When Will I get my Period back Postpartum?

Jul 2, 2023 | Tips & Tricks for Recovery

In his month’s solo episode I walk through the differences between Lactational Amenorrhea and Hypothalamic Amenorrhea to help you understand if/when you can expect to get your period back postpartum. I will also be answering a few listener questions, so be sure to listen until the very end!

In this episode:

  • What is lactational amenorrhea?
  • The “hormone reset” theory after having a baby
  • When you should expect your first postpartum period
  • How to avoid relapsing back into HA during pregnancy
  • Tips with get your period back while breastfeeding
  • Seeking support after relapse

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Podcast Transcript

Lindsey Lusson  00:00

Hey guys, I am so excited to be coming to y’all solo this week talking through one of the top questions that I get in my Instagram direct messages probably every single week. And that is how do I know the difference between not getting my period due to breastfeeding versus not getting my period due to hypothalamic amenorrhea, especially if someone has a history of H A. So ultimately, what we’re going to be talking through on today’s episode is where is the line between lactational amenorrhea and hypothalamic amenorrhea. We’re also going to talk through some tips if you’re currently pregnant, how to avoid relapsing during your pregnancy. And we’re going to talk about if you have relapsed postpartum how to course correct and be able to get your period back. Finally, I’m going to be answering some of your top listener questions at the end of today’s episode to be sure to stay tuned in all the way to the end this week.

Welcome to the period recovery and fertility podcast. Here we discuss the challenging, rewarding and life changing process of recovering your period and finding freedom with food and exercise. Whether you’re hoping to regain your cycle to get your health back on track or you’re ready to become a mama. This podcast is for you. While the recovery process isn’t always rainbows and butterflies, it’s my hope to bring you both information and inspiration during your own recovery journey. I’m your host, registered dietitian and fellow at a woman Lindsey Lusson.

Hello beautiful people. Welcome back to the period recovery and fertility Podcast. I’m Lindsay Lawson, your host coming at you guys with a another solo episode on one of the most common questions that I get in my DMs on Instagram and when I host weekly q&a is on Instagram. And that is how do I know if or when I will get my period back postpartum. So I do want to dive in and talk about the difference between lactational amenorrhea and Hypothalamic Amenorrhea. So let’s start there.

And then I also want to talk through kind of some facts and also some myths about when to expect your period back postpartum, how to know the difference between the two and how to know what are the next steps for you if you are working to get your period back in the postpartum period, especially if you want to keep nursing and how to avoid, you know, relapsing back into ha if you’re currently pregnant or you are very newly postpartum. So with that, the difference between lactational amenorrhea, which is not having a cycle while you are nursing and hypothalamic amenorrhea. So lactational amenorrhea is common in women who are nursing babies who are under six months old. And this happens due to elevated prolactin levels you are producing milk, therefore that prolactin hormone is very high and it interferes with your body’s ability to ovulate. And then if you’re not ovulating, you will not be expecting your period to return.

Remember, ovulation always comes before a period we see lactational amenorrhea in moms who are exclusively breastfeeding, and in particular babies that are six months or younger. The reason for this is around the six month mark, you should be introducing solid foods to your baby. Now while baby is probably not taking a ton of calories from the foods that you are giving them at only six months old, they are still getting some really good nutrition. And some babies at six months old are sleeping through the night. If your baby is six months old, and they’re sleeping through the night, congratulations if your baby is six months old, and they are not sleeping through the night that is not totally abnormal, especially if you are a breastfeeding mom. So one of the things that can kind of indicate when periods return postpartum is how frequently your baby is nursing how many times you’re nursing over the course of a 24 hour period, the age of the baby. And whether you’re nursing overnight or not. And so as you get further and further and further out postpartum, it is likely that your baby is going to start dropping feeds it is likely that your baby is going to start sleeping through the night and it is likely that your baby is going to start taking more and more of their calories through food than from your breast milk.

