The impact of HA on your fertility
Given hypothalamic amenorrhea is the absence of a menstrual cycle, naturally you’d expect the condition has a significant impact on your fertility and ability to fall pregnant too. During HA, your hypothalamus stops or slows the production of a key reproductive hormone, GnRH (gonadotropin-releasing hormone). GnRH directly impacts the production of other sex hormones including FSH (follicle stimulating hormone) and LH (luteinising hormone) which help eggs mature and release, as well as oestrogen. When these hormones are interrupted, your ability to ovulate and menstruate is too, which has flow on effects for your fertility, and your general health and wellbeing.
While your hypothalamus isn’t producing GnRH, and your ovulation and menstruation have stopped, you’re likely to experience infertility. The good news is, this infertility is most often temporary, and can be reversed when the root case of HA is addressed.
How does HA directly affect fertility?
As we’ve discussed, HA can cause complications when you’re trying to conceive, due to the lack of ovulation, menstruation and sex hormones being released. Without these processes occurring, your body cannot conceive a baby.
Additionally, if you’re underweight and suffering from low energy availability, your poor body fat reserves can’t support the growth of a little bub, meaning your ability to conceive is further impacted. You need enough body fat and energy availability to support fertility, so if you’re in a significant calorie deficit your chances of falling pregnant will decrease significantly.
Then we come to the stress side of things… Not only is emotional or physical stress a key contributor to HA, it can also be the direct result of the condition. The absence of your period and cycle is a huge stress on your body. If you’re not getting enough energy in your diet, or you’re exercising excessively, your body can easily become “stuck” in fight or flight mode. Essentially, it believes it needs to conserve energy as it can’t rely on when its next adequate meal will come along, so it begins pumping out stress hormones such as cortisol, and reducing energy usage on things like ovulation and menstruation. When you’re in this fight or flight response, the last thing your body is looking to do is support or conceive a child, as it simply doesn’t have access to enough energy to support you, let alone a second human developing! Evidence shows the more stressed you are before conceiving, the higher your risk of infertility, and the longer the time it takes to fall pregnant generally becomes.
For many people, during eating disorders and disordered behaviours, dietary fats are neglected due to their high energy density. But this is again a problem if you’re trying to conceive… Healthy fats are essential precursors for the normal production of sex hormones like oestrogen and progesterone. If you’re not eating enough in your diet, via foods like avocado, olive oil, oily fish, nuts and seeds, your body can’t produce adequate amounts of these hormones, which again results in the absence of ovulation and menstruation.
So your fertility and chances of conceiving are interrupted by so many different factors when you’re suffering from HA.
Can you improve your fertility?
As we mentioned, the good news is that you can restore your fertility when you recover from HA. Evidence shows that the sooner you recover, the more easily you’ll regain your period and fertility, while women who have suffered from HA for more than two years may find it more challenging or time-consuming to regain the ability to conceive a baby.
So if you’re ready to recover and committed to the process, there are several key pillars you need to address in order to optimise your fertility.
- Restoring body weight. While it’s one of the scariest parts of recovery for many people, you can’t hope to restore your fertility without returning to a healthy body weight. This involves gaining enough fat reserves to support the production of your sex hormones, and the development of a baby. In order to reach this healthy weight range, you’ll need to ensure you’re getting enough energy in your diet, and reducing stressors in your life – including excessive exercise patterns.
- Increasing your energy intake. This goes hand in hand with restoring your weight, using more regular or substantial food, snacks and drinks to increase your overall energy intake and allow your body to resume core functions including menstruation. Without adequate energy, your body attempts to conserve energy by pausing these functions, so it’s critical to help your body feel safe, and know that a reliable and consistent source of energy is guaranteed.
- Eat your carbs and fats! These are both essential for maintaining healthy hormone production and menstruation. Particularly when it comes to fats, if you’re not getting enough, you can’t expect to see your period return any time soon!
- Reduce exercise intensity and volume. Switch out your more intense workouts for gentle walks, yoga, or complete rest. High intensity exercise can wreak havoc on your hormones, and add stress to your body, making your recovery from HA more difficult and time consuming.
- Reduce stress where possible. Whether it’s emotional, physical or other, stress can increase your tendency to turn to disordered behaviours, or even cause you to lose your period.
- Address the underlying cause of HA. Whether it’s stress, inadequate energy, or excessive exercise (or a combination!) causing your HA, specifically addressing the issue is critical to recovery. Often, behavioural change will be required to ensure you don’t revert to damaging, disordered patterns, to allow your body to fully recover and restore itself (and your menstrual cycle along with it!). Remember, you won’t regain your period overnight, so it will take some time for your body to replenish all the nutrients and energy it has been deprived of, and to start to feel safe, energised and balanced before you can expect your cycle to start back up again.
So while HA undeniably has a significant and detrimental impact on your fertility, you can rest assured that if you’re willing to do the work, repair your relationship with food and your body, and commit to recovery from HA for good, you can restore your fertility and chances of conceiving.
Looking for some support and guidance to help you find food freedom, heal your relationship with food and your body, and regain your period and health for good, sign up for the waitlist to our next intake of Healing HA today – there are limited spots available, and you’ll be the first to know when doors open! Don’t miss out.
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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.