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How long to recover a missing period?

When you learn about hypothalamic amenorrhea (HA) and how your own habits might have caused your period to go missing, there are a range of responses. For some, it’s “WOW I did not know my body needed that much fuel and rest, let me go take care of that now”, for others it’s more grudging “Aw crap, I have to undo all my hard work to get and maintain this body” and for still others getting to the state of *actually* eating more and cutting high intensity exercise takes a huge amount of mental and self-work.


So some people are able to jump right in, go “all in” which we define more precisely in No Period. Now What? but the gist is eating 2500 calories a day (preferably without being anal about it and counting every morsel) and cutting out high intensity exercise.


As part of the survey I did for NPNW, I asked about how long it took for women to recover their cycles – the range was quite large, because some were “working” on recovery for quite a long time before they found the Board and learned what it actually takes (aka going All In). The median time to recovery was five months, and the average was about eight. (The average is higher than the median because of those people who took a lot longer).


Here’s the graph showing time to recovery versus time without a period, which illustrates, as I’ve shared in a previous post, that the length of time you’ve been without a period doesn’t impact recovery time much, if at all. This is illustrated by the regression line (red line) being essentially flat, meaning there is not a relationship between time without a period and time to recovery.




I wanted to ask the question in a different way, though, now that I’ve worked with so many more women on period recovery, and it has seemed from posts in my Facebook support group that many are recovering their periods sooner than the five month mark. I wondered if that was “selection bias” – basically that we notice something more when we’re looking for it, or if it was reality.


I did a poll in both my 2018 support group and the Life After recovery group, asking members how long after going “all in” did their periods return. This is different from my previous question which was how long did recovery take overall. Here, I’m asking, once someone commits to eating a minimum of 2500 calories, not restricting any particular food groups, cutting out high intensity exercise, reducing stress (and probably working on the mental side in other ways too – accepting their new body), how long did it take to get the first period?

Before I share the data I do want to say that IT DOES TAKE SOME PEOPLE LONGER. It can feel incredibly disheartening to have been working on recovery for nine months or a year and see someone else recover their missing cycles in a few weeks. It is so important to remember that we each have a different journey and while you can get some ideas based on other people’s experience, NO-ONE has the same genes as you do, each person followed a different set of behaviors to lose their period, and has approached recovery in a different way. If you are truly at a weight where your body is happy (this is often around the weight you were at prior to significant weight loss, we have a lengthy discussion of this in NPNW), are eating all the foods and enough to support your body, and have cut high intensity exercise etc etc. and still haven’t ovulated/cycled, I would recommend checking out the “Still No Period?” Chapter in NPNW. There are quite a few options to explore. You can also book a time to speak with me and we can go through everything you’re doing, see if I can offer any tweaks, and I can help you figure out which other options might be good to help with moving forward.


Alright, the data. Remember this is time to period recovery AFTER going all in… the median time is 3 months (meaning 50% recover in three months or less, and 50% in three months or more), and the average time to recovery is 5.4 months. The average is pulled higher because of a few individuals who took a year or more to get their cycles back.



And here’s the data broken down a little more for those who like numbers…



Here are a few comments from women in the FB groups who responded to the poll- I wanted to give you a range of experiences…because like I said, everyone is different!!:

