What’s happening to your hormones during Hypothalamic Amenorrhea?

Hypothalamic amenorrhea (HA) occurs as a result of your body being under-nourished, or not getting the energy it needs to function optimally. If you’re under-eating and/or over-exercising, your body doesn’t have the energy it needs to support the many bodily functions happening 24/7 – many of which you’re probably not even aware of!

So, naturally, your body looks for ways it can conserve energy, and save the minimal fuel it is receiving for life-saving processes like breathing.

One of these ways is down regulating hormone production. By reducing the production of hormones, it saves some energy to go towards other things. But what exactly is happening to your hormones, and what impact does this have on your overall health?

Monique Cormack, APD, is an expert on hormonal health, and says HA results in your brain ceasing its communication with your ovaries.

“During HA, your reproductive hormones are basically taking a little (or a long!) nap,” she explains.

Given the hormones you need to be producing to maintain a regular menstrual cycle are produced in your brain and ovaries, when your brain stops talking to your ovaries, this means your ovaries can no longer receive hormonal messages to trigger ovulation.

“So, your ovaries go on hiatus and stop ovulating, and you stop getting a period,” Monique explains.

The reduced production of reproductive hormones means HA causes oestrogen deficiency, along with the loss of a menstrual period, in premenopausal women. Given what we know about the importance of oestrogen for maintaining bone health, reproductive health, cardiovascular and psychological health, this can be a very real concern.

You can expect short-term side effects of hair thinning or loss, low libido, vaginal dryness, low energy, and other not-so-fun consequences.

But what about the long-term implications?

“It’s important to understand that ovulating is not just about fertility and getting pregnant. A regular menstrual cycle/regular ovulation is a marker of good health during your reproductive years,” Monique says.

“The process of ovulating and menstruating involves the production of important hormones like oestrogen, which not only affect our cycle, but also your cardiovascular system and bone health. A lack of these hormones can also affect things like your mood, sleep, digestion and body temperature,” she explains.

The low oestrogen levels can impair healthy bone growth, meaning your bone density can be negatively affected.

“This is why bone strength declines during menopause, and fracture risk increases! If you develop lower oestrogen levels earlier in life because of HA, then your bone strength will decline earlier,” Monique adds.

What about the impact of these hormonal changes on your fertility?

“If you’re not supporting your reproductive hormones and ovulating regularly, it can be very difficult to fall pregnant. If you do not ovulate, you can’t conceive naturally,” Monique says.

“Some forms of assisted reproduction like ovulation induction medications may not even work at all if your hormone levels are too low, because you simply won’t respond to the stimulation… Think about the future too; you need to be able to support baby’s growth and development all through pregnancy as well,” she adds.

If your body doesn’t have enough energy to meet its own basic needs to function fully, how can you expect it to support the growth of new life? It’s a big stress on the body, and an additional energy requirement you need to meet.

What can you do to support hormone production?

Don’t panic, all hope is not lost… There are things you can do to support hormonal health and repair during recovery. One of the key strategies is ensuring you’re eating enough energy – and especially making sure you’re getting enough fats and carbs into your diet! These nutrients play a critical role in hormone production.

“Although carbs get such a bad rap, we actually need carbohydrates to function and this is especially true for our hormones,” Monique shares.

“Carbohydrates are the preferred energy source for our brain. If you deprive your body of carbs, you may notice an effect on your mental health. This deprivation can also affect your hormone health, as the brain is the central axis for hormone production and regulation in the body,” she explains.

Fats also play an essential role in hormone health, so much so that they are actually required to enable your body to physically produce your reproductive hormones. So if you’re not eating enough fats, your body simply can’t produce the hormones you need for good health.

“Fats provide us with specific essential nutrients (like fat-soluble vitamins A, E and D, plus omega-3 fatty acids). Finally, fats simply contribute to getting in enough energy each day to signal to our body that we have enough fuel in the tank to keep on making hormones,” Monique explains.

Lifestyle and Dietary Strategies

When it comes to strategies to support hormonal health and recovery, Monique has a few suggestions. She says beginning by “doing less rather than doing more” is a good place to start for anyone looking to rebalance their hormones and recover from HA.

“Once you have started working on behaviour change (and genuinely committing to it) I would most often be looking to increase the frequency and/or regularity of meals, together with increasing carbohydrate intake,” she suggests.

“This is in order to convince the brain that now is a ‘safe’ time to start making hormones again! Total energy intake should also be assessed to make sure that it matches the amount of energy being expended,” Monique adds.

And she urges you to look at your lifestyle in its entirety, not just what’s on your plate. This includes reducing exercise intensity and stress levels.

“Healing from HA needs a body-mind approach,” Monique says.

So while your body is under-producing hormones like oestrogen and other reproductive hormones, many other processes and functions are compromised too. Not only will you find yourself lacking energy, your mental and physical health will take a hit over time too. Hormones are crucial for your body to function at its best, but in order to keep producing them in adequate amounts, you need to be eating enough, and reducing stress in your life.

A huge thank you to nutritionist Monique Cormack, from Monique Cormack Nutrition, for her contributions to this article. You can find Monique on Instagram @moniquecormacknutrition or at her website here.