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How long will it take to recover?

One of the unique aspects to our book on recovering from hypothalamic amenorrhea is the data we include from our survey of over 300 women who have experienced missing periods. I also love having the data set because when people ask me questions that I didn’t address in the book I can go and get the answer pretty quickly.

A question that was recently asked was Is there a difference in time to recovery depending on how long one’s period has been missing? The range of time for which periods were missing for the women who took our survey was from three months to over twenty years!

However, I found that there was hardly any difference in time to recover based on length without a period. Note that the start of working on recovery was defined as the time at which eating more / weight gain commenced. The data are shown below (note that the scale is logarithmic, not linear):

Each point represents one woman, with the amount of time she was without a cycle on the horizontal axis, and number of months to recover on the vertical. Note that for some who took a long time to recover, there was a small amount of weight gain from a very low weight, but it’s not until they truly went all in (for example my friend Priscilla, who shares her story here) that they finally recovered.

I performed a linear regression (red line) to see what line might describe the relationship between months without a period and how long it took to recover, and astonishingly, the line was almost horizontal – meaning that there is essentially no effect of time without a period. The median time to recovery was six months whether the women’s period was missing for three months or 10+ years.

Another interesting fact was that there was no difference in the time without a period between women who recovered natural cycles and those who decided to use fertility treatments to get pregnant.

I hope that this provides some hope and inspiration if you are among those who have been without a natural period for many years.

How long have you been without a period? How long working on recovery? Or, if you’ve already recovered, what were the timeframes for you?

My personal story is a little convoluted, but I hope you’ll bear with me. My journey started in May 2004 when I decided that on top of my approximately two hours of daily exercise I would restrict my calories, turns out to about half of what I actually needed. At the end of that month I went off the pill, and surprise, surprise, no period. Over the next eight months I slowly added food back in, cut my exercise to about an hour a day five days a week (turns out that was still too much, in hindsight) and in March 2005 on a three week vacation I got my first period.

I wish that I could go back in time and tell that me to just be patient. Because I had an ultrasound on cycle day 13, when one would expect a dominant follicle to be nice and juicy, if one were to have a normal cycle. And shocker of all shockers, I did! It was 13mm (natural follicles typically start growing 1-2mm per day when they’re 10-12mm in size) and I thought I was golden. Unfortunately two days later it hadn’t grown, and my doctor recommended that I start injections as she didn’t think I would ever cycle naturally. I did four cycles, none of which got me pregnant. After the last failure we decided to pursue IVF but wanted to wait six weeks for new insurance that would cover the procedures, to kick in. During that time I refused birth control as I wanted to see what my body could do, and to my utter astonishment, I ovulated and got pregnant.

So technically, it took me seven to eight months to “recover” if you count that first period. I’m not sure how long my cycle was missing for prior to working on recovery as I was on birth control pills, but likely only one or two months.

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