Getting Periods Again Postpartum

One thing many women who have experienced hypothalamic amenorrhea / no periods want to know is … will I get my periods again after I have a baby, and if so, WHEN??

We discuss this in depth in No Period. Now What? and here’s a cool graph that shows when my survey respondents started cycling again in relation to weaning (because breastfeeding increases levels of the hormone prolactin, which suppresses the reproductive system – to different levels in different women).

One of the key factors I found in my research around cycle resumption was an article that suggested a small weight gain was helpful in cycle resumption; this makes sense as it signals the body that energy is plentiful and reproduction is once again “safe” – just as with resuming cycles after hypothalamic amenorrhea in the first place. I was recently listening to the Period Podcast with Kate Clancy and was pleased to hear the expert she interviewed back this hypothesis up. Which turns out makes a lot of sense because it was Dr. Claudia Valeggia, who wrote the article I referenced. 🙂

Anyway, Laurel who is in my facebook support group agreed to share her story, including postpartum cycle resumption – she hoped to continue breastfeeding but wanted to try and get pregnant again.

“I was a heavy teen and young adult. I went on oral contraceptives early to lessen my acne. I lost weight quickly when I was 23 years old and got into running. I never really noticed my cycle until I got married at 28 and went off the pill. I didn’t regain a cycle after 6 months, and started looking for reasons. Everything about HA resonated with me, and I found the support of the Fertile Thoughts board [genesis of No Period. Now What?] around the same time I met with a reproductive endocrinologist. Two rounds of injectables and 20 pounds later, I still didn’t have a period and wasn’t responding well to meds. I was “all in” in name only, but not mentally all in, as I was already resigned to doing IVF. We did one very easy (probably because I had gained weight!) round of IVF in May 2014 and I conceived my son. He was born in February 2015.

I breastfed my son and he was very needy, never sleeping more than an hour at a time. He nursed constantly. I started running again at 6 weeks postpartum and slowly lost weight. I settled at about 10 lbs. above my HA weight and was running what I thought was a reasonable 4 times a week, definitely not as much as before pregnancy. I wasn’t worried when I didn’t get my period for the first year, then 18 months, then 2 years postpartum. When my son turned 2 I started wondering. He still nursed all the time and I was still running. We weren’t trying to conceive, but I was worried about my bone density and heart health long-term. After running a disappointing race in October 2017, I quit running and vowed to give “all in” a better try. If I didn’t get my period in a few months, I’d try to start the weaning process with my son.
I looked at my diet and although I wasn’t restricting, I went 12+ hours without eating overnight and was nursing multiple times during that time, so my caloric deficit was high for several hours. I had just read an article on Nico’s blog about hours in energy deficit, so I added in a big pre-dinner snack and amped up my breakfast. I ate and ate. Twenty+ pounds and 3 months later, I noticed funny symptoms. I randomly took an ovulation test and it was positive! Eleven days later, I got my first non-medication (BCP or fertility medication) period since I was 17! It was amazing. My husband and I thought that since I was cycling, we might as well try to have a baby naturally. My second cycle was long, and I didn’t ovulate until cycle day 38. I was excited to have a second cycle, and even more excited when I started getting positive pregnancy tests 10 days later!
I’m very happy I didn’t have to wean to conceive again, because extended breastfeeding was important to me. Figuring out that the energy expended overnight was an important part of the equation, for me, was great. I also had to be comfortable getting to a weight I hadn’t seen since my overweight teens. It’s worth it for another baby and for my long term health.

If you’re in this situation, or might be in the future, I hope that it helps you to know that 84% of women in my survey resumed natural cycles after pregnancy (in those who wanted to conceive again), and 94% had resumed cycles at the time I performed my survey, after they were done having children. I do need to update those numbers, I do believe that a few years out the final cycle resumption number is higher 🙂

Many of those who resumed cycles had not restored periods prior to pregnancy – but they maintained a weight at which their body was happy, fully fueled any exercise they were participating in, and did resume cycles after having a baby. For those who didn’t, many were anxious to conceive again and didn’t want to wait – hence the higher rate of recovery after families were complete.