So that is why we say lactational amenorrhea is what occurs in mothers who are nursing exclusively breastfeeding babies that are six months or younger. Now that does not mean that it’s not totally abnormal to not see your cycle return until you’re kind of closer to 12 months postpartum. Especially if you have a baby who’s not sleeping through the night and especially if you are a mom who is exclusively breastfeeding so once we start introducing formula And once we start dropping feeds, as the baby gets older, and as nursing less frequently, we’re more likely to see cycles return. And so this is kind of what’s normal in the average woman, the average person without a history of HA, remember ha or hypothalamic amenorrhea is curious loss or not having a period for three months or longer, because your body is too stressed from over exercise, under eating, and probably also some other psychological stress going on, we typically kind of see some sort of combination of this stress over exercise, and under eating in a woman who is experiencing ha.

And so it’s interesting because women with H A do seem to take a little bit longer to see periods return postpartum. And there’s a couple of theories on that. And I’m gonna kind of talk through that here in a second. But main take home for the kind of the first thing that I want to talk about today is that there is a difference between lactational amenorrhea, you know, all the way up until a year, it can be normal to not have a cycle, if you are exclusively breastfeeding. Again, breast milk is the primary source of nutrition for your baby. And then once we start getting past the 12 month mark, that’s where in my opinion, we kind of start getting into the gray area of is it lactational amenorrhea? Or is it Hypothalamic Amenorrhea?

Now, if you’re not breastfeeding at all, or you’re not exclusively breastfeeding, so maybe you’re doing some form of combination feeding half formula, half breast milk, supplementing some formula, it would be more likely to see your period return when you’re not exclusively breastfeeding. However, it has been observed that women with a history of HA tend to have maybe a little bit more difficult time seeing periods return postpartum. And one of the reasons for that, and those are the theory, I don’t think we actually have like a research study to show this. And we absolutely don’t have any sort of proposed mechanism to believe that this is what’s going on. But it is a theory that women with ha just simply have a more sensitive hypothalamus. So the body is going to be more sensitive to stress, hey, let’s face it, you’re a new mom, you’ve got a newborn, you’re breastfeeding, you may or may not be working. There are a lot of stressors that come with having a young child and in particular, if you’re a first time mom, and if your body is simply more sensitive to stress, it makes sense that ovulation would be delayed and that your body would kind of put reproduction on hold. While you are really stressed.

We also have to consider the fact that breastfeeding can burn a lot of calories, we talk about breast milk containing around 20 calories per ounce. So if you’re making 25 ounces per day, which is about the average amount that a baby will take some babies take more so babies take less. That’s kind of the average amount that a baby will take when they’re exclusively breastfed, you’re burning about 500 calories a day just from breastfeeding. And that’s not with an oversupply. If you are somebody who makes tons of milk, you might be burning 1000 calories per day or more. And so the stress from nursing being up in the middle of the night, the stress from being a new mom or being a mom maybe have multiple young children, that alone could potentially prevent periods from returning, especially if we knew you had a history of HA and your body is more sensitive to stress. Also, too, I think a lot of women struggle. I think a lot of women in general struggle to keep up with the caloric demand of breastfeeding. And just because you aren’t losing loads of weight from breastfeeding doesn’t necessarily mean that your body isn’t in a calorie deficit and that your body isn’t very stressed. So we take the caloric demand of breastfeeding paired with the typical history for someone who develops HA, and they are very clean eaters. They are very meticulous about how much that they eat, they tend to put off eating, they tend to pride themselves on existing off of a small amount of food, they pride themselves on looking a certain way and having a certain thin physique. And so when you pair kind of the expenditure from breastfeeding with some of the typical eating habits that we see in women with HA, it makes sense that one of the reasons we would struggle to see cycles returned is because we simply aren’t eating enough having worked with a lot of women that experience infertility related to HA and their goal being getting pregnant. I know how hard it can be to continue your recovery once you are pregnant because you don’t have that period that monthly report card to remind you that, hey, maybe we’re exercising too much, maybe we are not eating enough.

