Hypothalamic amenorrhea (HA) is a condition characterized by the absence of regular periods due to hormonal imbalances. This is caused by factors such as low body weight, excessive exercise, stress, and/or restrictive eating habits. One key aspect of recovery is nourishing your body with an adequate intake of overall calories, carbs, fat, and essential micronutrients. Eating to get your period back is strategic and involves eating a wide variety of food. Let’s explore the importance of these nutritional elements in detail!

Eating Enough Overall Calories

To restore hormonal balance and recover from hypothalamic amenorrhea, it’s crucial to provide your body with enough energy. When you’re not consuming enough calories your body perceives it as a state of scarcity, leading to hormonal dysregulation. Women with HA often present with low estrogen, low progesterone, low testosterone, and elevated cortisol. Increasing your calorie intake, ideally under the guidance of a registered dietitian, can help correct these hormonal imbalances and  reactivate your reproductive system.

Emphasizing Carbohydrates

Carbohydrates play a vital role in restoring hormonal balance and menstrual function. Carbs are actually one of the most important macronutrient for period recovery. This is because the brain needs to sense a certain amount of glucose (carbs broken down) to ovulate again. Research has even shown that the more available glucose the body has, the quicker we see hormones like FSH and LH increase (1), which leads to an increase in the growth and maturing of a follicle for ovulation.

Complex carbohydrates such as whole grains, fruits, vegetables, and legumes provide essential vitamins, and minerals. They also support the production of the hormone leptin, which is responsible for regulating the menstrual cycle. Because complex carbs also pack a decent amount of fiber, it’s important to include lower fiber sources of carbohydrate. Ideas include as crackers, bagels, pancakes, and tortillas so that the body isn’t working overtime on just on digestion. Focusing on a mix both of simple and complex carbohydrates helps minimize the digestive discomfort you may feel as you work on eating more to support period recovery. 

Embracing Healthy Fats

Fat is crucial for hormone production, including sex hormones like estrogen and progesterone. Incorporate healthy fats such as avocados, nuts, seeds, olive oil, and fatty fish into your diet. These fats not only promote hormonal balance but also aid in nutrient absorption and support overall health. Adequate intake of fat will also help with satiety and proper blood sugar regulation. 

Ensuring Adequate Micronutrients

In addition to macronutrients, micronutrients play a vital role in recovering from hypothalamic amenorrhea. Key nutrients include iron, calcium, vitamin D, and the B vitamins. Iron-rich foods like meats, legumes, and leafy greens are essential for red blood cell production, while calcium-rich foods like dairy and fortified plant-based alternatives support bone health. The best source of Vitamin D is obtained from sunlight exposure, but consuming foods such as whole grains, eggs, and leafy greens can help. 

If you are actively trying to conceive, it may also be worth having your Vitamin D levels checked by your doctor. If you’re below 30 ng/ml, consider getting guidance on supplementation from a fertility dietitian for to achieve optimal levels (2).

The Food Freedom Fertility method is a proven approach designed to help you regain your natural cycles and develop a healthier relationship with food. Since most women who develop HA have a history of restrictive or disordered eating, the FFF method is designed to help you get back in touch with what your body need to be healthy and fertile.

It involves consuming three balanced meals and three snacks each day, ensuring that all three macronutrients (carbohydrates, proteins, and fats) are included in each meal. This helps provide consistent nourishment to your body, supports hormonal balance, and promotes a regaining a regular menstrual cycle.

The last, and in my opinion most important part of the FFF method is identifying and breaking your food rules. Often, individuals struggling with hypothalamic amenorrhea have developed strict food rules. This may look like cutting out of certain food groups, time restricted eating, calorie/macro counting, or very strict, “clean eating”.  Breaking free from these rules is an essential part of recovery. Working with a registered dietitian who specializes in disordered eating can help you identify and challenge these rules to promote a more flexible and balanced approach to eating.

If you’re aiming to recover from HA and regain your natural cycle, nourishing your body with enough overall calories, carbohydrates, fats, and micronutrients is crucial. The Food Freedom Fertility method, with its focus on balanced meals and snacks, allows for consistent nourishment and hormonal regulation. Remember, getting proper support and personalized guidance is key on your journey to recovery.

1. Zhang C, Bosch MA, Levine JE, Rønnekleiv OK, Kelly MJ. Gonadotropin-releasing hormone neurons express K(ATP) channels that are regulated by estrogen and responsive to glucose and metabolic inhibition. J Neurosci. 2007 Sep 19;27(38):10153-64. doi: 10.1523/JNEUROSCI.1657-07.2007. PMID: 17881521;
2. Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol. 2010 May;202(5):436.e1-8. doi: 10.1016/j.ajog.2009.11.036. Epub 2010 Jan 12. PMID: 20060512; PMCID: PMC3784988.