Anyway if you’re interested in more data and information on this topic, please do check out our book!



Seed cycling for no period? Nope.

Seed cycling has been touted as helping to regulate menstrual cycles. One is supposed to take a combination of flax and pumpkin seeds (1-2 tablespoons each) during the first half of the cycle (from when your period starts until you ovulate, the “follicular phase”) and then sesame and sunflower seeds during the second half (after ovulation until your period starts again, the “luteal phase”). And if you have no period, you’re told to follow the cycle of the moon, taking the flax/pumpkin seeds from full moon to new moon, and the sesame/sunflower combo from new moon to full moon.

quick summary of evidence-based recommendations:

I find no support in the medical literature for the idea of switching seeds based on cycle phase, in fact, every study uses one (or two) seeds consistently for weeks to months at a time before benefits are seen. The highest quality evidence suggests flax seed for increasing luteal phase length, and sesame seeds for women with PCOS (increases sex homone binding globulin, which is typically low in women with PCOS). I recommend using these seeds consistently, not switching back and forth. If you do not currently have menstrual cycles, the strongest evidence suggests benefits of daily flax seed consumption.

Info on seed cycling

In some places discussions of seed cycling seems reasonable – like this article at Natural Health Perspectives, or this one at Herbal Academy where they discuss the lignans from the seed hulls as helping to modulate hormones (these are phytoestrogens that can affect your hormone levels) and fatty acids in the seed body that provide omega fatty acids that provide the building blocks for making the hormones estradiol and progesterone.  And then there seems to be a protocol making the rounds where the explanation is that during the follicular phase that you use flax and pumpkin seeds “to block excess estrogen” and then sesame and sunflower seeds during the second half of the cycle “to help block excess estrogen”. Um, what? that makes no sense. There are times in your cycle when you need and want estrogen! (like when the follicle is growing during the follicular phase).

In line with my ongoing series examining supplement use and recovery of missing periods (hypothalamic amenorrhea), I wanted to examine the scientific underpinnings of this idea. Is there any real basis to switching seeds during the middle of the cycle (especially when the explanation of how the seeds are affecting hormones seems to be the same in both phases…)?

what is the evidence for seed cycling?

If you look in the medical literature (pubmed or google scholar searches), there are no published studies comparing seed cycling with any kind of control, or looking at alterations in hormone levels when using the variation of seeds. So the only evidence we have is inference from other studies, and anecdotes.

There is some evidence for the individual seeds. I covered flax seed in a recent post, In summary, flax seed has been shown in clinical studies to be associated with more ovulatory cycles, longer luteal phase, lower stress hormones and perception of stress. I do think that having 10g (ground) flax seed per day is a worthwhile addition to your daily fare, based not only on the cycle related benefits I just listed, but also overall health benefits.

So now let’s look at the other seeds. In seed cycling, flax seed is supposed to be paired with pumpkin seed. Continue reading

Energy Balance and No Period…

Why is it that some women have no period, where others, in seemingly the same situation with exercise and energy consumption continue to menstruate regularly?

A possible explanation for this difference was recently offered by researchers in Sweden. Instead of looking at energy balance or availability for a whole day, as is the standard in energetic research, they computed energy balance on an hourly basis.

Before we get into the meat of the paper, it’s results, and my analysis, a few terms that might be helpful to understand:

  • energy balance: Total energy intake (kcal) minus total energy expenditure, i.e., resting metabolism + daily living + exercise.
  • resting metabolism: calories burned to fuel involuntary processes: pumping blood, fueling brain, building muscle and bone
  • glycogen: stores energy in the liver for short term use, ~300 kcal worth (Farenholtz et. al, 2017)
  • kcal: short for kilocalorie, measure of energy. In the US we usually say “calorie” instead.
  • negative energy balance: more calories expended than consumed; during small deficits, liver glycogen can make up the difference. During larger deficits (e.g., < -300 kcal), fuel is obtained from other body stores, for example, fat and muscle (called catabolism).

