Life after recovering from hypothalamic amenorrhea

This post about hypothalamic amenorrhea has been a long-time coming. Because even though you see me now as a happy and healthy mom of a sweet little baby boy, I never want to forget what I had to go through and learn in order to be the mom I am standing here today. And while I realize that this may not apply to so many of you, I do think that some of the takeaways that I’ve implemented into my life since healing my body and recovering from hypothalamic amenorrhea are beneficial for everyone.

Ashley doing barre pose at the Lafayette Reservoir by A Lady Goes West

That’s why today, we’re going to talk all about hypothalamic amenorrhea. What it is. How I got it. And what my life has been like since recovering from it two years ago, and how I plan to make sure I never get it again. Ready, set, go …

What is hypothalamic amenorrhea?

Had you ever heard of hypothalamic amenorrhea before reading A Lady Goes West? I’m guessing 50 percent of you had not. In fact, you may have only first heard of it when I said it on the blog in combination with announcing my pregnancy and my ebook about fertility  — I kept quiet about it while I struggled, and it’s not a widely known condition, it’s hard to pronounce, and it’s a little embarrassing to discuss. But, sadly, there are a lot of women out there who are also dealing with it, particularly in the fitness industry and the wellness world. Go figure. 

Foam rolling at the gym by A Lady Goes West

Hypothalamic amenorrhea, or “HA” as it is called for short, is the loss of a menstrual cycle. The loss of the cycle happens when a woman is either exercising too much, has too much stress in her life or is not eating enough food to sustain her activity level — or all three. Basically, the hypothalamus sends a signal to the reproductive organs via the pituitary gland to tell the reproductive organs to stop working because there is a stressful environment in the body not right for reproduction. It’s a very smart reaction, in which the body tries to conserve energy and stop procreation — thus, a woman’s monthly cycle stops happening naturally.

And here’s the tricky part: There are countless women out there who are not getting a regular cycle and may not even know that they have hypothalamic amenorrhea, because if they take a hormonal birth control pill, they will have a forced period every month. But that forced period is not a sign of health in the body. Not at all. It’s just a mask for deeper issues.

Why should you care about hypothalamic amenorrhea?

When a woman stops getting a natural menstrual cycle because she is working out too much, not eating enough or has too much stress in her life, it means that many other things in the body can be off.

And while some women may think it would be no cause for concern, certainly if they aren’t even ready or sure if they ever want to have children, it’s a much bigger deal than just the cycle. She may experience irritability, fatigue, headaches, higher risk of endometrial cancer and a host of other things — in fact, she probably doesn’t feel all that great most of the time and can’t quite put her finger on why. Basically, because a woman’s natural hormones need to be mostly balanced to conceive a child, having a regular cycle is a good marker of overall health. And when it’s missing, it needs to be addressed.

My path to recovering from hypothalamic amenorrhea

It took me quite a while to actually uncover that I had hypothalamic amenorrhea, because a lot of Western doctors still don’t properly diagnosis it — it’s rare, and they often just tell you to go back on birth control if you’re not getting a regular cycle — which is clearly NOT the answer, and is not what I chose to do.

How did I get hypothalamic amenorrhea? I talk a bit more about it in this post — (as well as give the entire backstory in my ebook, of course). But suffice to say it was exercise related. When I was working as a trainer and group fitness instructor in San Francisco, I taught and completed multiple hours of workouts a day and walked no less than five miles a day to get where I needed to go (carrying a huge backpack), and my body couldn’t handle that physical stress, day in and day out, with minimal recovery. And yet, I had no idea anything was wrong with my life or me, because I was so “healthy.”

After several months of various doctor appointments and testing and lots of blood-work, I realized I had HA. And from there, it took me several more months to recover from it. I reduced my workouts by about half, I increased my healthy fat and overall caloric intake, I changed my diet to feature more warm foods, I tried to de-stress as much as possible, I improved my sleep, I gained quite a bit of weight (oh what, you didn’t notice the transformation over the years?), and I began going to acupuncture once a week — which I believe was the true game-changer, because with my acupuncturist’s help, I took multiple herbal concoctions each day and started to truly understand how to heal my body. It worked.