6 months half in, still exercising but eating over 2500 but not responding to more hunger, i only got it back when I stopped all exercising and responded to extreme hunger SH
I was all in right after reading the book and it took me 4 months before I got my first recovery period. HK
I was “half in” for a year beforehand and already a little over my pre-diet-that led-to-HA weight. I then went all in for three months (which for me went even no walking) and recovered. SG
It took me years … SZ
It took me close to a year but I also went on Bromocriptine to lower my prolactin level which was originally overlooked during that time by my doctors. MM
3 months all in after reading the book (just yoga and walking instead of daily workouts + letting go of food rules). But worked towards recovery for almost 3 years beforehand (slowly gained back weight and increased my intake after anorexia). SB
I made lots of changes before I went all in but it took me 3-4 months eating above minimums and a big weight gain to get my period and maintain a regular cycle 😁 JB
I recovered my period after a month of being half in – still exercised, but cut out all high intensity and gained weight. Got pregnant naturally on my 5th cycle 🙌 VH
9 years with HA after losing almost half my body weight and becoming calorie and exercise obsessed. I was half in for about 6 months, then all in for 6 or so. I couldn’t let go of exercise for awhile and was so frightened of the changes to my body. I began doing yoga, walks and some pilates. This allowed my body the rest it needed and allowed it to gain weight. It is hard for me because I’m getting married next year but I just but the bullet. I didn’t see the point in being “skinny for the day itself but having months of hard work ahead of me before I could try for a maybe. And maybe by then it would have been too difficult. I’m looking forward to reintroducing some formal exercise but I’m really deeply changed as a person. I understand the disordered way in which I was living my life and even though my period is back (2 cycles) I know I’ve lots more work to do on my relationship with food and exercise. CO
4 months half in (no exercise but still not eating enough) and then 6 more months of all in no exercise and eating all the food. CN
half in for like 9 months. went all in and got it no more than a month later EG
About 2.5 years half in and then got my period after 3 months all in. Then got pregnant. EF
10 months or so…all in. 8 years with HA LO
Before I went off bcp and even knew about HA I had been half in for a few years…essentially relaxing my relationship around food and exercise (not tracking calories or restricting, exercise 5-6 days a week but only running/high intensity a few and yoga or barre on others) and gaining some needed weight. I believe I was in a really good place mentally and physically when I went all in, but all in was the extra push my body needed to cycle! KW
I was still only half in when I got my period but I drastically cut exercise to about half of what I was doing and upped my calories slowly letting go of food restrictions to no restrictions. I gained weight and am thinking I’m at my set point. I’ve had 4 periods now, the last one 28 days! SA
It took me about 3 months and I had amenorrhea for many years. Made changes but wasn’t even all in. It did take me 16 regular cycles to get preggo tho a few years later so tho I didn’t have to wait for my cycle I darn waited for my baby. Got my period back while nursing the week of my daughters first birthday and have had two cycles since. LR
6 weeks to ovulate all in. unknowingly I guess was half in by upping cals/fats for 4 months prior (however! cut out dairy and sugar in that time as recommended by a naturopath so im sure that was a hindrance to recovery). once i read NPNW i went all in the next day or 2. no regrets! AK
I went all in from the start and gained my period back in about 2 months... but I mean ALL IN. Bring on the food 😋 KS
I said 6-7 months but I was only half in once I fully committed it was 3 months….also my weight was back to the place I was before losing weight or restricting. My body definitely seems to have a set point weight for periods to continue. CR
I had been making changes (decreased running and increased calories) for about 6 months before finally jumping all in and recovered in about a month. AJ
Half in for 5 months, all in 8 months. No period for 5 years. AB
I had already had one recovery period when I found NPNW and started following its principles. But first off I was only half in. However, following that first one 96 days passed before I got my second one! I didn’t go all in-ish until after my wedding in September last year and since then I have had cycles ranging from 51-35 days and just got my positive pregnancy test after a miscarriage in November ‘18! DS
Half in a few months, all in 6-7 months AT
10 months in and still no period in sight 😥 BN
Half in for 6 months. All in for 6 weeks. Then period. LM
I had mostly eaten a relatively large amount of calories but I had created a baseline way below where my body wanted to be. So for me focusing on gaining the weight was key. With the weight came the period! And all the attendant awesomeness of hormonal normalcy and not being obsessed with food and exercise SH
I was maybe “1/3 in” for 6 months; then all in for one month before I got a period. MM
Half in for 3 months and all in for another 3 months, but overall it took 16 months after I stopped my birth control! And got pregnant naturally on my third cycle 🙂 VB
I was sort of half in for a while… not sure how long. I weaned my son and didn’t get my period back… then I injured myself while running about 4 months after hat and around the 5 month mark I got a period. They even put me on provera and I didn’t bleed. I thought once my period came back everything would be fixed but I’m still recovering. I’ve had 5 periods so far but they’ve all been pretty far apart with very short luteal phases. LM
Half in for nearly a year, stopped exercising completely for 2 months, started eating entirely intuitively (as in, as much and whenever I wanted, I’d been OMAD before, but eating as much as I wanted) for a month. Been having acupuncture for the last 2 months weekly, then every day of my period when I got it back last week <3 Hadn’t had a period for over 2 years. KH
3 weeks all in and I was half in for 12 months JZ
2 months half in after getting a stress fracture- significantly reduced exercise mainly doing swims, yoga and weights. however still not probably eating enough. 3 months ‘all in’ eating as much as I wanted and just doing yoga and walking then it came back 🙂 AE

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Thanks!!

Nico

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