Alright – getting back to the paper. The findings were remarkable; the average time with a negative energy balance of < -300 kcal for athletes with regular periods was 17.6 hours (Interquartile range (IQR) 3.9 – 20.8 hours), versus 21.8 hours in athletes with no periods (IQR 17.8 – 22.4). Athletes with no periods were in a catabolic state (negative energy balance) for four more hours per day than athletes with regular periods.

What I found really interesting was a diagram the researchers included, illustrating how hourly energy balance was calculated. This example shows a period of significant energy deficit at night, with no positive energy balance until the middle of the day (presumably lunchtime). Thinking of energy balance on an hourly basis like this rather than simply the amount of energy consumed in a day leads me to wonder if this might be part of the reason some women can be “all in” for 6+ months without period restoration, where others resume cycles within just 6-12 weeks. Continue reading

No period or irregular periods? Flax seed might help

There are multiple benefits to consuming flax seed, that I’ve discovered as I research the seeds used in seed cycling. 1) Fewer anovulatory cycles in normal cycling women, 2) longer luteal phase with higher progesterone/estradiol ratio, 3) reduced stress hormones and perception of stress, 4) a number of more general health benefits including improved lipid profile, reduction in risk of cardiovascular disease, decreased A1c in type II diabetics, and potentially cancer prevention. I will discuss the first three in this post – for an excellent review of the other health benefits, please see this article.

There are three major components in flax seed that are thought to have health benefits – the fiber (6% of dry weight), the lignan alpha-linoleic acid (20%), and the phytoestrogen precursor secoisolariciresinol diglucoside (SDG, 1%). One can consume either whole (ground) flax seed or lignan or SDG extracts. If you’re trying to recover your period I would recommend ground flax as the relevant studies were mostly performed with that rather than extracts. For other health benefits, I would suggest looking more closely at the studies (in this review, for example) to determine whether they used extract or whole flax (many used specific extracts).

Flax seed and menstrual cycles

Hormone levels and menstrual cycle parameters in women consuming 10g flax seed per day were examined for the duration of three menstrual cycles (comparing with three menstrual cycles in the same women where no flax was consumed but diet remained otherwise the same). For each woman, the second and third cycles were examined.

There were two important findings. First, there were no anovulatory cycles (0/36 cycles in 18 women) in women consuming flax seed compared with three anovulatory cycles during the control phase (3/36 cycles in 18 women, anovulation occurred in three different women).

Second, luteal phase when consuming flax seed was 1.2 days longer than with no flax seed consumption. I loved that this paper actually graphed the change in luteal phase between the flax/no flax cycles rather than just reporting averages: 1 woman had a shorter LP by 1 day, five women had no change, one had half a day longer LP, five had a 1-day longer LP, two had a 1.5-day longer LP, and one each had 2, 2.5, 3.5, and 4.5 day longer LPs! Both of these results suggest that daily flax seed consumption might be beneficial for women trying to regulate periods, and those with short luteal phases (another tool to add to the short LP arsenal!)

When hormone levels were examined, there were no significant changes in any hormones: estradiol in the early or mid-follicular phase, or progesterone or estradiol during the luteal phase. Testosterone levels during the mid-follicular phase were about 10% higher, a significant difference. The researchers speculated this might affect the luteal phase length. There were also 25% higher progesterone to estradiol ratios during the luteal phase (non-significant 10% higher progesterone and ~15% lower estradiol combined to give a significantly higher P/E2 ratio under flax seed consumption). This could potentially explain the longer luteal phases.

flax seed and improved stress perception

Another set of studies seem to show positive effects of flax seed consumption on hormones associated with stress response, and this is where I think that flax seed might help those who are working toward recovering missing periods, but not there yet.

The first study I want to tell you about looked at stress markers in mice fed either a control diet, or one that contained a commonly used anti-depressant (imipramine), pomegranate peel extract or flax seed extract. After 50 days various hormones were measured – cortisol, epinephrine, and norepinephrine. Flax seed extract and imipramine showed similar levels of decrease in each of these hormones, which is great for someone trying to recover from hypothalamic amenorrhea / no period, as each of those hormones help suppress the hypothalamus – decreasing levels will only help get the hypothalamus going again!

