorrhea Taught Me
I’ve always been into health and fitness and thought they were one in the same. I exercised most days of the week and ate what I thought was a healthy diet for me, while maintaining a fairly low body weight. I was into running long distance races like half- marathons, marathons and trail races and trained to get faster. I liked pushing my body to see how far I could run or how fast I could go. I also strength trained, took spin classes, swam, did boot camps and the occasional yoga class for cross training. I thought my fitness level made me healthy and frankly was oblivious to all the symptoms that told a different story.
After ending a long-term relationship I decided to stop taking the birth control pill. I’d heard it was bad for your health and depleted certain nutrients such as your B vitamins and zinc. My period stopped as soon as I stopped putting those artificial hormones into my body. My training also increased with the end of that relationship as I had more time to focus on it. A year later I was the fittest and fastest I’d ever been but still without a period. So I went to see the doctor, who took some blood tests and did an ultrasound. I was told at the young age of 26 that I was in early menopause. The doctor also informed me that, “this happens sometimes” and I’d have to take synthetic estrogen for the rest of my life.
I had always wanted kids, so you can imagine how devastating this was for me. After a good cry in my car and a talk with my mom on the phone, I booked an appointment with a Naturopath in the city to get a second opinion. This is when I learned about the female athlete triad, adrenal fatigue and hypothalamic amenorrhea.
Hypothalamic amenorrhea is when an established menstrual cycle ceases and is absent for 3 or more months. Although common in female athletes, hypothalamic amenorrhea is not normal. I had actually known about amenorrhea, as I had been diagnosed with it when I was really struggling with anorexia about 8 years previously. At that time, the doctors only solution was to put me on the birth control pill. It worked and brought my period back, but didn’t fix the underlying problem. At the same time, we’d just moved and I had started struggling with binge eating. I was also unable to workout near as much, as I’d hurt my back and knee cliff jumping. This lead to weight gain, which I know was another factor in why I started menstruating again.
The female athlete triad results from three linked issues. These include menstrual disturbances/amenorrhea, an energy deficit with or without disordered eating and bone loss/osteoporosis. I had the amenorrhea and disordered eating, as I’d been struggling with a cycle of restriction and binge eating for years and we just assumed with my history that I had some bone loss as well.
This journey has taught me 4 important things that I wish all women knew:
Exercise is a stress on the body and more isn’t always better.
When we exercise for long periods of time, like running for an hour or more, or do high-intensity interval style workouts multiple times per week, it increases the stress hormone cortisol. If we continue to push long enough and also have other stressors in our lives like; digestive issues, lack of sleep, relationship issues, blood sugar imbalances and work related stress, we end up being in a chronic sympathetic state also known as the fight or flight response. This means our body is constantly producing cortisol to deal with theses stressors. Over time the body can’t keep up and starts to steal from our sex hormones to produce cortisol, which is known as the pregnenolone steal. You need to find the right amount of exercise for your body and don’t be afraid to do more gentle types, like walking outside or yoga, when life is stressful.
You need to eat fat and you need to eat enough food.
Fats, specifically cholesterol and saturated fats are the precursors for our sex hormones (1). I was eating a low fat diet, which made it hard for my body to produce hormones. I was also under eating for my activity level, which puts the body in that sympathetic state I talked about in point #1 (2,3). When we don’t eat enough our bodies think we’re entering a famine. They slow down our metabolism to conserve energy for life sustaining needs. Reproduction is not important in this state and amenorrhea often occurs. Nourishing my body with satiating fats and enough food has given me the building blocks and energy needed to bring my hormones back into balance.
Health and fitness are not the same thing.
To get fit like an Olympian or Crossfit athlete, you have to train a lot. As you learned in reason #1 there are consequences to exercising or training this much (4). Having proper hormonal balance not only affects your fertility but it also affects your bone health, cardiovascular health, mood, weight and digestive function. Being fertile even if you don’t want children is the ultimate sign of health and vitality. As an example, your digestion becomes impaired when you’re in a chronic sympathetic state, which leads to nutrient deficiencies like amino acids. Amino acids are found in protein and are the building blocks to important feel good neurotransmitters like serotonin and Gaba. Therefore digestive issues can lead to depression. This domino affect continues as other body systems become affected from the excess stress, including the thyroid. This can lead to issues with mood and weight, cause constipation, hair loss and fatigue.
Being skinny doesn’t make me feel sexy, having hormones to support my libido does.
When I gained a bit of body fat and curves, worked on supporting adrenal health and balancing my hormones, my sex drive reappeared too. For most of my teenage and young adult years it was MIA. I began to feel like a woman when my hormones returned and this made me feel sexy. I desired intimacy with my partner and this made me feel sexy, not being “skinny.” When I was “skinny,” I could have cared less about intimacy. I also had to learn to love my body as it was and change my idea of what my body was supposed to look like. I focused on self-love and improved my body image, which made me feel radically sexy with my newfound curves.
Truly understanding how our bodies work and focusing on health can help women become empowered in their bodies. When you’re empowered, its easier to make choices that support your health long term.