Urban Plates lunch by A Lady Goes West

After finally getting my cycle back naturally, it took me another full 13 months to get pregnant, and that’s because I don’t think my first few cycles were actually ones that were viable for reproduction, because my body was still healing and regulating — from many years of stress. It was quite the process, and that’s where I want to offer some tips, because every step I took was a lesson learned and has made me so much healthier.

How I am staying balanced after recovering from hypothalamic amenorrhea

If you are someone who lives in a body that is prone to or has ever experienced hormonal imbalances and hypothalamic amenorrhea, you have to be particularly careful to watch out for yourself, all the time. While I could be mad that there are plenty of women in my life who are able to do multiple workouts a day and have no issues with their cycles, that’s not me. I know this, and I will always have to act accordingly. I cannot go super hard in workouts every day of the week, even though I’d like to, and intense exercise just happens to be my favorite.

Nike ID shoes - postpartum fitness journey by A Lady Goes West

After I got my period back and was trying to get pregnant, I kept my activity levels the same as they were when I was recovering, in fact, I even lowered them a little more. At that point, I was taking two full rest days (no activity on these days outside of general life and maybe a dog walk), I also did at least one gentle mind/body yoga session each week, avoided HIIT and running almost entirely and never did more than one workout a day. I also never let my workouts go longer than an hour. This proved to be just enough of a routine to keep me mostly fit, (although my fitness level was definitely NOT what it was before this), and yet be healthy. (And I still taught a couple of group fitness classes a week — Bootybarre and BODYPUMP.)

I also continued to take herbal supplements, track my cycle religiously with an app, get quality sleep each night, focus on reducing my stress and go to acupuncture twice a month. After I got my cycle back, and because of my work schedule at the time, I was only able to go to acupuncture every other week while trying to get pregnant, and I think that was just enough to keep me balanced and feeling good. My insurance didn’t cover acupuncture, and it was certainly an expense, but to me, it was worth every penny. I can’t go any more, because of the whole child-care issue with baby Brady and my acupuncturist’s availability, but if I could, I’d be a regular acupuncture attendee for the rest of my life. It’s not scary. It’s awesome. And here’s more information why you made need it too. Honestly, I think everyone can benefit from Traditional Chinese Medicine in some form. I’m a total convert and do plan to return when I can.

These lifestyle changes were so good! In fact, during the time that I was trying to get pregnant, I truly believe that I reached the most optimum level of health that I’ve ever had. My skin was absolutely clear and glowing every single day. My hair was long and thick. I slept amazing every single night and woke up rested and full of energy. My digestion was amazing. I was mobile, flexible and functional, even if I was not ripped with a visible six-pack of ab muscles like I used to be. I ate a lot of food, which was mostly clean and unprocessed, but I also never skipped dessert, wine or pizza on the weekends. I had many SO many changes to my lifestyle, and they were clearly working for me. I felt great — although, let’s not forget that I was totally yearning to conceive.

After I got my period back, I did return to eating some colder food here and there, but that was still a rare occurrence. And even though you see me eating a lot of salads right now, I actually took almost two years off of eating salads, as the cold and raw vegetables are not warming for the reproductive system, according to Traditional Chinese Medicine. Makes sense, doesn’t it?

Favorite lunch in the new house by A Lady Goes West

Overall, I didn’t go back to how things were, I actually continued to build on my path to more balance. And because of what I’ve learned, many of the changes that I made will remain, so that I never let my hormones get imbalanced again. Granted, being that I’m just about five months into the postpartum phase, my hormones are still all over place, but for an entirely different reason.