And so I do unfortunately see a fair amount of relapse back into HA, during pregnancy and during the postpartum period. Another contributing factor two delayed periods in women with a history of Ha is too much weight loss postpartum. So we talked about gaining enough weight during pregnancy being very important for women with a history of HA, because many of them are coming into pregnancy in a body that is undernourished and potentially a body size that is too small for them and their genetic setpoint weight healthy pregnancy weight gain is at least 25 to 35 pounds. If we talk about what makes up the majority of that weight gain, about seven to eight pounds is the actual baby. Another one to two pounds is the placenta, another two pounds is amniotic fluid, it’s very common for women to gain around an extra two pounds or so a breast tissue, your blood volume doubles, so that’s roughly another four pounds, your uterus gets a lot larger in size, and that’s another two ish pounds, another four pounds can be fluid, or just extra tissue. And then you know, in between five and 10 pounds would be fat storage. And if we add up kind of the minimum side of that, that equals about 25 pounds. So what that means is, if you don’t gain at least 25 pounds during your pregnancy, you’re actually losing weight during your pregnancy. And this is probably the biggest area, I see women go wrong and set themselves up for failure with relapsing with ha in the postpartum period is that they don’t get enough weight during pregnancy, when I was pretty active, and a lot of HA recovery, Facebook groups and message boards, there seem to kind of be the school of thought that was going around that, oh, I gained so much weight to recover my period, I don’t need to gain as much weight during my pregnancy. And that way of thinking is can pull the weight backwards, the amount of weight that you gave to get your period back does it count towards the amount of weight that your body needs to eat and for pregnancy, for the reason that I just described that minimum of 25 pounds is basically all of the changes that go on in your body to support a healthy pregnancy.

And so under gaining during pregnancy can be really dangerous, again, for somebody coming into pregnancy, who is undernourished and somebody who might have a really long history of disordered eating habits. And so gaining adequate amount of weight during your pregnancy is going to be key to avoiding getting back into ha postpartum and being able to get your period back. The next reason someone might struggle to get their period back postpartum with a history of Ha is too much exercise.

So you know, not having your period for nine months or longer if you’re a nursing mom, or postpartum, you have a lot of, you know, flexibility to do about as much exercise as you could. I think one thing that I see a lot of moms fall into in the postpartum period is feeling like exercise and their me time. And that’s awesome. That’s great, it is a really great time to dedicate to de stressing and taking care of your body. But I think when exercise is our only tool for stress management, and we’re super stressed because maybe baby isn’t sleeping a whole lot or we don’t have the help that we need, or we’re just in this new place. So we don’t recognize who we are anymore.

If exercise is your only stress outlet, then it’s really common to go back to over exercising. And so if you are a mom who’s doing an exercise class and then taking your baby for a three to four mile walk afterwards, that’s probably too much too much exercise. And it would be really hard to keep up with fueling for that appropriately, especially if you are nursing and so exercise is really something to consider as well. And then finally, the last reason that we see moms struggle getting periods back postpartum when you have this history of Ha is relapse into old habits, right and it can be hard to break some of these habits and if you are like myself and many of the clients that I work with, you may have had disordered eating habits and tendencies to over exercise and body image issues, majority of your adult life and so if you are at this place post partum and you are struggling again.

I do want to pause and and acknowledge how hard it is. And to encourage you to have some grace with yourself, you’re likely not going to undo 10 years of disordered eating in nine months of pregnancy. And so this recovery from Ha is absolutely a journey. And it’s an ongoing process. And it’s important to have grace with yourself, but also recognize when things might need to change and when you might need a higher level of support. So let’s talk a little bit about that as well. But before we do, I’ll give kind of a brief summary of what we’ve already talked about main difference between lactational amenorrhea, and hypothalamic amenorrhea is the root cause. So when you’re nursing, you’re not getting a period because of elevated prolactin, when you have a che, you’re not getting a period because your body is too stressed, you’re probably not eating enough, and you’re probably exercising too much, it is more likely to be hypothalamic amenorrhea, again, versus lactational amenorrhea.

