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How to recover from Secondary Amenorrhea??

Answered on August 19, 2014
Created May 12, 2013 at 4:50 AM

Hi everyone,

I am 18 years old, and have had secondary amenorrhea for nearly one a a half years. This began since I moved to a new city last year to begin my undergraduate studies. Due to the high demands of my course, I was very stressed out, lost my apetite(that being said I never skipped a meal) and lost a lot of weight in a period of 4 months.(49kg to 43kg, I am 5"1). Looking back now, I didn't realise it then, I was probably suffering from anxiety and depression those first four months of uni.

After no period for 4 months, I went to see a doctor, did some tests and although I have normal TSH levels, I have very low levels of the sex hormones(LH, FSH, oestrodiol). Doctor told me not to worry and that I should just "eat healthy and do exercise"

So I didn't think too much of it and just got on with life.

2 Months passed and no period. I gained about 1-2kg, advised by my mom(who I think gives me better advice than any of the doctors I've been to). So I went to see another doctor who could hopefully give me some better advice. Did the tests again, same thing normal TSH and low sex hormones. She pretty much told me to eat more/gain some weight and my period would return. She also referred me to an gastroenterologist(I'm not really sure why... but its probably because I told her I have lactose intolerance and she wanted to confirm this?) and he told me the same thing. EAT MORE and exercise less(I didn't exercise much to begin with- I jog about 15 minutes(yes only 15 minutes) 3 times a week because a) it helps with my stress, b) I enjoy it)

So thats what I've been doing for the past 6 months? I am now heavier than my initial weight(51kg) but still no period. I will do what it takes to get it back but its so frustrating! Obviously I don't want to put on any more weight and not to mention I don't think it's working as well.

I don't follow a particular diet. But I don't eat processed food/fast food etc and I don't really experience cravings or fancy confectionary items from the supermarket in the first place.

I feel so helpless... I feel like the doctors I have seen don't really know much about this than I do. And all the stuff I find on the internet are associated with anorexia and eating disorders. I am going to make an appointment with a gynocologist this week.

What am I doing wrong? I am definitely less stressed(had a 4 month break, spending time with family and friends, holidaying, I'm back to uni now and while its still a bit stressful its way better than last year).

Any advice or help would be greatly appreciated. (And if anybody can explain amenorrhea in detail for me that would be greatly appreciated as well...all I can understand is that I'm not producing any sex hormones but WHY????) I am very worried I really don't want to get osteoporosis(I don't really understand why this happens too.i.e. what osteoporosis has to do with my periods) and affect my fertility(I'm thinking about my health in the long term).

Thankyou.

Sincerely, Sammy

68655ec9711d207d69a63ebf96b37573

on May 13, 2013
at 11:43 AM

You don't need to be high carb, just don't go low carb. Try a diet of fat - 40-50%, protein 30%, carbs 20-30% 6 meals - don't really see the need, IMO. 3 should be fine. It doesn't sound like a simply low thryoid issue. I only eat paleo carbs. Berries, stone fruits, starchy veggies like parsnips, carrots, beetroot, butternut squash

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 13, 2013
at 09:26 AM

I'm looking at my blood tests again. I also see super high levels of ALT(99H) the reference range is <34H, and also slightly elevated GGT (24H) reference range is 7-21. I also have low white cell, neutrophil and monocyte counts... O_O'' My doctor didn't say anything so I'm guessing that is okay??

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 13, 2013
at 12:36 AM

The more I read the more I am getting confused. Some recommend to eat a high fat diet because thats what are sex hormones are made of, but some others like you have also recommended more carbs. Also, what types of carbs did you include in your diet(does it really matter?)? I eat a variety e.g. white rice, brown rice, potatoes, sweet potatoes, quinoa, beans, bread-wholemeal/sourdough. I am aware that this is a Paleo site and most of the people here follow a Paleo diet of no grains.

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:07 PM

Thank you. Its great that you have recovered :D

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:06 PM

Thank you so much celticcavegirl. I did some reading and I am aware the the thyroid needs carbohydrates(I eat plenty of those hahah!). Is it a good idea to eat perhaps 5-6 small meals a day so that I am continuously replenishing my carb stores?(am I making sense), instead of the usual 3 meals a day(This is what I've been doing most of my life-I'm not a snacker either).

A4e6473c7791ca1ddeedf5c5db5fbe14

(85)

on May 12, 2013
at 12:24 PM

No, I got it back at around 15 pounds less than my original weight, which is in the middleish range of a healthy BMI for me. At that time, I wasn't really educated on what types of fats were good/bad, but I cut down on carbs (especially sugars) and just stopped being so afraid of animal fats

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:14 AM

Thanks Smeags. Thats great you got it back !! What types of fats did you eat?? Did you have to go over your original weight to get it back??

