1

votes

Amenorrhea Advice/Info Appreciated!

Answered on August 19, 2014
Created July 21, 2011 at 5:30 PM

So i found a relatively good doctor to communicate with out of TX. Long way from me but whatever. I cant afford doctors visits and hormonal/blood work ups so this is what i got. Anyways I talked to him about my past. FWIW, i suffered anorexia and have gained weight in recovery and restored weight and been messin around with paleo/primal trying to find what makes me feel best since. my hobby is the brain, love studying it and obviously nutrition. so yes, before its said, i know eggs and all the yum cod liver oil and sat fat is good for fertility. same with starch, been eating plenty of food. its not anything i ever took out of my diet(besides when actively anorexic..) but the point remains i have gone 7 years without a period. so anyways, the doc told me this:

"I can tell you that amenorrhea can be caused by suppression of pituitary function from excessive cortisol or psychological stress. Basically, the pituitary shuts down some of it's output, and in the case of amenorrhea, shuts down output to the gonads. To really find out you'd need a complete functional neurological and functional medicine work up."

guessing this is about where i stand... anyone got some information, advice, ideas? i need help with sleeping, im up all night- sweaty mess around 3(cortisol? low blood sugar?). i workout once a week, other days walk in the sun/stretch/meditate. been reading primal wisdom, ray peat and rosedale recently and everything is getting confused because each seems to 'make sense'

100fd85230060e754fc13394eee6d6f1

(18706)

on July 25, 2011
at 04:55 PM

Yeah. I'm not sure exactly where you are, but university libraries are usually open to the public, and you can go to the periodicals section and browse hard copies of the journals. If your local U has a medical program, they're more likely to carry copies of medical journals, and they should have archives of all the back issues. I've resorted to this in the past, especially back before you could get anything online.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:40 PM

medical school? like college?

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:39 PM

i serrrriously doubt Mississippi has TCM schools haha

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:38 PM

how did you manage to get yours back?

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:38 PM

i am scared of pills/supplements, seriously

100fd85230060e754fc13394eee6d6f1

(18706)

on July 23, 2011
at 12:23 AM

Yeah, I couldn't confidently guess your BF from photos. I'm sure you have a better idea than I do. I'm sorry, I don't have the full-text. Do you have a medical school near you? You could use their library.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 22, 2011
at 09:57 PM

Mallory-- have you tried going through the usual suspects of "natural" sleep aids? Valerian, melatonin, kava, etc etc? One dark horse possibility is this: a factor in inability to fall asleep is previous history of inability to fall asleep. Thus, if you could get sleep from a pill or tea for a few days, you could stop that vicious cycle.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 22, 2011
at 09:55 PM

Ambimorph-- yes, it overestimates. In another forum (Lyle McDonald's, with a lot of keto dieters), there were very thin and muscular women with high readings. I've also seen a case study comparing bioelectrical impedance to DEXA in athletes that gave similar conclusions.

Medium avatar

(4878)

on July 22, 2011
at 04:09 PM

Ha, no lentils or beans. My L.Ac practitioner was the first one to comment that my diet was "not appropriate for sustainable health" when I was a veggie. She also knew I was not eating "cooked orange veggies", and a number of other, VERY specific things which were quite shocking to hear during that first 90 minute appointment. TCM is much more Paleo than one would think from listening to the common media. It is less about needles, more about diet, with herbal concoctions thrown in to encourage the body to find it's balance point.

Bd271299b2d4d9b2e3da9c252fef058c

(2854)

on July 22, 2011
at 04:07 PM

It's very hard- I didn't menstruate from age 23-27. Although Time is my biggest advice, stress is a factor that could counteract that. Weigh the pros and cons, and if taking medication feels like the better choice for you, do it!

Medium avatar

(4878)

on July 22, 2011
at 03:37 PM

Mallory, go to a local TCM school. They have sliding scales for treatment costs, and you'll probably just be charged for herbs ($15). Your case is a GREAT case for their students as your symptoms are a "classic" case of hormonal distress.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:31 PM

do you have full text to that study?