If you are more than 12 months postpartum, if you are nursing less than five times a day, especially if you’ve kind of weaned down to just morning and night nursing and you are not exclusively breastfeeding. And this would be common in a baby that’s older than 12 months, because we would expect them to be taking a decent amount of table food at that time. And then I would also say it would probably be more likely to be ha if you are kind of nearing that 12 month postpartum mark and you are not exclusively breastfeeding, maybe you’re complicating and you’re using formula, although there are always kind of outliers and unique situations. Now, I do want to touch upon this theory that your hormones reset postpartum. And that’s not untrue. Again, it is a theory, I don’t think that we necessarily know that to be factual, but it kind of makes sense that your hormone levels during pregnancy are so different than they’ve ever been during your entire life. And there is kind of this thought process that they kind of prime your body to be more balanced in the postpartum period. And that you could potentially have irregular cycles, get pregnant and then get on the other side of pregnancy and never have a regular cycle. So that is observed kind of in the wild in the real world. And we’re not exactly sure why with a HA history, I would not bank on that happening for you. And we have to remember what is the root cause of period loss with HA it is your lifestyle habits and your nutritional status. And so if you do not change any of your habits with food and exercise before pregnancy, and you do not change any during pregnancy, I would not be shocked if on the other side of pregnancy, you’re struggling with hypothalamic amenorrhea again.

And so while the hormone reset theory can be true for some people, I haven’t really observed that to be some sort of magical thing that happens. And then a day is gone forever and ever. And so you might be asking, Will you know when should I expect a period back postpartum or at least after weaning? And unfortunately, research on this is scant probably because you know, a lot of women don’t have hypothalamic amenorrhea. It is a more newly named and more newly understood health issue. Women’s Health in particular is widely under studied. But from what I have read in the research and from what I have observed in my practice, you shouldn’t expect to ovulate within about four to six weeks of fully weaning from breastfeeding, which would mean we would expect to see your first postpartum period within about six to eight weeks of weaning. And so if you are 100% weaned and you are, let’s say three months postpartum and still no period, I would say it is very unlikely that it is related to lactational in Korea at that point, but it could be a good time to get some labs done. Ask yourself, you know, some really serious questions that I’ll kind of highlight here at the end of the episode. And just kind of think about what makes sense for you.

So let’s say you’re listening to this episode, and you’re not nursing, let’s say you’re halfway through your pregnancy. Or maybe you’re newly pregnant. First of all, congratulations. I think there’s always milestones in recovery that we really need to pause and celebrate and not get too far ahead of ourselves in terms of what’s going to happen next. What if I can’t get my period back postpartum? There is so much power in trusting your body and the fact that it’s gotten you this far. That being said, I do kind of have some best practices that I recommend to avoid relaxing back into ha postpartum and the first one is to not dip more than about five pounds below your pre pregnancy weight. big disclaimer here. If You went through fertility treatment, and you did not gain any weight and you did not regain your cycle prior to getting pregnant, you still may not be at a weight that your body feels safe and healthy and fertile. And so when I say don’t dip more than about five pounds below pre pregnancy weight, I’m speaking more towards women who were able to recover their cycles. And, you know, maybe needed low level interventions with fertility treatment, or got pregnant naturally. And again, you know, if we didn’t really address the root of the problem before we got pregnant, and we use fertility assistance to get pregnant, that’s not wrong, I’m so happy that you were able to get pregnant and to have a healthy pregnancy and to have a baby, it’s not wrong to go about it that way.

However, we shouldn’t be incredibly surprised if we’re struggling with a tag and postpartum if we didn’t really address the root issue. Another way. Another tip that I always give my clients to avoid relapsing into aging postpartum is to make sure that you’re eating enough. And I think a good way to think about it is to eat pretty similarly to how you ate to recover your period, and possibly more. You know, we talked at the beginning of episode about how many calories, breastfeeding might be burning. And so it’s not uncommon to feel hungrier, and to require more food while you’re nursing than you did when you were pregnant. And possibly, then you needed to recover your period. My next tip is to not exercise for more than an hour a day. What I mean by that, and yes, walking counts as exercise is that it’s important to move your body and that can feel really good.