35 postmenopausal women consumed different varieties of flaxseed containing varied levels of two active components SDG and alpha-linoleic acid. Blood pressure was used as a marker of stress, and all three types of flax seed reduced blood pressure during a frustrating cognitive task, in comparison with the same task without flax seed consumption (the study was a crossover design so some women took the test with flax seed first and without second, for others the order was reversed so the reduction in blood pressure was not due to having taken the test before.) All three varieties reduced plasma cortisol as well, but the Linola 989 variety with the highest SDG showed the highest reduction.

flax seed recommendations

I started researching the effects of flax seed in the context of seed cycling. As I read the scientific literature I noted that there was not a single study that alternated seed types – all the medical literature I could find had people (or animals) taking one seed type consistently. I will present the evidence on the other seeds included in “seed cycling” shortly (pumpkin, sesame, and sunflower seeds) but I have not found any evidence to suggest value in changing between seed types.

Studies show flax alone has the potential to reduce stress hormones, and have positive effects both on the follicular phase (including ovulation) and the luteal phase of a menstrual cycle. Based on the reduction in stress hormones and perceived stress, along with other health benefits and no adverse consequences, I see no reason not to add flax seed to your arsenal as you work to restore missing menstrual cycles or to potentially help with normalizing menstrual cycles that are wonky for other reasons. Instead of making yourself crazy trying to figure out what seeds to take when, as one has to do with “seed cycling”, simply eating ground flax seed every day (the other seeds could be added as you like) might be beneficial. Note that as with other supplements, it is unlikely that taking flax alone, without increasing food intake, reducing high intensity exercise, and reducing stress will be successful. Check out No Period. Now What? for evidence and recommendations on how to do all this.

This is the ground flax I use, from BJs . My mom started adding flax seed to the yogurt she had for lunch every day ages ago, I tried it and liked it, and started adding it too (along with chia seeds, ’cause I like the crunch).

I’d suggest 10g/d as a reasonable amount based on the study finding fewer anovulatory cycles and longer luteal phases. For other health benefits, again, please examine the specific literature to find the optimal form of flax to use and what dose.

Also, note that there have not been any detrimental effects found with flax seed so far for most people, but the recommendation is not to consume flax in large quantities while pregnant as studies in rats do show some negative effects (included in this review). I wouldn’t stress if you’re pregnant and have some, but probably best not to have daily.





Can Maca help restore periods?

Can maca help restore a missing period?

A little while back I did a survey of women in my “No Period. Now What?” facebook support group and found that among 53 women 63 supplements were being taken with the idea of helping to restore missing periods. Maca was taken by 10 of these women, so I thought we’d investigate it next. Thanks to Eryn for digging up some references!

Overview of Maca

Maca, aka Lepidium meyenii, is grown in the central Andes. The part that is eaten is the “hypocotyl”, a tuberous root-like structure that is a storage organ for nutrients. Maca has been cultivated and used for food and medicinal  purposes for hundreds of years.

From Creative Commons License 4.0

Maca and period restoration

Our question is whether maca can be useful in a woman trying to restore menstrual cycles. I was rather surprised after reading some abstracts to find that there were hints of potential usefulness of this supplement – but after reading the full studies, my conclusion is that while maca is not going to hurt recovery, it is unlikely to help either.

In the first study, rats were fed dried maca powder as 5%, 25%, or 50% of their diet. Seven weeks later, during the “pro-estrus” phase (like the follicular phase in humans) hormones were measured, and in the rats consuming 50% maca, a 4.5-fold elevation in LH levels and 19-fold elevation in FSH levels were seen. This elevation was dose dependent (meaning elevations were seen at lower amounts consumed as well, in proportion to the amount of maca). However, there are two key points missing from the abstract, which is where that info comes from. One is that there was essentially no elevation at the lowest dose, 5% of feed, which is about 3g/kg/day.  The second point was that these elevations were very transient, seen only at the time of the pre-ovulatory surge. There was not an overall increase in LH levels.