My personal lifestyle rules for staying hormonally healthy

So let’s get to my new personal rules, if you will, which are working for me — and these certainly keep me as balanced as I can be. And granted, I will always be extra cautious, and every body and everybody is different, so you’ll have to figure out what works for you. My story is just that, my story, but because I love to share …

  • Rest: Always take at least one full rest day a week, usually two off from exercise. Here’s how and why you should take a rest day, just like me!
  • Workout duration: Never work out for more than one hour a day and do no more than one workout a day. Why? It’s taxing on the body, and exercise is a form of stress. Sometimes beneficial, but too much of a good thing is not a good thing.
  • Eat more fat: Eat at least one avocado, a helping of nut butter and a helping of healthy oil a day and always choose full-fat products over low-fat. Fat. Fat. And more fat. Fat at every meal.
  • Sleep: Try to get as much quality sleep as possible. (Totally a work in progress with Brady around, but I have my plan in place and will always strive for as much quality sleep as I can.)
  • Go light: Find and do a lighter workout at least once a week, like yoga, Pilates or gentle barre, to have low-impact sessions you enjoy, with a mind-body element. Because I tend to gravitate to tougher workouts, I decided to get certified in barre and now love to do barre workouts each week. They are low-impact and super body friendly and have a lot of stretching too.
  • Limit the HIIT: Be mindful of HIIT (high-intensity interval training) and running, and do it no more than twice a week. While I stayed away from HIIT and running while recovering and even while trying to get pregnant (outside of teaching BODYPUMP, by the way), I have and will return to doing HIIT and even running, but will make sure it doesn’t happen more than twice a week, just to be on the safe side.
  • No fake stuff: I avoid soy, and I avoid synthetic hormones — like birth control pills. Hands down. Just natural and real stuff going into my body these days.
  • Hot foods: Whenever I eat something cold, I like to have something hot and cooked along with it to stay true to my Traditional Chinese Medicine healing method of warming the reproductive system with warm foods. That’s why I get cooked salmon on my salads and have miso soup with sushi, etc. And while I don’t go crazy about this rule, in general, I just try to be mindful of consuming too much cold stuff at once. Except for ice cream. Because ice cream.
  • Relax: Even though I can’t go to acupuncture right now, I try to find time for self-care and relaxing to recharge, because it truly helps me to feel balanced and happy, and it’s important for everyone. Whether that’s a manicure, a nice bath with a book or even just a solo walk — I like to have plenty of down-time and not always be go-go-go. 

And that’s about it!

Moral of the story: Even though I recovered from hypothalamic amenorrhea and successfully got pregnant, I know I will never be able to return to my excessive exercising — even as much as I love to work out and love to sweat, it’s clear to me that I have to do less and work smarter, in order to keep my hormones in check.

Ashley doing Bootybarre at the Lafayette Reservoir by A Lady Goes West

While I’m not exactly happy that I had to go through what I did over the course of two quite painful and emotional years, I know that it was meant to happen to me, so that I could learn from it and talk about it too. Every experience makes you a better person, and my fertility journey and recovering from hypothalamic amenorrhea did JUST that for me. And speaking of sharing …

The most amazing Fit & Fertile testimonials 

Other than getting pregnant and having Brady last year, the next best thing I did was write and release my first ebook, “Fit & Fertile.” While I was super nervous about putting so much personal information out there (WAY more than makes it onto the blog, believe me), the second I got an email from a woman who was able to get her cycle back just weeks after reading my ebook and following my tips, I felt good. And then I got an email from a woman who got pregnant while following my tips. And then I got another. And another. And another. And all of a sudden, I knew that opening up and walking people through how I uncovered what was wrong with me and healed my body and got pregnant — sometimes going against the advice of my Western medicine doctor — it was meant to be shared.

Ashley's pregnancy announcement photo by A Lady Goes West

I don’t know exactly how many women have healed their bodies thanks to my ebook, because I’m sure a lot of them don’t reach out. But I do know, that I’m soooooo proud to have helped even just one woman feel like she had someone else out there who understood this very confusing, emotional and strange condition. 

If you’re currently struggling with hypothalamic amenorrhea — whether that be from too much exercise, too little food or too much stress, I encourage you to find a support system. You can hopefully get great insight from my ebook (use the code BLOGFRIEND for a discount at check-out), and I’m here for you. There are also Facebook support groups too, which you can find by searching “hypothalamic amenorrhea” in Facebook and engage in some great discussions with other women. Also, this is an excellent book about all things fertility and woman-hood to buy as well.

