Understanding and treating missing periods naturally.

Hypothalamic Amenorrhoea (HA) is a condition you may have been hearing about more frequently lately. Despite being a bit of a mouthful to pronounce, this condition is unfortunately more common than many women realise. In simple terms, HA occurs when your brain stops communicating properly with your reproductive system, causing your periods to go completely AWOL! Let’s explore this condition in depth to help you understand what’s happening in your body.

Understanding Primary vs Secondary Amenorrhoea

Before diving deeper, it’s important to understand the difference between primary and secondary amenorrhoea:

Primary amenorrhoea refers to when a young woman hasn’t started menstruating by age 16, despite having undergone other normal pubertal development.

Secondary amenorrhoea, which includes Hypothalamic Amenorrhoea, occurs when menstrual periods that were previously normal and regular stop for three or more consecutive months in a woman who was previously menstruating.

Photo by Rodolfo Sanches Carvalho on Unsplash

What is Hypothalamic Amenorrhoea?

Hypothalamic Amenorrhoea exclusively affects women, as it’s directly related to the female reproductive system. This condition is characterised by the absence of menstrual cycles for three months or longer, and in some serious cases, periods can disappear for years.

HA stems from disruptions in your hypothalamus function – a small but mighty structure located in your brain. The hypothalamus serves as the control centre for numerous vital bodily functions, including:

• Regulating body temperature
• Managing hunger and thirst signals
• Controlling blood pressure
• Governing your sleep-wake cycle
• Influencing sex drive
• Orchestrating hormone production and activity

When the hypothalamus senses that your body is under stress, it responds by reducing the production of gonadotropin-releasing hormone (GnRH), which subsequently affects the release of follicle-stimulating hormone (FSH) and luteinising hormone (LH) – both crucial for ovulation and menstruation.

What Causes Hypothalamic Amenorrhoea?

Several factors can trigger this protective response from your body:

• Nutritional deficiencies or inadequate caloric intake: Your body needs sufficient energy to maintain reproductive function
• Excessive exercise or overtraining: This can occur across many activities and sports, not limited to any particular field. Even regular fitness enthusiasts can experience HA if their exercise regimen is too intense relative to their individual needs and caloric intake
• Chronic or elevated stress levels: Both psychological and physical stress can disrupt hormonal balance
• Low body weight or rapid weight loss: Even if you’re not clinically underweight
• History of oral contraceptive use: Some women experience delayed return of menstruation after stopping the pill
• A combination of these factors: Often multiple stressors compound the effect

It’s important to note that susceptibility to HA varies significantly between individuals. Some women can maintain intensive exercise routines or experience temporary stress without losing their periods, while others are more sensitive to these factors. This is why comparing your diet and exercise regime to others isn’t a good idea – your body has its own unique thresholds and requirements.

Many women experiencing HA don’t fit any stereotype. Even moderate caloric restriction combined with regular exercise and everyday stress can be enough to trigger this condition in susceptible individuals.

Why Does My Body Stop Menstruating?

From an evolutionary perspective, your body has sophisticated mechanisms to protect you during times of perceived threat. When your brain detects signals of potential famine (insufficient calories), physical danger (excessive exercise), or emotional threat (chronic stress), it essentially puts reproduction on the backburner to conserve energy for survival.

Think of it as your body’s wisdom – if resources are scarce or conditions aren’t optimal, it’s not an ideal time to support a pregnancy. Your body prioritises vital functions over reproductive capabilities until conditions improve.

The intricate hormone cascade that regulates your menstrual cycle requires everything to be working in harmony. When disrupted, the delicate balance of oestrogen, progesterone, LH, and FSH becomes compromised, resulting in anovulation (lack of ovulation) and subsequently, no menstruation.

It’s important to note that while HA is a common cause of secondary amenorrhoea (periods stopping after they’ve been established), other conditions such as PCOS, thyroid disorders, and premature ovarian insufficiency can present similarly. This is why proper diagnosis through a healthcare provider is essential.

Signs and Symptoms of Hypothalamic Amenorrhoea

Beyond the obvious absence of menstruation, you might experience:

• Low energy levels and fatigue
• Mood changes, including anxiety or depression
• Disrupted sleep patterns
• Reduced sex drive
• Dry skin and brittle hair
• Cold intolerance (feeling cold frequently)
• Bone density concerns (if prolonged)
• Difficulty concentrating
• Digestive changes

Comprehensive Approach to Managing Hypothalamic Amenorrhoea

Restoring your menstrual cycle requires a holistic approach targeting the root causes. As a naturopath, I find that a balanced strategy incorporating lifestyle modifications, nutrition, targeted herbs, and supplements offers the most effective path to recovery.