The huge elevations in LH are clearly not reproducible in humans, because 50% of our diet as maca powder is not feasible. Even 3 grams per kilogram, i.e., 180 grams per day in someone weighing 60kg (about 130 lb) doesn’t jibe with the dosages normally prescribed. A website selling maca powder indicates that a serving is about 9 grams. In the Andes, people will often eat 100-200g of the root 2-3 times a week, a much higher amount than what is realistically available to those of us outside Peru.

There are a few other studies in rodents, but unfortunately not much in humans to support or refute these results. A study performed in men (due to positive effects on sperm parameters) showed no change in FSH, LH, estradiol, prolactin, or testosterone while taking 1.5 or 3g of maca for up to 12 weeks.

These two results, an elevation in the levels of LH and FSH *only* during the pre-ovulatory surge in mice, and no change in reproductive hormones in males in response to maca suggest that maca is not going to help with no periods based on a hormonal mechanism.


As I was researching the toxicity of maca (which seems to be zero), I came across an article where they did a double-blind, placebo-controlled study looking at a number of health outcomes after consuming maca (3g/day) for 12 weeks (197 subjects across all groups). The health outcomes were assessed on a weekly basis, giving a really nice data set. There were no adverse events reported which is great, and they reference another study that found no toxicity in rats at up to 17g/kg, which is an enormous amount, so maca seems to be very safe to eat.


Some of the health outcomes that were measured in the study I just mentioned and found to be significantly different from placebo (on top of a placebo effect!) may be of interest to readers – improved libido, energy, mood, and “Health Related Quality of Life” score. The “HRQL” is a 36-question survey that contains “five items related to general health, five items related to physical activities associated with current health status, two items related to limitations on work or other regular daily activities as a consequence of reduced physical health, two items on bodily pain, one item about vitality, and five items on mental health [].”

This study suggests that there may be other reasons to take maca than period restoration per se… it may help with overall quality of life while you are working to recover. And in someone who is at a “fertile BMI,” not doing high intensity exercise, but still stressed and anxious… maybe something like maca could help with the mental stress part.

MACA for Missing periods?

My ultimate conclusion is if you like maca, go ahead and have some (after checking the sourcing, see below), but don’t feel like this is something that you need to go out and get to help you restore your missing period. It may have some mood boosting effects that could be helpful during recovery in other ways though.

I will leave you with a quote from a recent review of maca,

To date, the health claims of maca cannot be fully supported from a scientific standpoint and more research is needed. It appears that the indigenous local knowledge about the health benefits of maca has been dragged out of context to fit the demands of a growing market for herbal remedies. This globalisation (or hype esp. in China) also has had serious consequences for the local producers in Peru. The lack of protocols to regulate the production and marketing of maca during this rapid expansion, poses a threat to both the safety of consumers and the sustainability of supply.



Acetyl-L-Carnitine and Restoring Missing Periods

Continuing my series of posts on supplements and recovery of mising periods… overview here, and post on Vitex here 🙂 I am going to review acetyl-l-carnitine next as it is a supplement for which there is evidence for effectiveness in restoring missing menstrual periods from controlled clinical studies. Thanks to Addie for helping with the research!

Here’s a table of contents for this post, as it ended up being super long!!

Alright, let’s get started. First, acetyl-L-carnitine, also known as L-acetylcarnitine, ALC, or ALCAR, is a derivative of the amino acid L-carnitine (aka levocarnitine). L-carnitine acts as a recipient of an acetyl group in a reaction that releases CoA for use in the Krebs cycle that generates energy (ATP) in the mitochondria. ALC is naturally synthesized in our bodies on an ongoing basis, and crosses the blood/brain barrier, therefore potentially affecting brain hormones, chemistry, or brain function. Studies have been performed examining the effectiveness of ALC in a number of indications, ranging from diabetic neuropathy to Alzheimer’s disease.