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:31 PM

thanks, yes i have used those same pics on my website but def dont think i am 15%bf

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:30 PM

haha so go check out primal wisdom, start eating lentils/beans/buckwheat and go the herbal medicine route?? wont lie, i am intrigued. i just dont see how it works

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:29 PM

again, i have no money whatsoever

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:28 PM

patience is hard when your 25 and you biological clock is ticking away... not to mention youre supposedly eating the 'healthiest diet' there is

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:28 PM

I dont have a doctor, i cant afford to go to one. sleeping...i am tired, room is dark/quiet but i cant fall asleep i just lay there til about 5am then fall asleep(to wake up at 630 for work). i have tried lights out before bed, calming down, a walk before evening falls, meditating everything, magnesium i really dont think my BF is as low as people think, ill post a normal picture today

100fd85230060e754fc13394eee6d6f1

(18706)

on July 22, 2011
at 02:49 PM

Kamal, do you mean overestimates?

Medium avatar

(4878)

on July 22, 2011
at 11:02 AM

Hmmm...Care to explain that down vote? Read any research on TCM and fertility treatments? Nope, probably not. FWIW, TCM has a long, well documented success rate regarding hypothalamic-pituitary-ovarian axis issues.

Bd271299b2d4d9b2e3da9c252fef058c

(2854)

on July 22, 2011
at 04:54 AM

+1 I fully agree! I had amenorrhea for 4 years, and I think Time plus Paleo is what made it come back. Patience and persistence!

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 22, 2011
at 04:42 AM

Bioelectrical impedence underestimates fat in very lean women (and in men, but moreso women). You are definitely under 15% bodyfat, which is contest shape for a fitness competitor. And fitness competitors rarely have their periods at this level.

Medium avatar

(4878)

on July 22, 2011
at 04:39 AM

Ditto! It is amazing what a TCM practitioner can do!

9d43f6873107e17ca4d1a5055aa7a2ad

on July 21, 2011
at 09:17 PM

also, what is your sleeping situation like? noise? dark? light shining in?

9d43f6873107e17ca4d1a5055aa7a2ad

on July 21, 2011
at 09:16 PM

scale is rarely accurate, what does you doctor say?

1f8384be58052b6b96f476e475abdc74

(2231)

on July 21, 2011
at 08:29 PM

thanks ill check out that book!

1f8384be58052b6b96f476e475abdc74

(2231)

on July 21, 2011
at 08:28 PM

um scale says 20.8% BF

100fd85230060e754fc13394eee6d6f1

(18706)

on July 21, 2011
at 08:20 PM

What's your bodyfat level?

D63a9a7789b948a1e88647f6c0e504ca

(1453)

on July 21, 2011
at 07:04 PM

I agree with the above commenter, those pictures still look scary-thin to me....

7d0c3ea9bf8be00b93e6433d8f125ac3

(7540)

on July 21, 2011
at 06:13 PM

I don't understand why so much research is necessary, not to be rude but looking at photos on your blog it looks like your body fat might still be too low to support fertility, even if you are in recovery. Am I wrong?

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 21, 2011
at 05:44 PM

Be careful who you believe and read. Reading tons and absorbing/following little is of no use.

77877f762c40637911396daa19b53094

(78467)

on July 21, 2011
at 05:41 PM

+1 for being confused, because when you're confused you're on the path of wisdom. I am impressed. You have in the past seemed so certain in your statements.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 21, 2011
at 05:41 PM

I don't want to turn this into a Peat revolution or anything - but his latest KMUD podcast on http://www.kmud.org/index.php?option=com_wrapper&view=wrapper&Itemid=83 (go to the dropdown menu Friday Night Talk find the third Fri in July -) That show was about hair but a caller asks about bulmia/anorexia recovery and hair loss. Ray addresses the cortisol issues.

9d43f6873107e17ca4d1a5055aa7a2ad

on July 21, 2011
at 05:34 PM

can you turn the title into a one-sentence question that summarizes your dilemma? It helps people find relevant questions. Thanks!!

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10 Answers

2
B76f22ed4373946b3c8990b667562683

on July 21, 2011
at 06:05 PM

I think that your doctor is right (I guess that's why he's a doctor!). Amenorrhea resulting from anorexia is called functional hypothalamic amenorrhea, and is the same type that athletes are prone to develop.