Nourishing Nutrition for Hormone Health

• Increase caloric intake: Most women with HA need at least 2,000-2,500 calories daily, sometimes more depending on activity level and body composition
• Prioritise carbohydrates: Adequate carbohydrate intake is absolutely crucial for hypothalamic function and hormone production. Your brain relies heavily on glucose, and including plenty of complex carbohydrates is essential. Include foods like sweet potatoes, pumpkin, whole grains (freekeh, quinoa, buckwheat, rice), sourdough bread, legumes, and starchy vegetables to provide essential energy for hormone production
• Include quality protein: Aim for 1.2-1.8g per kg of body weight from varied sources like eggs, fish, legumes, and quality animal products
• Prioritise healthy fats: Your reproductive hormones are made from cholesterol and require adequate fat intake. Include avocados, olive oil, nuts, seeds, and fatty fish in your diet
• Don’t fear dietary fat: 30-40% of your calories should come from healthy fats to support hormone synthesis
• Support gut health: Consume fermented foods (yoghurt, kefir, sauerkraut) and prebiotic fibres to maintain the gut-hormone connection (Note: fermented foods may not be suitable for those with histamine intolerance)
• Important: Under no circumstances should you attempt a low or no-carb diet when dealing with HA – your body needs carbohydrates to signal reproductive safety

Supportive Lifestyle Practices

• Effective stress management: Practice daily meditation, journalling, or gentle breathwork
• Prioritise sleep quality: Aim for 7-9 hours of uninterrupted sleep in a cool, dark room
• Connect with nature: Forest bathing (shinrin-yoku) has been shown to reduce cortisol levels
• Sunlight exposure: 15-30 minutes of morning sunlight helps regulate circadian rhythms and vitamin D production, both crucial for hormone health
• Mindful breathing: Practice 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8) several times daily to activate your parasympathetic nervous system
• Create boundaries: Learn to say no to excessive commitments that contribute to your stress load

Appropriate Exercise Modifications

During recovery from HA, it’s crucial to scale back high-intensity exercise until regular menstruation returns. Consider these gentler alternatives:

• Restorative yoga: Focus on yin or gentle hatha practices that activate the relaxation response
• Pilates: Build core strength without excessive cardio stress
• Mindful walking: Particularly in natural settings at a conversational pace
• Gentle swimming: Non-weight bearing and relaxing for the nervous system
• Mobility work: Maintain flexibility without taxing your adrenal system

Once your cycles have returned consistently for 3-6 months, you can gradually reintroduce more intensive exercise while carefully monitoring your menstrual health.

Herbs & Supplements for Hormonal Support

Herbal Allies:

• Adaptogenic herbs: Help balance the body’s stress response and support adrenal function
  • Withania (Ashwagandha): Helps reduce cortisol and supports thyroid function
  • Rhodiola rosea: Enhances stress resilience and energy without stimulation
  • Holy Basil (Tulsi): Balances stress hormones and supports metabolic health
• Nervous system supporters:
  • Chamomile: Gentle calming effect without sedation
  • Passionflower: Reduces anxiety and promotes restful sleep
  • Lemon balm: Uplifts mood while calming the nervous system

Targeted Supplements:

• Acetyl-L-carnitine: Supports LH production and egg quality
• Magnesium glycinate: Essential for over 300 enzymatic reactions, including hormonal pathways (300-450mg daily)
• Zinc: Critical for reproductive hormone function and thyroid health (15-30mg daily)
• Vitamin D3: Many women with HA have insufficient levels (2000-5000 IU daily, based on blood levels)
• B-complex vitamins: Support energy production and stress response
• Omega-3 fatty acids: Provide building blocks for hormone production (1-3g daily)

When to Seek Professional Support

Recovery from Hypothalamic Amenorrhoea typically takes 3-12 months, depending on the severity and duration of the condition. While some women see improvements within weeks of implementing these changes, others require more time and personalised support.

If you’re experiencing:

• Absence of periods for more than 3 months
• Symptoms that significantly impact your quality of life
• Concerns about fertility or bone health
• Difficulty implementing lifestyle changes alone

It’s time to seek professional guidance. As a naturopath specialising in women’s hormonal health, I can help identify the specific factors contributing to your HA and create a personalised recovery plan that addresses your unique needs.

Your Path to Hormonal Balance Starts Here

Hypothalamic Amenorrhoea is not just about getting your period back—it’s about restoring your body’s natural rhythms and creating sustainable health practices that support your hormonal wellbeing for life.