Chemical structure of Acetyl-L-Carnitine:

By Ed (Edgar181) - Own work, Public Domain,

Continue reading

Missing period recovery story!

Just about every day there is a new post in one of my facebook groups about someone getting their first post-hypothalamic amenorrhea period, or their positive pregnancy test. It is so inspirational and truly helps those who are still working to recover to stay the course. I wish that everyone struggling with missing periods, thinking about maybe doing something about it but perhaps too scared, afraid of “losing everything they’ve worked so hard for” could read each of these stories and see how much there really is to gain. (We did include a lot of recovery stories in our book/ebook 🙂 ) I’m going to start sharing some here, in hopes that others will be motivated to start or continue their own journey toward true health.

Gemma wrote:

“I have always been a fit and active person ever since I was young. And my weight had never really fluctuated. I went on BCP when I was about 16 years old until I was 28. I came off the pill because my partner and I wanted to try for a baby.

Before making the decision to try for a baby I had a job for about five years that had become very stressful, 10 hour days with minimal rest, and I was commuting to and from work on my bike, which came to about 9 miles a day. Weight-wise I had always been a healthy weight for my height, but from cycling everyday my BMI had gone down a couple points and it had been there ever since. I never questioned it because I was never fussed on my body shape, big or small, but looking back these were all signs that I chose to ignore. Weight loss, stress, and for the amount of activity I was doing I was not eating enough.

I don’t know for sure that this is when I lost my period because I was on BCP but after reading Nicola Rinaldi’s book I think that could have been my significant HA moment.

When I came off the pill I went to the doctors after 3 months because I wasn’t having a period. I was told that it was normal, coming off the pill can take a while for your body to adjust, come back in a year. So, a year later I went back, the doctor tried to put me back on the pill so I could have a ‘period’. I refused, I don’t know why but I knew that my lack of period was a symptom of something and I needed to find the cause.

The past 5 years have been very hard for me, both emotionally and physically, with a lot of medical poking and prodding, blood taking and a lot of mental exhaustion, confusion, anger. The doctors decided that It was just a case of unexplained infertility and the only thing that might help would be IVF.

Strangely enough my next GP appointment is next week, this was going to be my opportunity to discuss fertility treatments.

I really had lost all hope, I just wanted my period back, I struggled with my friends, those who do know about my condition try really hard to understand it but they don’t really get it, and I would be an awful person to expect them to but It is just something that unless it is happening to you it is a very difficult concept to comprehend.

I felt so alone and so lost but then one night, completely by accident i came across Nicola’s book No Period. Now What?. I read the book from cover to cover in about two days, everything in it was so true to me and I just knew that this is what I had. It was such a leap of faith, I never doubted the process for a second but I was scared of It. Scared because this conditions forces you to face your self head on and admit things to yourself that you have maybe been denying. Recovery is giving me such a feeling of freedom, freedom from exercise, freedom from anxiety which was a huge thing when I was doing too much, not eating enough or resting enough.

My husband thought I had gone temporarily crazy when I told him about this adventure I was about to embark on, stopping all the things that I loved like mountain climbing, surfing, cycling and eating 2500-3000 calories a day but he has and continues to support me, he has seen me re-emerge from myself like a flower. I didn’t know how much of a shell of myself I had become but having this condition and finding the tools that I need to rebuild myself has helped me come back to life.

I have gained 17 lbs so far, I started recovery on the 25th November 2016 and every pound is a pound that I am so proud of and so grateful for. At first, it could’ve been 6 weeks, I hardly put on any weight which made me realise just how much damage I had caused to myself. At this point I decided I was literally just going to walk to and from work and anything beyond that, that was un-necessary activity I would just have to stop. So, since January I have been parked on my bum, not even doing yoga but still walking to and from work. Then about 2 weeks ago I injured my neck, all my muscles had seized up and the pain was radiating down my shoulders and back, I literally couldn’t move for a week and I think that was the final kick start my body needed, just complete bed rest.