There are some drug therapies that have been found very helpful, but seeing as you are paleo, I'm sure you would like to avoid that at all cost. It sounds like you have recovered amazingly well from such a debilitating illness, and are living a very healthy paleo lifestyle. Unfortunately, there is not much data on how well people with this type of amenorrhea recover from restoring proper exercise and diet, so there is no telling what will happen as of right now.

If you're trying to conceive, and this is a time-sensitive issue, I would suggest seeing a reproductive endocrinologist. This doesn't mean going on drugs, but he could help and guide you in attempting to treat your amenorrhea naturally. If things go well, your experience could potentially add to the case study literature and help other women who are going through similar issues.

If you are truly unable to see a physician regarding this, I would give the paleo diet some time to balance out your system. Women who have been on Depo-Provera shots for any length of time require over a year for their endocrine system to balance back out. Years of damage often take just as long to repair. Best of luck, and hopefully there will be some good input on this issue from other paleohackers!

In the meantime, here is a good article from NEJM about functional hypothalamic amenorrhea.

Bd271299b2d4d9b2e3da9c252fef058c

(2854)

on July 22, 2011
at 04:07 PM

It's very hard- I didn't menstruate from age 23-27. Although Time is my biggest advice, stress is a factor that could counteract that. Weigh the pros and cons, and if taking medication feels like the better choice for you, do it!

Bd271299b2d4d9b2e3da9c252fef058c

(2854)

on July 22, 2011
at 04:54 AM

+1 I fully agree! I had amenorrhea for 4 years, and I think Time plus Paleo is what made it come back. Patience and persistence!

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:28 PM

patience is hard when your 25 and you biological clock is ticking away... not to mention youre supposedly eating the 'healthiest diet' there is

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:38 PM

how did you manage to get yours back?

1
B14dc4aa1ddefbec3bc09550428ee493

on July 22, 2011
at 04:23 AM

The waking up sweaty sounds like you are low on estrogen. The best doctors for straightening out hormonal issues, I've found, are traditional Chinese medicine doctors. Acupuncture, herbs and diet worked wonders on my hormones. My periods were more like monthly spotting when I started, but now they are full, normal flow. I remember eating a lot of leafy greens helped too.

Medium avatar

(4878)

on July 22, 2011
at 04:39 AM

Ditto! It is amazing what a TCM practitioner can do!

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:39 PM

i serrrriously doubt Mississippi has TCM schools haha

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:29 PM

again, i have no money whatsoever

Medium avatar

(4878)

on July 22, 2011
at 03:37 PM

Mallory, go to a local TCM school. They have sliding scales for treatment costs, and you'll probably just be charged for herbs ($15). Your case is a GREAT case for their students as your symptoms are a "classic" case of hormonal distress.

0
Db285d45a7c3b3e72664ffd26d37205c

on February 09, 2014
at 03:41 AM

It seems to be somewhat common for women who have recovered from anorexia nervosa -- as well as women of normal weight who have been on the pill for several years -- to experience difficulties in getting their period back. Chinese Medicine has methods to help restore pituitary function, ovulation, and fertility. A Chinese herbal formula specific to your "constitution" can be helpful with or without acupuncture. I practice functional medicine as well as Chinese Medicine, and have seen this work in clinical practice.

0
43415e864447504fb7e659e58abdc309

on November 07, 2011
at 04:43 PM

I have a master's degree in Traditional Chinese Medicine, and I do health coaching via email and phone. There are several variations of different herbal formulas that specifically address amenorrhea. Some individuals require only 1 month on the right herbal formula before menstruation returns. I've seen others who require at least 6 months on a formula. Anyway, feel free to contact me if you have any questions or are interested in coaching/herbs.

0
1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 04:13 PM

this is pretty interesting too...

Circulating leptin concentrations showed two peaks; one coincides with the maximum fat accumulation prior to winter dormancy, whereas the second shorter peak coincides with late pregnancy. The in vivo study in S. heathi showed that the increased circulating leptin level during winter dormancy coincides with the decreased expression of ovarian steroidogenic acute regulatory (StAR) protein, and low circulating estradiol (E2) level. At the same time, increased circulating leptin level coincides with increased expression of ovarian insulin receptor and high circulating A4 level. The low circulating leptin level during preovulatory period coincides with the increase in StAR protein but decrease in insulin receptor protein. The in vitro study confirmed the in vivo observations of inhibitory effect of leptin on LH induced StAR expression and E2 production, whereas the stimulatory effect of leptin (high dose) on LH induced expression of insulin receptor protein and A4 production. However, pharmacological dose of leptin produced inhibitory effect on the expression of insulin receptor protein. The results of the present study thus suggest that high circulating leptin level during winter dormancy promotes adiposity and impairs ovarian activity by suppressing StAR-mediated E2 production as well as by enhancing insulin receptor-mediated A4 synthesis thereby contributing anovulatory condition of delayed ovulation