If your periods have disappeared or become irregular and you suspect Hypothalamic Amenorrhoea might be the cause, I invite you to book a consultation today. Together, we’ll investigate the root causes of your hormonal imbalance and develop a comprehensive plan to restore your menstrual health naturally.

Your body wants to heal—sometimes it just needs the right support to find its way back to balance.

References

Abou Sherif, S., Newman, R., Haboosh, S., Al-Sharefi, A., Papanikolaou, N., Dimakopoulou, A., Webber, L. J., Abbara, A., Franks, S., Dhillo, W. S., & Jayasena, C. N. (2021). Investigating the potential of clinical and biochemical markers to differentiate between functional hypothalamic amenorrhoea and polycystic ovarian syndrome: A retrospective observational study. Clinical endocrinology, 95(4), 618–627. https://doi.org/10.1111/cen.14571

Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., Murad, M. H., Santoro, N. F., & Warren, M. P. (2017). Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. The Journal of clinical endocrinology and metabolism, 102(5), 1413–1439. https://doi.org/10.1210/jc.2017-00131

Meczekalski, B., Katulski, K., Czyzyk, A., Podfigurna-Stopa, A., & Maciejewska-Jeske, M. (2014). Functional hypothalamic amenorrhea and its influence on women’s health. Journal of endocrinological investigation, 37(11), 1049–1056. https://doi.org/10.1007/s40618-014-0169-3

Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., & Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad–Relative Energy Deficiency in Sport (RED-S). British journal of sports medicine, 48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502

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It’s been a rampant time for viral infections lately, and not everyone bounces back that smoothly. While the most notable viral infection in recent years has been COVID, it is not the only infection known to cause long-term health issues.

Approximately 30% of people will experience longer symptoms from viral infections (not just restricted to COVID). Some papers I have found say that long covid symptoms may affect up to 80% of people.

Up to 12 weeks after covid infection is still considered to be post-acute infection symptoms, but longer than this enters the realm of long covid.

This can be an incredibly frustrating and debilitating experience as there is often few answers as to what can be done to help, and like many chronic illnesses is poorly understood. The symptoms can also fluctuate from day to day. It’s not uncommon to feel misunderstood or dismissed.

What are the symptoms of long covid? While not an exclusive list of course, I have listed below some of the more common symptoms I have been seeing in my patients who have experienced a health decline after viral infection. While research is still ongoing, this article reviews some of the symptoms of long covid quite thoroughly.

Common post viral symptoms

• Fatigue
• Brain fog
• Hair loss
• Irregular periods
• Menstrual flow changes (usually as a heavier and/or clottier flow)
• Body aches and pains
• Endometriosis and adenomyosis flares
• Digestive issues
• POTS (postural orthostatic tachycardic syndrome)
• Pain at ovulation
• Increase in cold sores
• Skin changes e.g. acne flare-up, eczema
• Respiratory symptoms, shortness of breath
• Swollen and painful glands

What makes someone more susceptible to a post-viral illness such as long covid?

There is still not enough known about this but your immune function’s ability to clear the virus, genetics, and history of/susceptibility to autoimmune disease will have a role. While long covid can affect anyone, even children, it’s more common in women and those with a history of immune imbalance.

Given what is being learnt about the importance of the mind-body connection, it’s possible that a history of trauma or emotional stress may also have an impact.

How do you know if your health issues are due to post-viral illness? Unfortunately, common tests will not always reveal an answer. Your symptoms may also come and go, which can be incredibly confusing. Blood tests showing the presence of antibodies can give a clue towards this virus still affecting your immune system and inflammation levels to some degree.

It can help to think back on your health and symptom timeline. If you feel that your health went downhill and hasn’t recovered ever since a viral infection there’s a good chance this has an impact.

How do we recover?

Sorry to say, but it depends. It depends on how it’s affecting you, your genetics, and your health history. Consulting with a practitioner will allow you to get an individualized set of recommendations.

While I cannot give individual recommendations regarding herbal medicines or supplements without consulting with someone there are a few general recommendations I can make.

• Work on your breathing technique such as consulting with a Buteyko practitioner.
• Prioritize rest and sleep.
• Work with someone to help process unresolved fears and emotions. Like chronic pain issues, post-viral illness has a strong mind-body involvement and this is an important aspect for recovery for many.
• Keep inflammatory food to a minimum – for most people, this is wheat, and dairy, but for others, it may be a low histamine diet.
• Bring laughter into your life where possible e.g. watch funny videos or comedy shows.
• Spend time in nature.
• Incorporate gentle movement e.g. pilates and stretching.