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 08:40 AM

Thank you for sharing Kara :) My GP suggested I take The Pill but I refuse to do that. I've heard nothing but bad things from the Pill(including post pill amenorrhea). Since both of us are not doing strenuous exercise...we can eliminate that off the list, which leaves us with DIET, STRESS LEVELS, SLEEP? Are you stressed?? I can't think of anything else that would affect our recovery? Or is it that our bodies are beyong repair :( I definitely hope not

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7 Answers

1
10121ac7b6beb99c0fbfbf1522c50adb

on May 12, 2013
at 12:12 PM

Hi Sammy,

I had anorexia for a while, which led to secondary amenorrhea. I got my first period (pre-anorexia) at 90 lbs/41 kg. Fast forward a little bit, and I dropped to 78lbs/35kgs. In case it's not obvious, this is when I lost my period. The eating disorder was a deceptive little f**, but once in its career did it serve me well: it told my doctors that I never had a period in the first place because if I had, I would have gone on the pill to get it back. That still didn't change the fact that I had to gain A LOT of weight, which I did. I got my period back at around 100lbs/45kg, which coincided with tremendous breakthroughs in therapy.

Then I relapsed down to 93lbs/42kg (yes, higher than my weight at menarche) and lost my period. Again. Then I gained weight. Again. This time up to 110lbs/50kgs before getting my period back. At that weight I was able to lose weight GRADUALLY while keeping my period. I got down to about 103lbs/47kgs over the course of 6 months (I said gradually, didn't I?). This was all before I discovered paleo, though. I went from having a "period" that required me to change a panty liner twice a day for one day to a legitimate tampon for 3-4 days, which incidentally marked the transition from low fat low calorie "food" to lots of coconut milk, avocados, nut butter, fatty meats, eggs, and the paleo shebang.

Advice in a nutshell: gain about .5 kg a week until you get your period back. In the meantime, see a psychologist. They are tremendously helpful even for those healthy in the mind, and they don't push medication (otherwise they'd be a psychiatrist). At that point, lose weight little by little until you get to what feels right. This may not necessarily be the same as what looks right, but it can be. Minds can be stupid. Bodies tend not to be.

Enjoy PMSing, Leah

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:07 PM

Thank you. Its great that you have recovered :D

1
A4e6473c7791ca1ddeedf5c5db5fbe14

on May 12, 2013
at 09:43 AM

I went without my period for almost 7 years. It was terrifying. It started with parasites and a lot of weight loss, but gaining the weight back after getting rid of the parasites didn't help it right away. When I finally did get it back, it was during the summer at camp, where I was finally able to relax and really be happy for the first time in years. I didn't realize how stressed and depressed I'd been until then. By that point, I'd been following a paleo-ish diet for about a year and half. I think that upping my fat intake, being more strict about gluten, and sleeping more all played a big part in it too.

I think I should also mention that since coming to Japan 5 months ago, today is the first day I had my period since January! I've had it regularly for a couple of years now, but I guess that being in a different country really messed with my mood, and therefore my hormones. I'm studying abroad and living with a host family; it's a cool experience but extremely stressful and I have almost no control over food (I still avoid gluten though). But the semester's coming to an end and I've been much more relaxed; I'm really excited to be going home soon.

It's good that you got a chance to relax, cause apparently that's what works for me. But I also have to be happy. I know I can't just tell you to relax and be happy, but that's what I need to get my period going. For the things you can control, I'd say eating good quality foods (and fats; no gluten), getting enough sleep, and doing whatever makes you happy.
I think that once it starts, you won't have to keep trying so hard; it should keep going on its own. Good luck! I know it's frustrating.

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:14 AM

Thanks Smeags. Thats great you got it back !! What types of fats did you eat?? Did you have to go over your original weight to get it back??

A4e6473c7791ca1ddeedf5c5db5fbe14

(85)

on May 12, 2013
at 12:24 PM

No, I got it back at around 15 pounds less than my original weight, which is in the middleish range of a healthy BMI for me. At that time, I wasn't really educated on what types of fats were good/bad, but I cut down on carbs (especially sugars) and just stopped being so afraid of animal fats

0
F281f6756145a4a96c68ca3cd3d89c4b

on January 22, 2014
at 05:59 PM

Hi @Sammy 2

I've just read your post and wondered if your situation had resolved itself?

I'm in a similar position and am baffled by it!

Amalie

0
Bcb67c1bbcb369f339c079be194ba54c

on June 13, 2013
at 10:08 PM

This is the exact threat I have been looking for! I also have secondary amenorrhea due to restricting my calories and exercising too much. Although I thought I was healthy, I haven't have my period in over 2 years and it's really starting to scare me. In the past 6 months I have gained 10kg, and have cut back significantly on my training but I still no progress. All I'm feeling is puffy and like I'm going crazy without my training. I still don't know if I am eating enough for my exercise and I'm getting really sick and tired of trying to gain weight with no results. Doctors don't really tell me anything except 'exercise less and eat more' which I'm obviously doing.

How long did you have to keep eating at a calorie surplus for to gen your cycle back and how did you know if you were actually meeting that requirement?

0
C4ed6ba382aed2eefc18e7877999a5de

(1579)

on June 11, 2013
at 08:45 AM

Hey! I have struggled with HA as well. For me, it was starting paleo (at about 54 kg, I'm also 5'1") and a weight loss of about 16 kg that caused me to lose my period. I was eating nutrient-dense food, but was way too low in carbs and not eating enough in general. For a year or so, I maintained around 40-43 kg, with no period, eating more but still not enough. It wasn't until I came to terms with the fact that I was dealing with an eating disorder, and committing myself to recovering completely from both the behaviors and the thoughts that my period returned (it's only come once so far, a couple of weeks ago, but it's progress!). I am currently about 52-54 kg, although I don't weigh myself now.