In conclusion, be kind to your body. Listen to your body. Know that pulling back from things you love (like exercising), is not the worst thing in the world and can be done. I’m still a fitness lover, fitness instructor and fitness professional, in spite of the fact that I now have to be conscious of my personal limits. It’s for my own good, and my health is WORTH it!

Ashley and Brady and Rudy in the nursery by A Lady Goes West

Thank you for reading, my friends! 

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Questions of the day

Can you think of a time in your life when you were your most healthy?

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34 Comments

  1. Thank you so much for sharing your post recovery experience and what you are doing to keep yourself balanced. I’m currently in recovery myself and have been struggling lately with the fact that I’m always going to have to be super careful about exercise and will probably have to maintain my current higher weight to stay healthy. It takes a lot of getting used to and I really appreciate you sharing that you are also making some lasting changes that are different from your life before. As always, thank you for sharing, your words definitely made me feel better?

    1. Hi Erin! Totally! Of course, it’s hard to think that you have to be “different” from what you were — but perhaps now, at a healthier state, you are BETTER than you were before. Also, I don’t think how it will play out in a few years, but it could be that once your hormones are totally regulated, you could always try adding in a bit more HIIT or tough exercise here and there, while keeping your life as stress-free as possible and see how it goes. We just don’t know what will happen, but we do know we have to honor our bodies and keep that cycle as regular as we can! Keep up the great work, lady! ๐Ÿ™‚

    1. Hi Emily! Thank you SO much for reading about it! And I hope you are able to offer some hope and resources to any woman you may meet in the future dealing with these issues! Send her over here heheh or to the other links I provided for help. I’m happy you’ve not had to deal with this too! ๐Ÿ™‚

  2. This is such an interesting post! The hot foods thing is fascinating! It is making me rethink some of my eating honestly. Is this something to do all the time, or around certain times in your cycles? Chinese medicine is so intriguing. I never was diagnosed with anything, but it took me several months to get a cycle after BC pills and then several more irregular cycles to conceive. So I’m not sure what will happen the next go-round as in, I don’t know if I just ‘got lucky’ and will have to look more carefully into things. I have always been quite active and even worked active jobs (retail or restaurant and Pilates/dance instructor) so it’s hard to tell whats ‘too much’. If you don’t mind me asking, are you being careful with all this to maintain general health or thinking towards conceiving again in the future? Feel free not to answer if you don’t want to share! It’s something I’m thinking about myself in terms of a possible 2nd baby (hard to imagine right now I must admit hehe) , like how hard should I even be going with exercise when I get the chance, and diet, etc.

    The most healthy I’ve felt was when I was 23 yrs old, the Summer I met my now husband. Life was good ๐Ÿ™‚ I was so happy, energetic, and maintaining a pretty rockin bod (if I can say that lol) without overthinking exercise or food. At 31 with a 3 month old it’s hard to re-capture that reality hehe but… I have a goal I guess. Not sure I’ll quiiite get the bod back but that’s ok , I can come close ๐Ÿ˜‰

    1. Hi Rose! EHhehehe! I know, I know! It’s so easy to glamorize how you DID look back then. But after having a baby and living a great life, you are bound to look different, and you should thank your body for that! As far as you being able to go hard in workouts here and there even though you want a second baby — I think that you can test it out and see. Try to make sure you are doing all the other things you can, like sleeping, eating enough and doing self-care (so hard with a baby, I know), then dabble in a HIIT workout once or twice a week and see how it feels. If you feel totally drained in a BAD way, then maybe it’s not the right time. There are plenty of other ways to stay fit, and HIIT will be there for you when you are done with your babies and ready to get back into things — but you just don’t know what your body will want to take. As far as the warming foods — I was EXTRA careful about eating all warming foods during ovulation and the second half of my cycle when I was trying to conceive — not sure why, but that seemed like the most important time. And you don’t always have to eat warm things, but if you know you have hormonal issues, it’s a good idea to add in warm things instead of having all smoothies, salads and sushi — which is what I HAD been doing before making the overhaul. Hope this helps, lady!