It can be very confusing navigating the possibilities of treatments. Working with a practitioner can help you to focus on what is best for you.

Hold onto hope and the belief that your body is working to do its best for you.

The post In it for the long haul… recovering from post viral illness appeared first on Alison Mitchell Naturopath.

Guest post by Hayley Stockbridge

The silly season is fast approaching and as summer hits we tend to overindulge. The extra alcohol, rich foods, fatty foods and sugar leaves less room for our healthy meals and our poor livers are left with a lot of work to do.

Luckily the liver is a very resilient organ. The liver is the only organ in the body that is capable of regenerating itself. It plays a major role in digestion and detoxification. It produces bile to help us break down fats and alcohol. It stores some of our vitamins and minerals, such as iron, vitamin A, B12 and copper. The liver is responsible for cholesterol regulation. Most importantly, everything that is absorbed in the small intestine (including food, drinks, vitamins, minerals, macronutrients, food additives, chemicals etc.) is then transferred via the blood to the liver for further processing. Nutrients are made into products that can be more easily used by the body. Toxins are generally broken down into less toxic substances and flushed out of the body. This is known as ‘detoxification’. It is this detoxification process that reduces the toxic effects of a poor diet.

So how can you support and stimulate liver detoxification?  Below is a list of suggestions to keep your liver functioning well this summer.

1- Start each morning with 1 tsp of apple cider vinegar in around 30-50mls of room temperature water. ‘Shot’ the vinegar 5-25 minutes before breakfast to kick start liver function, detoxification and stimulate digestion for the day.

2– Drink dandelion root tea. Research has found that 2 cups of dandelion root tea a day stimulates liver detoxification. Sometimes called ‘dandy coffee’, dandelion root is a great substitute for all the coffee drinkers out there as it does have quite a bitter, coffee like taste but is caffeine free. It tastes best with a splash of soy milk and honey. Drink between meals to support the liver and to help digest meals.

3- Turmeric. Go crazy on turmeric! Turmeric supports liver detoxification (as well as being a fantastic anti-inflammatory, it low cholesterol, is anti-cancer and an antioxidant). Turmeric is a yellow Indian spice commonly used for colouring in curries. It has a mild taste so can be added into many different foods. You can find it raw (it looks like ginger) but it is just as beneficial to use the dried powder. Add ½ a tsp. of turmeric powder into marinates, soups, curries, stir frys. It can be mixed into rice, cous cous or quinoa after cooking. You can mix through smoothies or juices. Of course it turns all your foods bright yellow, but with such a mild taste it can be mixed into many different foods.

4- Another spice that aids liver health is rosemary. It contains rosmarinic acid, which inhibits toxic damage to the liver. Add to marinates, soups, casseroles. You could also make a rosemary infused olive oil by adding a few sprigs and using as a dressing.

5- Keep your vegetable intake high. Specifically, broccoli, brussel sprouts, cabbage, alfalfa and beetroot improve liver function. Try to include these veggies in your diet on a daily basis.

6- Have a freshly squeezed vegetable juice most days. Fresh juicing is a great way to sneak more veggies into your day and make up for you what you may otherwise miss out on. Please find a detox juice recipe below!

7- Supplement with Chlorella. Chlorella is a type of algae with a high nutrient level. It promotes alkalinity within the body, but most importantly is has the ability to bind to toxins such as heavy metals and chemicals and pull them out of the body. It is often prescribed as part of a detox regime and can be taken as an alternative to a multivitamin due to it vitamin and mineral levels.

Detox Juice

Ingredients

• Beetroot
• Celery
• Spinach/kale
• Pineapple
• Papaya
• Lemon
• Mint
• Optional extra- chlorella, spirulina, wheatgrass etc

Method

Push all ingredients through the juicer, ensuring you mix the ginger, lemon, mint and leafy veggies between the more juicy ingredients.

Hayley Stockbridge, Naturopath 

B. App. Sc (Nat Stud) Post Grad Dip Nat

Hayley is a Naturopath at Better Health Practice in Stanmore, and Sydney Health and Fertility, Manly NSW. A passion for a healthy lifestyle lead her to become a Naturopath. With over 5 years of experience in the industry, a passion for a healthy lifestyle lead her to become a Naturopath.  Her major focus is always educating her patients to live healthier and happier lives. She treats women, men and children of all ages and a wide variety of health issues such as weight loss, digestive problems, anxiety/stress, food intolerances and headaches.

Check out her website for more information www.hayleystockbridge.com.au

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