I in no way think I am recovered, I am still at the very beginning and I fear that this gift I have been given could be taken away from me at any moment but time will tell, regardless of the outcome I am recovering, my body is reacting to rest and nourishment and I never thought my body would ever feel strong enough or trust me enough that it felt it could try to bring another life into this world. I think my body is a miracle.

We are all incredible, we show incredible strength by facing our fears head on and not running from them but I wouldn’t be on the path to recovery if I didn’t have you all supporting me, I hope I give back to you what you give to me.”



Does Vitex Help Restore Missing Periods?

why would I use vitex, and WHAT IS it?

To determine what supplements women might use to try and restore missing periods, I did a quick survey of women in my “No Period. Now What?” facebook support group. The most common herb/supplement mentioned  was Vitex, taken by over a third of those who responded to my survey (21/53). Vitex is a shortened name for Vitex Agnus Castus also known as Chasteberry.  Most women reported taking “vitex’, but some said “agnus castus” or “chasteberry” – as far as I can tell they are synonyms. It’s a small, bushy plant, with pretty purple flowers and small brown berries.



I did a search of the medical literature using the following queries in pubmed to find research relevant to understanding whether vitex can help restore a missing period.

Vitex fertility
Vitex amenorrhea
Vitex oligomenorrhea
Vitex luteal phase
Vitex follicular phase
Vitex progesterone
Vitex estrogen
Vitex osteoporosis


The searches came up with between 5-25 results, many overlapping between searches. I read through abstracts where available (a few articles were in languages I don’t speak, or had no abstract available) and the full article if the abstract seemed relevant and I wanted to learn more.

My conclusion is that Vitex Agnus Castus does NOT lead to restoration of cycles in someone experiencing hypothalamic amenorrhea (unless that amenorrhea is due to elevated levels of prolactin), and may in fact be hindering the return of a missing period.

Continue reading

Supplements to Recover Missing Periods?

I recently asked in my Facebook support group what supplements women had used while trying to recover from hypothalamic amenorrhea / no period as I wanted to look further into the science behind each of them. I was astounded at the range of answers – 53 women used one or more of 65 different supplements!

Can pills help recover missing periods?

By Root66 (Own work) [GFDL ( or CC BY-SA 3.0 (], via Wikimedia Commons

How do I restore missing periods?

Unfortunately, many women are prescribed supplements instead of what we all know works – eating more, exercising less (particularly less high intensity exercise), and reducing stress. A common refrain was captured well by one poster:

Ellen: Oooh, I’ve tried so many supplements in hopes of sidestepping real lifestyle change! I’ve dabbled with vitex, maca, soy, estroven, bulletproof diet recipes, acupuncture…while some (acupuncture) really benefited me in other aspects like stress level, none served as proxies for eating bravely and resting bravely- which I am finally giving a go.

It is really important to take heed of what Ellen says – there is no way around making lifestyle changes, which you can learn more about in our book, No Period. Now What?. If you have no period due to HA, while you might (possibly – success is not guaranteed!) be able to get pregnant using injectable gonadotropins or IVF, those are not going to restore your system to balance or bring back that missing period / cycle. In the words of another wise woman: Continue reading

Positives of Recovering from Hypothalamic Amenorrhea

I asked women in my new facebook support group to tell me about one thing (or more) positive about recovery or working toward recovery, which they did not expect. Some responses are shared below…

Lindsay: a sense of freedom and ease and ability to go with the flow that I had been missing since I was a teenager and that I never thought would come back.

Oh, another one: when my husband says, “Doesn’t a burger sound good tonight?” not having to make things difficult and try to convince him to go somewhere healthy and insist that I don’t really like burgers … and just get to enjoy the freaking burger together! With a side of fries!

One more, because there are so many: when I first get home after being on a long flight, not having to go on a run before I even unpack my bags and instead just collapsing on the couch and ordering takeout.