      1. Thank you for the info ๐Ÿ™‚ That makes sense about the 2nd half of the cycle and salads are a go to for me too so itโ€™s certainly something to consider. And you are right those workouts will be there waiting when babies are out of the equation. And yes haha Iโ€™m ok with looking a bit different, just fun and a bit inspirational to look back at those old pictures!

  3. Oh man we are on the same journey right now as we struggle to get pregnant with baby #2. I don’t have HA, but I think my stress levels (Hello toddler life and lack of sleep) have been causing some issues. I too jumped on the Acupuncture train and it’s such a struggle since we don’t have coverage but I really feel it’s helping, especially since each session I fall asleep! Ha! So I always tell myself, even if I don’t get pregnant at least I get a 40 min nap once a week. I’m not sure how much longer though we can financially keep it up, but we are doing what we can. I loved everything my acupuncturist said about the warm and cold foods, increasing fat and working on de-stressing and I love hearing that you got the same message. I too started taking extra herbal meds to help just increase my overall health and I so hope we get the outcome we are looking for ๐Ÿ™‚ Thank you for all your honesty and tips, I think they are so helpful to so many women out there struggling xo

    1. Hi Fiona! Ohhh I MISS that acupuncture nap! It was the deepest and BEST sleep! I want to go back just for that. I always felt like I was leaving a massage. Have you looked into community acupuncture clinics? I never went to one, and it may not be as stress-free, but apparently you can go into a room with a lot of others for cheaper treatment. I wish you the BEST of luck, lady! And remember that sometimes things take longer than we want, but in the end, they happen if they’re supposed to! ๐Ÿ™‚

  4. Love this post! Do you mind sharing what you are using for birth control now? Iโ€™ve been on the pill for years and Iโ€™m considering going off of it, but very hesitant because I havenโ€™t really had any problems with it. Thanks!

    1. Hi Hilary! Great question — I asked a ton of questions at my doctor’s office and did research, and these are the two most NATURAL methods — tracking/family planning (which seems a little scary, if you ask me, because basically you use nothing and just try to avoid fertile windows, but that’s not easy if your cycle isn’t super regular) — second method is the copper IUD (which apparently can slightly increased bleeding). I’d say ask your doc what is an option to you and go from there. However, if you are having NO issues with your birth control and have no reason to believe your cycle is messed up, and you feel fine and healthy, I don’t think you need to stop it just yet. Some women are just more sensitive than others.

  5. HA is also caused by certain birth control pills. It’s not something most women realize, but some forms of birth control do come with this side effect. This was what happened to me. Even after I got off my birth control pills, it took over a year for me to get my period back and that was with estrogen replacement which I would never recommend anyone do.

    1. Hi Megan, yes, post-pill amenorrhea is certainly a thing too — and I know that can be very confusing for some women. Overall, synthetic hormones just MESS us up! I know you’ve come through HA too, and I’m so happy you are healthy now and less stressed heeheh! ๐Ÿ™‚

  6. I’ve never had an issue where I stopped getting my period because I believe I’m still a bit over on body fat but I have heard more and more about people who have dealt with HA. It’s amazing how our bodies function and while we think we are doing well by being super healthy, we’re actually throwing things out of wack. I’m glad you were able to find a balance and conceive such a wonderful blessing!

    1. Hi Virjinia! The body is an amazing thing and will tell us when we aren’t making the right choices — so yes — HA is a way to know you aren’t doing what you should be doing to keep your body happy. I’m so glad you haven’t had to deal with it. Thank you so much for saying hi! ๐Ÿ™‚

  7. This is still something that is so tough for me; even though I no longer run more than 2-4 miles at a time, I STILL struggle with not having my period regularly. I know my body is affected by large amounts of stress, but I wrestle with slowing down and knowing when to say ‘no’ and ‘yes.’ And I appreciate the advice about warm foods. I do like warm foods so much better too!

    1. Hi Emily! I know, it’s confusing to figure out what works for your body, and it could be that even with minimal running you are still in need of a bit more bodyfat or less stress — or both. It’s SO worth it to keep trying to heal and find balance, whatever that may be for you. Good luck, lady!