On the flip side, if you are exhausted, and you don’t have time, please don’t guilt yourself into feeling like you need to be exercising, all of that will come in time. But if you are the person who is exercising for hours on end, then that is a lot of stress on a body who has already gone through a stressful nine months of carrying the baby and stressful months in the postpartum period. And so if you want to exercise, it is my recommendation to cap your exercise at an hour a day. I also encourage my clients to take at least one to two rest days per week. And to be able to really work on tuning in with your body and what your body needs that day. If you have a planned workout at 5am, and your baby was up three times in the middle of the night, probably not helpful, healthy or productive for you to go work out in a body that has been sleep deprived and is stressed as a result. And so just be smart with your exercise. And sometimes that’s easier said than done. But this is your reminder to listen to your body. And to recognize that rest is and always will be a very healthy part of an exercise routine. And then finally, my last tip for avoiding relaxing back into period loss with ha postpartum is to make sure that you have some really good accountability, whether it’s through a partner, a best friend, or a recovery community to make sure that you have people on your team asking you maybe some hard questions, holding you accountable to fueling well, not losing a ton of weight, postpartum and continuing to work on having a healthy relationship with exercise.

So those are my big tips for again, maybe pregnant mamas listening, or people who are just taking this information and thinking about it. But I also want to speak to people who are back in this place. So maybe you’re listening to this episode and you’re like, oh, shoot, this is totally me like I have gone back. I am you know, more than 12 months postpartum. And I’m maybe not you know, you know, maybe we’re at maybe this is episode is bringing up some questions. Maybe I am exercising too much. Maybe I have gained a little bit or lost a little bit too much weight postpartum. What are you know, what are kind of the next steps for me. Now, I’m going to give a couple of different tips for those who are maybe wanting to continue nursing who are currently nursing and want to continue, versus people who you know, haven’t nursed at all where they have already leaned and they’re still not getting a period. So let’s start with those who maybe want to continue nursing, but they want to make sure that they are doing all the right things to get their period back as their nursing. A couple of tips that I’ve seen work really well for clients of mine in the food freedom fertility society is to drop feeds. And if you have one of those babies that’s a little fussy, like my first one was, I get that that can be really difficult. Breastfeeding can be a really great way to bond with your baby and it can be a really great way to soothe your baby and so dropping feeds is easier said than done.

However, The last often that we’re, we’re feeding, the lower prolactin levels will drop and the more likely we are to see periods to return. So my first tip if you are wanting to continue nursing, and work on getting your period back would be to drop to just morning and night nursing. Now please don’t do this. If your baby is younger than 12 months old, and you don’t want to supplement supplement with formula, it is important that breast milk or formula is Baby’s first form of nutrition for up to one year old. But let’s say you are 12 months postpartum baby just turned one. And you want to get your period back but you’re not ready to stop nursing, I would cut down to the morning and night nursing. And then if that if you go a couple more months, and nothing really changes, you can always consider 100% weaning that probably will bring your period back if you’re well nourished, and you’re not over exercising. But morning tonight, nursing would probably be like the first thing that I would recommend, in addition to that, right, because we want to address kind of all the factors that could be going on with you. And what might be preventing you from getting your period back would be to make sure you’re eating enough and probably even getting your body into a bit of a calorie surplus. Here we go on theories from the internet again. But there is this theory that a way to get your period back while still nursing is to eat in a calorie surplus, much like how you would do to recover your period with HA with eating in a surplus, you will probably gain some way.

Now this is not the end of the world. Remember, our bodies love and get positive energy balance when we talk about wanting to have enough energy to make a baby. And so that would be my next tip for nursing mamas who are ready to get their period back is to make sure you are eating enough, consider eating enough to even put on a couple of pounds. And then my third tip would be to slow down on exercise, hey, if you’re not following already, the recommendations that I set for not relapsing back into ha postpartum start there, if that’s not making a huge dent, or if you’re kind of falling into some of the categories that I’ve already talked about with like losing a lot of weight, postpartum, not gaining enough weight during your pregnancy, doing IVF and not really addressing the root cause I would highly highly, highly encourage you to slow down on exercise and take much of a less is more approach with both the intensity of your exercise and the duration. So how much you’re exercising.