As much as I believe in theory that the paleo diet is a good way to eat,for me it was fueling ED behaviors and so I am just eating anything I feel like eating now, while I let my body heal itself. I think I will gravitate towards mostly paleo in the future but this is working for me, for now.

The forums at Fertile Thoughts have helped me a lot- there are many women who are struggling with exactly the same thing. They have lots of wisdom and encouragement to offer, and I would highly recommend checking it out: http://www.fertilethoughts.com/forums/hypothalamic-amenorrhea/

Relaxing, eating more, and taking a break from exercise while you heal your body is probably a good thing!

0
68655ec9711d207d69a63ebf96b37573

on May 12, 2013
at 07:39 PM

At this age, it's really important to get your period back, for your bone health. At least you're aware of this and making a lot of positive steps. Female sex hormones help maintain bone density. Osteoporosis is when your bones are not dense and are therefore weaker. You gain a lot of your bone density from 15-21 or so which is why it's really important to be healthy at these ages.

I've had secondary amenorrhea twice. The first was a very similar situation to you - I was 5'1", about 51kg, 17, had a lot of stress, exams, walking a lot in the cold home from school. 6 months with no period, it only came back when I gained back the weight.

2nd time was when I was 23 and went from 55kg to 52kg on VLC paleo, low daily calories, and sometimes IF. Unlike you, I had low thyroid with it from the very low carb.

The female body needs a certain bodyfat percentage to maintain a pregnancy. If you don't have enough fat, your body knows that it's not a good time to get pregnant, and you wont have periods. Keep in mind that this % varies. Some women can be 17% and still have periods, some need 25%.

Same goes for stress. Cortisol plays havoc with your hormones. Personally, I know that I didn't ovulate this month due a combination of extreme relationship drama, travelling, insomnia, and a broken nose. So I'm not having a period this month, I'm 100% sure!

You've gained back the weight you lost, you've reduced your stress. I think now you just have to give your body time to realise it!. Eat a nutrient-rich diet. Lots of iron, lots of protein, lots of healthy (animal) fats. Don't do low carb. 80g minimum a day of carbs,

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 13, 2013
at 12:36 AM

The more I read the more I am getting confused. Some recommend to eat a high fat diet because thats what are sex hormones are made of, but some others like you have also recommended more carbs. Also, what types of carbs did you include in your diet(does it really matter?)? I eat a variety e.g. white rice, brown rice, potatoes, sweet potatoes, quinoa, beans, bread-wholemeal/sourdough. I am aware that this is a Paleo site and most of the people here follow a Paleo diet of no grains.

68655ec9711d207d69a63ebf96b37573

on May 13, 2013
at 11:43 AM

You don't need to be high carb, just don't go low carb. Try a diet of fat - 40-50%, protein 30%, carbs 20-30% 6 meals - don't really see the need, IMO. 3 should be fine. It doesn't sound like a simply low thryoid issue. I only eat paleo carbs. Berries, stone fruits, starchy veggies like parsnips, carrots, beetroot, butternut squash

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 10:06 PM

Thank you so much celticcavegirl. I did some reading and I am aware the the thyroid needs carbohydrates(I eat plenty of those hahah!). Is it a good idea to eat perhaps 5-6 small meals a day so that I am continuously replenishing my carb stores?(am I making sense), instead of the usual 3 meals a day(This is what I've been doing most of my life-I'm not a snacker either).

0
Fc02ca065d619b52b11545f14ce0acb3

on May 12, 2013
at 08:09 AM

This exact same thing has happened to me and unfortunatly I haven't had a period for over 2 years. The doctors did a hormone blood panel and found that I have low estrogen now. My mom thinks it was caused by a (healthy) weight loss of 20 pounds a few years ago when it stopped. I think it was from prolonged use of the progesterone-only pill (mini pill) because that's when it initially went away. My choices are to take synthetic estrogen to prevent osteoporosis but I want to get off the synthetic hormone train! I tried gaining some of the weight back but again, it brought me into a healthy BMI range and I feel like I am at a comfortable and healthy weight. I stopped exercising for a long while to try and bring it back but I have had no success. Now I do more low key exercise like yoga and walking. I guess I am at a loss here... Maybe someone somewhere has some insight they can share but for now I just want you to know you are not alone :(

E1c374d6f86a8e366728b7cebce508dc

(0)

on May 12, 2013
at 08:40 AM

Thank you for sharing Kara :) My GP suggested I take The Pill but I refuse to do that. I've heard nothing but bad things from the Pill(including post pill amenorrhea). Since both of us are not doing strenuous exercise...we can eliminate that off the list, which leaves us with DIET, STRESS LEVELS, SLEEP? Are you stressed?? I can't think of anything else that would affect our recovery? Or is it that our bodies are beyong repair :( I definitely hope not

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