  8. Iโ€™ve been reading more and more reports of how HA is more common than we think… )just not talked about or diagnosed enough. Especially with the increased popularity of keto diets and intermittent fasting. Both of which are so hard on womensโ€™ hormones – sex hormones and thyroid, that HA is almost becoming epidemic. Thanks for using your popularity and SM platform to discuss our t and bring attention to this. So many women donโ€™t understand the importance of a regular period.

    1. Hi Mo — you are SO right! Whenever I see these “wellness” people doing fasting and cleanses and workout challenges, I always wonder if they have a period or not. It’s a super important topic, and I will continue to talk about it. Thank YOU for reading!

  9. You better believe your ebook worked for me! When years of trying and all the advice said ‘give up working out completely’, your book was a saving grace to still feel good about myself and do the work. It’s slightly terrifying to read you still keep up those practices as you did in recovery, but I can sense it’s worth it for you and that gives me hope.

    1. Hi Kate! I LOVE to hear that the ebook worked for you, lady! Congrats!! ๐Ÿ™‚ And yes, continuing everything that healed me definitely lead me to get pregnant too — sooo worth it!! Thanks for sharing with me, friend!

  10. Hi Ashley, would you mind sharing some of the herbal supplements you took while recovering? There’s so much out there and it gets confusing!

    1. Hi Lauren! Totally! I took a special blend from my acupuncturist, which you can’t buy over the counter. I also took Chaste Tree Berry daily and Royal Jelly daily. ๐Ÿ™‚

  11. Hi!:) I absolutely LOVE your post! I am a freshman in college, and last semester I decided to go all out and get “in shape.” (even though I was already a healthy weight). I started running 3-5 miles every morning, and decreased my caloric intake to about 1400 calories a day (being 5 feet 11 inches and 155 pounds, that was DEFINITELY NOT a good idea). I lost 18 pounds (and my period) during the first three months. Around Thanksgiving, I realized what I was doing to my body, and decided that my health was more important than a number on a scale. At first, it was absolutely horrible. Gaining weight without being able to do anything about it was one of the worst feelings I had ever experienced. But, after three months of almost nonstop tears, I finally have my period back (YAYYY), and I couldn’t be happier. Your post was extremely helpful in finding ways to balance my lifestyle, and I really can’t thank you enough! ๐Ÿ™‚

    1. Claire!! Thank YOU for saying this. I’m really glad you realized you needed to make some changes and am SO glad you have your cycle back and are living a more healthy life!!! ๐Ÿ™‚ xoxoxox

  12. Hi Ashley,
    Thank you for sharing your story. I have also experienced HA and after years adjusting everything to a better lifestyle with less exercising and better eating, I learned that doing less was not enough for my body. I had to stop exercising completely. But then I got my period back and one month afterwards I got pregnant.
    Now I am nursing my 9 months old daughter and my period still has not returned. I am wondering what will change after weaning. In addition to that I am struggling with losing the last few pounds.
    I know that this is common while nursing.
    The last months I did a HIT workout 5 times a week and think that this could be too much stress for my body with sleep deprivation and nursing.

    What was your experience at this point?
    Would be happy to hear from you.

    Thanks,
    Victoria

    1. Hi Viktoria! Congrats on your new baby! First of all, I totally understand your want to get back to intense exercise and lose weight. But right now, while you’re nursing, your body needs more food, more rest, more fluids and more weight — so I would not try to lose anymore weight, because you’ll want to keep that to support milk production. As far as your workouts — five HIIT workouts a week is WAY too much. Knowing that you had to stop exercising previously to get your period back, I would probably only do AT MOST 1 HIIT workout a week (less than 30 minutes in length) right now and do lighter things, like Pilates, barre and walking the rest of the time. Remember that at 9-months postpartum you are still healing your body, so it’s not a time to do super intense workouts. Take it easy, nourish yourself, nourish your baby, and know that’s okay to do! ๐Ÿ™‚ And here’s another post that may be helpful for you … stay well, momma!! Thanks for reading! ๐Ÿ™‚ https://aladygoeswest.com/how-i-protect-my-fertility-and-hormones-life-after-recovering-from-hypothalamic-amenorrhea-part-2/

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