All right, so we’ll wrap up by talking about next steps for what to do if you are more than two to three months post weaning or maybe you are someone who chose not to breastfeed and you are in this space of recognizing that it is no longer lactational amenorrhea. Maybe it never was for you. It is absolutely hypothalamic amenorrhea. Or maybe you’re unsure. Like maybe you you know, there’s a big part of you that says probably too again, but you’re not sure what would be the next steps, the first thing that I would encourage you to do would be to go for labs. So get your hormones tested. Let’s look at estrogen. Let’s look at FSH and LH. Let’s look at progesterone for the heck of it. Maybe you already ovulated and you’re about to get your period back and you didn’t even realize it. So go for labs, let’s before we freak out, let’s go for labs. You might also want to have prolactin check just to see if for whatever reason it is still elevated. Some women are producing milk, even they don’t even realize it can just still be there. You can also have elevated prolactin for other reasons. So first line of defense, see your OB have some labs done as you’re waiting for those lab results to come back. I really want you to assess your lifestyle factors. I want you to think through a lot of the things that I’ve talked about in this episode, in particular with how recovered you consider yourself right like can you confidently say I really addressed my issues with food and movement and body image before pregnancy. And you know, I should expect my period return.

If you feel very confident in that, then there’s nothing to worry about here. But if there are some things that are really, if you know, in your gut, that we’re still really stressed about food, we aren’t eating enough, we’re still exercising too much. Then, you know, I think that that’s an important time to start thinking about getting more support. So in my group coaching program, the food freedom fertility society, I work with women in all different stages of recovery. That means women who have never been pregnant before never had a period before looking to get their period back for health and fertility. And I work with women in the postpartum period. Women who are feeling overly stressed women who have lost too much weight postpartum women who never addressed ha ever before and their array to get into it this time around and women who felt like they recovered pretty well and then relapsed or During pregnancy, or that super stressful postpartum period. And so I say that and I’m coming to you guys with this episode with information for you to know. And without judgment, because as I’ve already talked about on this episode, you guys, it is not easy to one recover, and to stay recovered, especially when we have kind of a longer history of disordered relationships with food and movement or body image issues. And so if you’re looking for a higher level of support, I want you to go over to my website, www.foodfreedomandfertility.com I want you to look into my programs. And if you feel so led, I would love to have you apply and visit with you more over the phone about your story and where you’re at in recovery.

Answering Your Questions

Okay, so I’m going to answer some of your listener questions. Now. These questions were submitted from people who are on my email list. So if you aren’t on my email list already, head over to my website, food freedom and fertility.com and scroll down to the bottom grab my freebie, my free period recovery meal plan. And that will put you also on my email list so that you can have a link to submit whatever question you have, for me, whether it’s something related to where you’re at in your recovery journey, or maybe a really unique period recovery situation. Or maybe you are trying to conceive, and you want some advice on what are the next steps for you and your unique situation. So I am happy to do the best I can with the information that you guys provide on these questions. And with that, let’s go ahead and dive in and answer a few.

All right, so the first question reads, some specialist recommend to switch from higher intensity workouts to lower intensity workouts like walking and yoga. I think this is what you recommend, as well. I do the listener asked, it’s what I’ve done. But with a history of an eating disorder, I tend to overdo things, including walking. So my question is how much walking is too much walking? And does walking count as exercise? So I love this question. And I first want to acknowledge that I’m proud of you for recognizing that walking is exercise, because that is something that even some of my clients in the food freedom fertility society don’t fully recognize until they’re here and we have to talk about it. So yes, walking does count as exercise. The way that I like to think about it is if you are heading out and you are going for like a two to three mile walk, you need to remember that that is getting your heart rate up to a certain extent, typically not crossing over into the high intensity exercise unless you’re doing a lot of hills or you walk really fast. But what we have to remember is that that still burns calories in when we are in a state of low energy availability. As is the case with H A, every kind of bit of movement counts. Now I don’t think we have to overthink this too, too much. But yes, walking counts as exercise to answer your question, how much walking is too much, it’s going to really depend upon the person and the nature of what they’re doing with the walking. So I always describe there’s a difference between somebody hitting, you know, eight to 10,000 steps per day, if they are a nurse or a teacher, or maybe you live in a city where you transportation isn’t readily available. And so you have to walk everywhere you go. To me that’s very different than somebody you know, getting on a treadmill, or waking up at 5am to hit X number of steps. And so there’s a difference in my mind versus what’s too much. And how much are we pushing our bodies? Is this movement naturally built into your day? Well, that’s not really anything we can change so much, versus again, the individual waking up at 5am to go get in our three to five mile walk.

