What’s the best diet for healing HA?
Hypothalamic amenorrhea is mostly caused by low energy availability, often due to undereating, overexercising, excessive stress, or a combination of all of the above. Given a regular menstrual cycle is an indicator of good health, as well as a crucial body process you want to maintain, for those suffering with HA or an absent period, recovery often involves changing your eating (and exercise) habits and patterns, to support the return of a regular cycle.
So what’s the best way to achieve this? What diet should you follow to help you recover your period as efficiently and effectively as possible? What way of eating should you adopt to ensure your body returns to its optimal function, and restores your menstrual cycle?
We’re so glad you asked…
The best diet is NO diet.
So much of the time, this state of low energy availability which leads to HA is the result of under-fuelling your body, avoiding or fearing foods or entire food groups, and simply not providing your body with the energy it needs to function and support your body’s natural processes.
And often, it’s diet culture which is at least partly to blame. Diet culture instils a fear of certain foods and eating behaviours in us. It tells us to aim to eat less, take up less space. It tells us our worth is determined by the shape and size of our body.
So guess what? The best way to address HA is to address the underlying causes… Including diet culture!
This means there’s no “best diet” to follow when healing HA. One of the most important parts of recovery is actually healing your relationship with food and your body, and in order to do so you actually need to confront and work through all the fears, food rules, and restrictive behaviours you’ve learned over long periods of time. This means “undoing” or unlearning all the diet rules you’ve gradually subjected yourself to, and giving yourself unconditional permission to eat any and all foods, as you please. And in essence, that is the exact opposite of any diet.
So perhaps the “best diet” for healing HA is the “anti-diet”, or the absence of any diet rules or restrictions, and the unconditional permission to eat any and all foods.
Your macro split may look a little different…
When you’re in recovery, your focus should primarily be on how much energy you’re consuming. In saying this, if you’ve previously aimed to get a large portion of your energy intake from protein sources, and far less from fats and carbs, you’ll need to shift this mindset. Instead of “protein everything”, try to prioritise carbohydrates and add in plenty of fats. Essentially, you want around 50% of your energy intake to come from carbs, 30-35% from fats, and the remainder from protein sources.
You can also add in “extras” to help you ensure you’re providing your body with the energy it needs to heal and repair after long periods of neglect and deprivation.
Focus on getting enough food into your body, and feel the difference it makes. Be sure to include a wide variety of foods from all key food groups. While your macros matter in recovery, by no means do you need to count them or aim for absolute perfection each and every day. Significantly increase your carbohydrate intake, add in some fats, and reintroduce those “soul foods” you’ve feared and restricted for so long, and you’ll be headed in the right direction!
Eat your fats.
If diet culture has you believing fat makes you fat, or low-fat is the way to go, it’s time to change that narrative. Your body needs fat to function and produce hormones, so particularly for anyone suffering with HA, eating enough fat is paramount to your recovery.
Not only do fats help you meet your daily energy requirements, but they’re also critical for supporting a healthy menstrual cycle, and maintaining the production of your reproductive hormones – which again play a key role in regaining your period.
If you’re opting for low-fat varieties of yoghurt, milk, cheese etc, make the simple switch to the full-fat alternatives. Or, focus on including more healthy fats in your daily diet, including nut butters, oily fish like salmon and mackerel, olive oil, avocados, nuts and seeds.
Carbs are your new best friend.
More recently, low-carb diets have been the go-to, alongside the low-sugar trend. Diets like keto or paleo allow for an insufficient carbohydrate intake, which again wreaks havoc on your hormones, stress levels, and menstrual cycle.
Restricting your carbohydrate intake can send your hormones entirely out of whack, and even result in low-energy availability and an absent period. Your body fundamentally needs carbs – they’re your brain’s preferred source of energy – so denying it carbohydrates can send your body into a state of extreme stress, and often even into survival mode. This signals to your hypothalamus that it’s time to conserve energy for the “dangerous situation” it’s currently in, causing it to shut down functions like menstruation and your reproductive functions.
So reintroduce carbs, plentifully. Your body doesn’t care if you’re getting carbs from bread, rice, potatoes, beans, quinoa… It just needs carbs, and the energy carbs provide. Consider this your invitation to enjoy all the carbs!
Don’t forget the calcium.
Hypothalamic amenorrhea can wreak havoc on your bone health and density, thanks to the interruptions to your menstrual cycle. Your sex hormone, oestrogen, plays a key role in bone strength, repair and health, and when your cycle is absent, your oestrogen levels are directly affected. So naturally, this impacts your bones too.
In recovery, it’s a good idea to consider your calcium intake, in order to support the repair and health of your bones! Try including some dairy foods, such as yoghurt, cheese and milk (the fats are back!) or fortified dairy alternatives, and ensure you’re getting enough sun exposure to maintain your Vitamin D levels. Supplements of these two nutrients may be useful in supporting bone repair and health, under the guidance of a health professional.
Adequate energy intake is the only “diet” you need to worry about.
The bottom line is this: you need to focus on eating enough right now. In recovery, it’s recommended you eat at least 2500 calories per day. And yes, that applies even if you’re resting completely and doing no exercise whatsoever. Your body needs to be in an energy surplus in order to heal, recover, and restore functions such as menstruation.
It doesn’t so much matter what you eat to achieve this target each day, it more so matters that you do eat enough to achieve this goal.
And remember, this is the minimum amount you need! If you’re still hungry, have an active job, or are exercising, go ahead and eat more! Listen to your body, and fuel it with whatever it needs, whenever it needs it.
The key takeaway: nourish your body, and work on your relationship with food and yourself! A fraught relationship with food only adds to your existing stressed state, further increasing your risk of developing hypothalamic amenorrhea. There may not be a “quick fix” diet to help you recover, but investing the time and effort into healing your relationship with food and your body is your one-way ticket to recovering your period, and your health, for good.
Need some support working through your food fears and rules, and improving your relationship with food? Aiming to recover your period and your health? Join us today for our current intake of Healing HA, for all the tools, encouragement and strategies you need to recover for good!
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Hi future friends, I’m Sarah King, an Accredited Exercise Physiologist and health coach.
Science, not trends is the foundation of my approach. By nourishing the body and mind with scientific facts we can build foundations for a life of realness, not just wellness.