Florence: Less anxiety, babies, ice cream, support from all of my fellow HA ladies into motherhood, boobs and poops, not waking up hungry at night, my hair growing back, feeling like a normally functioning woman, saving my bones, sleeping better, spending more time with my family and friends, holidays without a single workout, not going round with my tupperwares, eating socially, finally using my time for something i love & aiming to save the world, discovering a more fun, more balanced person inside of me.

Nicole: Not having to worry about when to eat, what to eat, and listening my body tell me what it wants. My eating used to revolve around an IBS and paleo diet as well as my workout schedule – no more of that taking up space in my head.

Oh, and my laughter is so much deeper now. Happiness feels amazing, like its own high.

Louisa: Realised that restricting myself and stressing around food/exercise was 100% the reasons behind my gut issues. Since eating everything I’ve actually been pretty ok!

Also, Sleeping in, not having to schedule my week around my workouts, desserts, a pretty much healed digestive system, freedom around food, just food in general, boobs, oh and you ladies!
Also as I’m not yet recovered just knowing there’s more that will improve is all the motivation I need to keep going 💪🏻 x

Sarah: Crying. Like full body weeping. You know that saying, “have a good cry?” I haven’t been able to do this for months and it’s felt strange. In the past week (just went all in), I’ve wept and I feel I’ve been cracked open in a healthy way.

Mary: Resurrection of my libido!

Corey: Realizing how high strung I was, and how my anger was on a hair trigger!! I was ALWAYS planning out the food I was going to eat, or rehashing the food I had just eaten. I still focus on food a lot, but now it’s looking forward to all the great stuff I get to eat, and enjoying it! I also didn’t expect all of the stories and personal growth shared in NPNW to apply to me as closely as it did…man, did I try to fight it! “But that’s not ME…. I’M not like that….” 😐

Liz:  I no longer feel out of control around food. I don’t feel disgusting anymore for feeding my body what it needs or weighing what it wants to (for the most part, there are some bad days). I had a list of “bad” foods I thought were poison to me (because if I had ever binged on them they went on this list of supposed poison trigger foods) much longer than the list of foods that I deemed pure and wouldn’t cause binging (protein veggies select oils). I had to go to the gym every day sort of like paying for an ok day. If I didn’t get to it for some reason I felt like it was an automatic terrible day. I’m definitely not in the best place but so much better and I’m so grateful. I usually am grateful to nourish my body. I try to eat mostly foods that I believe are nutritious for my body and feel grateful for that. If I am hungry or crave something I don’t usually think it’s an urge to binge but maybe that… I’m hungry and my body is telling me. I no longer eat salad for every single meal… I no longer feel like many of the foods I thought were poison are (some I do still struggle with… it takes time and is a journey to completely free myself and don’t know if I’ll ever get there… but the list is def a lot smaller)… I can eat all u can eat sushi sometimes usually no guilt. Chocolate sometimes ❤️… I’m happy to enjoy a treat once in a while and see now that I can have one or two when I want and not have a compulsion to stay up and binge on 20 like I feared)… I can walk some mornings (hope to get back to running sometime bc I enjoy it) and others rest if I don’t feel like it… and it’s not the end of the world and I can function and have an ok day without exercise. So there are a lot. I have a way to go and there are def some weird thoughts about food still but I’m in a much better place and someday if I’m a mom I feel I’ll pass on much better attitudes that I would have.

Oh another very random that i was thinking of recently during a discussion with someone… i used to have major bladder issues for most of the time i had HA. I thought i might have interstitial cystitis as I frequently had infections, and even when I didn’t i often felt burning and sharp pain sensations… very strange another thing no one could quite figure out 🙁 It mysteriously went away around when I recovered from HA. I have never had any pain or a bladder infection since. I can’t help but wonder if it was related to my super low estrogen levels…

Erika: Bladder issues is a symptom of low estrogen. 😊 I had them, too. Mine was more frequency (now if I go in the middle of the night it’s 1X where used to be as much as 4Xs). Also if I had to go, I had to go. Extreme urgency. Some of mine could have also been kidney function just from low body weight, too.

This is just a sampling of the comments. Are you ready to dive into YOUR recovery and discover how your life will change?