That to me is very different. And so whenever we’re talking about exercise in general, we always want to think about the individual their situation. And of course, are you able to offset that with food? Because if the answer is no, then we need to dig a little deeper and figure out can we offset with food? Or do we need to have a reduction in even low intensity exercise. And so the way that I approach exercise is always very different per the individual and their situation. And that’s something that I discussed with my clients in the food freedom fertility society, as a general rule of thumb, if you can’t steps a keep it under 10,000 steps per day. And if you don’t count steps, I would say any intentional movement via getting outside and going for a walk or being at a gym and walking on a treadmill. I would keep that walking under 60 minutes per day. So again, always depends on the individual. Are we fueling for what’s the intention behind the movement, but as a general rule, we want to keep it under 10,000 steps per day or under 16 minutes. Walking per day.

Let’s move on to our second listener question. So this person says, Hi, is it true that the longer your period has been missing, the more weight you will need to gain in order for your body to feel safe? Again, great question. And for my clients, I don’t have them really report weights all throughout the recovery journey. And so while I could, you know, do a deep dive and look at what I’ve seen from my clients, this isn’t something that really I pay attention to in my practice. So typically, clients that are working with me have already achieved a quote, healthy BMI, meaning that they are at least a BMI of 18.5 or higher. And so at that point, I really encourage people to not pay attention to weight and number on the scale. And that has a lot to do with improving body image, I have seen individuals be able to make way bigger strides in improving their body image when they’re not so skill focused, not so focused on the number on the scale, chances are, you’re not going to need a scale to tell you that your body is gaining weight, you should be able to feel it in some aspects, or if you see it in the way that your clothes are fitting. So number one, I would recommend, you know, kind of stepping away from the scale.

Now how much body your individual body needs to gain to have a period return will depend on a number of factors. And some of it will have to do with how malnourished your body was to begin with. So somebody’s starting period recovery while also actively battling an eating disorder, they might need to gain more weight for their bodies to feel safe and healthy and ready to ovulate and have this non essential body function of reproduction. Working for them again, however, there is always going to be a bit of a genetic component here on where someone’s body is going to cycle naturally, meaning we all have a very different weight setpoint weight range, different bodies need different amounts of body fat to feel safe and comfortable to ovulate again. And so this is kind of a complicated question. And my answer, in short is, it depends. If your period has been missing for 15 years, and you know, 14 of this 15 years, you’ve been battling an eating disorder and you’re starting your ha recovery. In the midst of also battling an eating disorder, I would anticipate that your recovery journey might be a little bit lengthier of one and potentially, you might have a more weight to restore than maybe somebody who’s been missing their period for eight months never had an eating disorder, and they aren’t going to be battling as many of the mental hurdles hurdles in their period recovery journey. So I hope that helps you. The truth of the matter is, is we really don’t know how much weight somebody needs to gain to get their period back, I don’t think we can draw a correlation between the amount of time your periods been missing, and you necessarily needing to gain more weight, just like we can’t necessarily draw a correlation between someone who hasn’t been missing their period that long and doesn’t need to gain that much weight. It really there’s so many more things wrapped up in this question that are really going to go back to the individual. How malnourished is their body genetics, and then you know how their individual body responds to the recovery plan. So I hope that helps them. But again, that’s kind of a tricky one to answer. And my best advice to you would be to really focus less on the scale and more on how to properly nourish your body, rest your body and have kind of a plan for you for period recovery.

