My journey in hypothalamic amenorrhea recovery.
On February 19th, 2022, I made a decision that changed my life. I decided to stop running.
I had not had my period for 3 years. After 6 months of not having a period, I was concerned. I scheduled an appointment with my primary care physician. She took some labs, did an evaluation, and ended up telling me I was healthy. She said that when I stop running it will probably come back and if it didn’t, we could re-evaluate. The issue was, I never stopped running. At the end of 2021, I sustained a stress fracture to my femur. When I started going to physical therapy for the injury, my physical therapist asked me if I had my period. My answer was no. I realized I might have an issue.
I started researching loss of period in female athletes. I learned how important it is to have a menstrual cycle. Menstruation supports so much more than just reproductive health. One thing that took me by surprise was bone health. Not having a period can actually lead to low bone density. It hit me; this is why my PT asked me about my period. The gravity of my situation was sinking in. What damage did I cause to my body by continuing to train without a period for 3 years? I decided that I would do whatever it takes to get my period back. I read about a condition called hypothalamic amenorrhea or HA. HA is dysfunction of the hypothalamus, the area of the brain in charge of regulating the hormones related to reproduction, which leads to amenorrhea or lack of period. ***I am not a medical professional. This definition was formed from my own understanding.***
The road to recovery from HA seemed relatively simple, manage stress, decrease exercise, and eat more food. I thought I could handle it on my own, still too untrusting of medical professionals because of the misguidance I had received from my physician. I dropped my mileage and took up weight training. When it came to eating more food, I was at a loss. I had no idea how to increase my overall nutrition. I was scared about what would happen to my body. This was when I realized I was going to need more help.
As a type A woman, who never likes to admit that she needs help with anything, asking for help was not easy. I reached out to a dietitian who specializes in endurance nutrition and eating disorders. We enlisted a new primary care physician and an OB GYN to help get an initial diagnosis for HA.
Before working with a dietitian, I thought my diet was healthy. I ate lots of fruits and vegetables, I focused on getting enough protein and I limited foods that had been labeled “bad” by diet culture. To my surprise, one of my dietitian’s first instructions was to eat less vegetables. I was filling up so much on fibrous veggies that there was no room in my gut for the nutrient dense foods that were necessary for recovery. I learned that there is no morality tied to food. Food is not “good” or “bad”. It is food. No matter what that food is, it provides nutrients to my body.
Each week, I identified a new food rule to break. For me, food rules are restrictions on certain foods like pizza, ice cream, pasta, bagels, donuts, etc. These foods are nutrient dense and proved as a fun and easy way to get in that extra nutrition that my body craved. Working with a dietitian was eye-opening for me. I was massively missing the mark for my overall nutrition before working with her. The diet that I thought was healthy was actually extremely restrictive and probably played a massive part in the loss of my menstrual cycle.
My dietitian recommended a book to me called No Period. Now What? written by Dr. Nicola Rinaldi. Reading this book made me realize that if I really wanted to get my period back, I would not be able to do so while running so I stopped.
Running was the main way that I coped with the stress in my life. When I stopped running, all of the things that I had been running from, family issues, past trauma, work stress, everything hit me at once. I had to find other ways to manage it. I started reaching out to my friends and family. I went from the friend who was never down for last minute plans, to the friend who would say yes to anything. I built a network of people around myself. I learned how to talk about my emotions. I found that writing down the things in my life that were giving me stress helped me to better process them, so I started journaling. With the extra time that I had in the mornings, I started a gratitude practice. I realized that there were so many other things in my life that gave me peace outside of running.
Social media was not serving me. Many of the accounts that I followed were spewing “diet culture” nonsense and were a constant reminder of the inner dialogue that I was trying to muffle. I unfollowed any account that was not serving me. I started to follow accounts of other women who had recovered from HA and accounts that celebrated the female body.
The more I focused on recovery, the more positive changes I noticed. My energy levels spiked. I started to feel emotions more deeply. I was more present in my life. The space in my head that had been taken by training and food was now free. I dedicated myself to finding new hobbies and growing relationships with people. My body began to heal. My hair grew thicker and my nails stronger. For the first time in a while, my body had an abundance of nutrients and she was using it. My body was working so hard for me. I grew a new appreciation for her, for all of the functions that she performed, for how she kept fighting for me, even when I was mistreating her. I vowed to never mistreat her again.
In October of 2022, I had my first period in 3 years. I was ecstatic. It felt like going through puberty for a second time. I felt a new sense of womanhood. I slowly started running again. I was afraid I had lost my fitness but was pleasantly surprised. I felt stronger than ever before.
I am now completely back to running with an extra emphasis on weight training for bone health. I am training for my longest distance, a 50k in September. I feel connected to my body. I take rest days often; both planned and unplanned, depending on how I feel my body is responding to training. I put extra emphasis on recovery, prioritizing sleep and stress management. I fuel with intention and never run or workout without a snack or a meal. Whenever I feel myself slipping into my old mindset of restriction or over-work, I remind myself of the vow that I made to my body and the amazing comeback that she made for me.