Hypothalamic Amenhorrhea is the fancy way of saying “stress-induced loss of menstruation.”  The hypothalamus is the part of the brain that determines if you are in a safe enough environment to bear children.  If your body receives signals that you are not “safe” enough, then your hormone production will decrease and you will stop menstruating.  You may also suffer symptoms of low libido, depression, anxiety, insomnia, acne, and fatigue.

“Safe” means both physiologically and psychologically.  Mental stress can hurt your fertility just as much as physical stress.  Unfortunately, these two stressors commonly occur in women today, and commonly in paleo dieters.  Mental stress comes from pressure and ambition and work and life as well as body image issues, low-self-esteem, and disordered eating.  Physical stress comes from low body fat levels, rapid fat loss, excessive fat loss, fasting, over-exercising, under-sleeping, and under-eating.   It’s no wonder that so many women struggle with this.

Estrogen, progesterone, LH and FSH — all female hormones — decrease with hypothalamic stress.  LH and FSH come directly from the pituitary and fall off the wagon, and then estrogen and progesterone, which take their cues largely from LH and FSH, fall off of it, too.

The thing about HA is that its severity and “cure” are different for each woman.  The trick is to address all of the kinds of stress that play a role in HA, and to focus on the type of stress that caused your problem in the first place.

Initially we need to understand, a hormonal imbalance can take several months to 18 months to self correct.  That is assuming we are putting all the steps into action that is advised.  Losing our regular menstrual cycle is common after coming off the OCP (oral contraceptive pill), after a traumatic event or it can begin by occasionally skipping a month and turning into a complete no show months down the track.  Either way it can be daunting and consuming, especially if your wanting to have a baby.  The good news is, it will return. However in order to have change we need to make some changes.

There are 3 main factors that influence the Hypothalamic Axis; exercise, food and stress.  So often woman tend to over exercise and under- eat, depleting the body of good fats, proteins and carbohydrates.  Doing this for just a few months can really effect the production of hormones.  In addition, if we add the final piece to the puzzle which is stress, we end up with a very frail axis which can lead to loss of menstruation.  So ultimately both the body and the mind is depleted.  This condition is commonly seen in the typical “perfectionist” personality.  These types of people are so focused on being fit and healthy that the obsessive nature of it becomes an internal stressor.  This mindset can often set ourselves on a path of self-destruction without even knowing it.. being ‘consumed’ with being fit and healthy can actually be more unhealthy in the long run.

From a Traditional Chinese Medicine (TCM) perspective, it can be simply suggested,we must re-balance our yin and yang.  Yin is our female body, its our nurturing, slow, compassionate forgiving energy.  When yin is in balance we have an abundance of blood and energy, our mind is at peace, we have regular menstrual cycles which flow smoothly and are we are able to conceive naturally.

In today’s paced life, we have no time to honour our female body, she is burnt out or ignored and we get stuck in our Yang male body.  We loose too much body fat, cant accept curves and a few graceful wobbles.  We work excessive hours, train extra hard at the gym and often follow very restricted and controlled eating habits which end up causing all sort of sensitive gut issues, inadequate food intake which leads our body into “survival mode”.

When we hit survival mode, often our sleep can be disrupted, our mind remains active, we ruminate over small things, we often experience palpitations, gut distress, night-sweats, become impatient, anxious, emotional  and fidgety and of course we loose our menstrual cycle.  Why would the body even contemplate procreation when its trying to purely survive.

So lets start with what is often the biggest issue:

Chances are you will need to eat more than you are currently eating.

How much do you need to eat? Well, everyone is different. You could start by plugging your details into an average BMI calculator.  My guess is that most of us females in this category are eating around 1000-1400 cals per day..

Where really we should be eating around 1800-2200.  Try putting your food into a calorie app and working this out.

Hypothalamic Amenhorrhea is all about convincing your body that it’s no longer in danger.

Eat fats and proteins:

These are the building blocks of your hormones. Get rid of your fat phobia now and start embracing:

real organic butter, coconut oil, avocado, all nuts, (if you tend to have a sensitive gut, activate them or buy them activated).

Seeds – are so high in omegas which is what our ovaries love to drink.

Eggs, OMG, eat them up, look what they resemble, our eggs as females.  They are natures multi vitamin, they have over thirteen essential nutrients.

So don’t just eat the white, the egg is a whole food within itself and designed to eat both colours.

Include adequate (regular) servings of bioavailable protein the most bioavailable form is animal protein – slow cooked is easiest on the gut so try and enjoy casseroles, stews, broths and soups.

Liver – pate – its rich in vitamin A and folate and super high in bioavailable iron.  Make your own, its really not hard.

Oily fish – Salmon, mackerel, herring, sardines….all wonderful sources of DHA (docosohexaenoic acid), which is important for our ovaries.. These help create the building blocks for happy hormones.


Carbs are not the devil. We need glucose running through out body – that’s why our body will make it by breaking down protein if you do not give it enough through the diet.

We need dietary carbs (preferably whole, unprocessed forms) for insulin release (sporadic, not all the time) to help with healthy thyroid function.

Whole grains, brown rice, oats, potatoes, lentils, quinoa, barley, rye, burgen breads are good too.  Plenty of fruit and vegetables.

GOOD carbs must be consumed during every meal.  3 x a day.  Increase your good carbs and stop the restriction of them to only once a day.. We are trying to nourish not heal not deprive and control..

Also, when we go low carb, high fat, we are satiated on less food. When you need to eat more, the last thing you want is a suppressed appetite.

Of course, my most important thing to remember is having cooked and warm foods.  Our body is a bit sick at the moment.  We need to recognise that by nourishing it with warm, cooked foods it is much easier for our digestive system to absorb nutrients and build blood!!!!

How many times have you taken a raw super green smoothie or a tuna salad to someone who is unwell? Apply the same rules to yourself.

Choose movement over exercise

Choose things like yoga (not bikram), walking (preferably in nature) and leisurely activities (you know – actually spending time playing with other people, not just staring at a screen as you run on the spot).

If you want to continue with weights keep sessions short and medium weight.

Only exercise if and when you feel you have the energy to do so. Do not use exercise as a way of giving yourself more energy. That’s what sleep and food are for!

Acceptance of putting on a little body fat

Our fat cells produce a hormone called leptin, which helps to tell the brain that there is sufficient energy for menstruation to occur. When body fat levels are too low, the brain does not receive the message.  Therefore no period.

This can be a scary thought. But once you come through the other side, it isn’t so bad.

Chilling out and looking long term, not short term

Mental stress can have a HUGE impact on your reproductive function. Again, if you are under chronic stress, your brain is going to get the “It’s not safe to make babies” message and will not send the signals to your lady garden to produce hormones necessary for menstruation.

Chronic stress can also increase cortisol levels, which subsequently decreases sex hormones, leaving you with low libido and often try vaginally.

Hypothalamic Amenhorrhea isn’t a quick fix, however the desired outcome can be achieved by following the guidelines above, accepting things have to change, reducing expectations of a quick fix and letting go of old habits that clearly don’t serve us like we once thought they did.