All right, let’s do one more. So this person says thanks to you. I recovered my period 10 months ago after losing my period for 12 years. Wow, congratulations. I have yet been able to test for ovulation even after his quasi which is a procedure to basically kind of see if we have any to blockage or any other kind of structural reason why we wouldn’t be ovulating. So the question is, should I proceed with forced ovulation or to keep trying naturally? So I’m going to assume from this question that you have recovered your period, but we haven’t been able to confirm ovulation. If you’ve been cycling for a while, I would like to think you would be able to catch ovulation naturally. I think I would start with having some testing done if it were me. So I would get out my APKs I would make sure you’re familiar with cycle tracking using a cycle tracking app. Make sure you’re familiar with the you know stages of cervical mucus and how to use that for predicting ovulation. These are all things that I teach to my clients in the food freedom fertility society and I do have a phase two group for people who have gotten their period back but they’re not sure if they’re ovulating or their cycles are kind of, you know, 60 days, 90 days, 22 days like all over the place. So that’s something we work on in my phase two group but step one here is I would see if you’re ovulating because You really don’t know unless you test and so using a PK cervical mucus and then basal body temperature tracking or going for a blood progesterone draw seven days after suspected ovulation is going to be the best way to confirm. So OPKs ovulation predictor kit strips only predicted they don’t actually confirm ovulation. I’d go for a blood progesterone draw here. And let’s see if you are and then whether or not you should proceed with forced ovulation or ovulation induction is really going to depend on you and your timeline. So I’ve worked with clients who are in unique situations, maybe they’re in their late 30s. And there’s concern for egg quality. And time kind of starts to become a factor or maybe somebody has been working on period recovery for over a year. And they’ve really put their all in, they’re not kind of dipping their toes in. They’re not two steps forward, one step back, but they have been working super hard. And it’s a celebration just to have their period back. Right. You know, if somebody has their period back, and maybe they’re ovulating, maybe they’re not, I would say if you’re in a really good place mentally, and this is subjective, right? Like this would be something that you your partner, other loved ones, and your physician would all hopefully get to kind of have this conversation together on deciding the best next steps. I don’t think it’s wrong at all, if somebody has, again, put a ton of work into recovery, and they are feeling you know, mentally 90-95% recovered, and they just want to be able to get pregnant. I don’t see any issue with using ovulation induction to do that.

On the other hand, if time is on your side and your late 20s, early 30s, we don’t necessarily need to be pregnant yesterday, I kind of think you owe it to yourself to see if your body could ovulate on your own if you could get pregnant naturally. Not that a natural pregnancy is superior in any form to a pregnancy where we use fertility assistance. But how freaking cool would it be if your body could do it naturally? I think that for most people in a perfect world, that is the goal. And I hope that you hear this message when I’m saying I see absolutely nothing wrong with using fertility assistance, especially when you have put in a lot of work into recovery. And you just want to be pregnant, I would say it depends on your situation, what you and your partner feel is best and your individual timeline. So I don’t think there’s necessarily a wrong answer here. It’s just gonna depend on what you prefer.

So that’s gonna be it for this week. I would love to do more of these and help you guys out. I know that getting answers about ha especially fertility and HA can be so tricky. You can’t just Google the answer. And you can’t necessarily get an unbiased opinion from a physician who is wanting you to use medicine because that’s how most reproductive endocrinologist work, nothing wrong with it. But if you’re just wanting an alternative opinion, I am more than happy to wait and see you guys keep these listener questions coming. I’ll probably have a question box on Instagram next month for you guys to do some there. But if you’re on my email list, I’m also going to have a link for you to be able to submit them through the email list. I get way fewer on the link from my email list versus the close to 100 But I’ll get on Instagram so you’d probably have a better chance of getting your question answered if you do it through my email list to make sure that you’re on it. I hope that this was helpful for you guys and thanks so much for tuning in. Thank you so much for tuning in and listening if you found this episode to be inspiring or helpful, please share on social media and tag me out through dot freedom dot fertility. Also don’t forget to leave a rating and a review

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I’m a fertility nutritionist and registered dietitian who specializes in hypothalamic amenorrhea. My passion is helping women trying to conceive find freedom with food and exercise, so they can recover their period, and get pregnant naturally.

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Jan 19, 2022

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