0
1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:35 PM

also, i have VITEX and have heard good things about it. anyone know about it? supposedly it works to naturally balance hormones, its also called chasteberry

0
100fd85230060e754fc13394eee6d6f1

(18706)

on July 22, 2011
at 02:58 PM

It's complex, and not well understood, and I don't have much specific advice for you, though I wish you the best of luck in your searching.

I think body fat plays a role, and I've seen the figures 20-22% quoted as necessary to recover fertility, but it isn't a guarantee, either.

Here's a comparison from Leigh Peele:

amenorrhea-advice/info-appreciated!

I'm thinking you look closest to the middle one at 15%, just as Kamal placed you.

Cortisol does seem to play a role in predicting who will resume menses when weight is recovered. See: Predictors of menstrual resumption by patients with anorexia nervosa

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:31 PM

thanks, yes i have used those same pics on my website but def dont think i am 15%bf

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:31 PM

do you have full text to that study?

100fd85230060e754fc13394eee6d6f1

(18706)

on July 23, 2011
at 12:23 AM

Yeah, I couldn't confidently guess your BF from photos. I'm sure you have a better idea than I do. I'm sorry, I don't have the full-text. Do you have a medical school near you? You could use their library.

100fd85230060e754fc13394eee6d6f1

(18706)

on July 25, 2011
at 04:55 PM

Yeah. I'm not sure exactly where you are, but university libraries are usually open to the public, and you can go to the periodicals section and browse hard copies of the journals. If your local U has a medical program, they're more likely to carry copies of medical journals, and they should have archives of all the back issues. I've resorted to this in the past, especially back before you could get anything online.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 25, 2011
at 03:40 PM

medical school? like college?

0
Medium avatar

(4878)

on July 22, 2011
at 04:38 AM

I highly recommend looking into Chinese Medicine. A good practitioner can do amazing things with a couple of needles and some herbs. I've had AMAZING success with TCM w/r/t my hormones...even when I didn't ask for anything to be "fixed", which was a great "convincer" for me.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 22, 2011
at 03:30 PM

haha so go check out primal wisdom, start eating lentils/beans/buckwheat and go the herbal medicine route?? wont lie, i am intrigued. i just dont see how it works

Medium avatar

(4878)

on July 22, 2011
at 11:02 AM

Hmmm...Care to explain that down vote? Read any research on TCM and fertility treatments? Nope, probably not. FWIW, TCM has a long, well documented success rate regarding hypothalamic-pituitary-ovarian axis issues.

Medium avatar

(4878)

on July 22, 2011
at 04:09 PM

Ha, no lentils or beans. My L.Ac practitioner was the first one to comment that my diet was "not appropriate for sustainable health" when I was a veggie. She also knew I was not eating "cooked orange veggies", and a number of other, VERY specific things which were quite shocking to hear during that first 90 minute appointment. TCM is much more Paleo than one would think from listening to the common media. It is less about needles, more about diet, with herbal concoctions thrown in to encourage the body to find it's balance point.

0
9dbfedbe21eae2a65093f8774ba8ad4d

on July 21, 2011
at 06:10 PM

I have trouble sleeping when I suffer from information/stimulation overload. This book had easy, efficient methods to help me stay focused when I had low motivation and also to calm me down when I was too anxious. If you have a history of mental illness, it's worth it to find tried-and-true methods that help keep you grounded and moving beyond your old compulsive tendencies. This is why I can see an anorexic person more likely to become orthorexic than someone without that history.

Find Your Focus Zone by Lucy Jo Palladino http://www.amazon.com/Find-Your-Focus-Zone-Distraction/dp/1416532005

1f8384be58052b6b96f476e475abdc74

(2231)

on July 21, 2011
at 08:29 PM

thanks ill check out that book!

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