Hypothalamic Amenorrhea - Could Under-Eating Be the Reason You’ve Lost Your Period?

Have you stopped getting your period? The cause might be simpler than you think—you might not be eating enough. Many women experience Hypothalamic Amenorrhea (HA), which occurs when the body doesn’t get sufficient fuel to maintain regular menstrual cycles.

Often, Hypothalamic Amenorrhea is confused with Polycystic Ovary Syndrome (PCOS), since both conditions can result in similar findings, like “polycystic ovaries” showing up on an ultrasound. But the underlying causes are quite different.

Recognizing the Signs of Hypothalamic Amenorrhea

When under-eating is the problem, certain telltale signs might point to Hypothalamic Amenorrhea:

• No period or withdrawal bleeding after provera challenge

• Lower-than-normal fasting insulin levels (less than 4 mIU/L or 25 pmol/L).

• Low thyroid hormone fT3 (under 2.4 pmol/L).

• A low ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH), whereas in PCOS, this ratio is typically higher.

  
  

Why Eating Too Little Switches Off Your Period

The relationship between food and your menstrual cycle is pretty straightforward. When your body doesn’t receive enough calories—or not enough of key nutrients like carbohydrates—it effectively decides to stop ovulating. This isn’t a mistake; it’s a protective measure. The brain recognizes that conditions aren’t ideal for supporting pregnancy and adjusts accordingly by reducing communication with the ovaries.

This condition is also known as Relative Energy Deficiency (RED-s), which refers to the imbalance between energy intake, body mass, and exercise. In other words, if you’re burning more than you’re consuming, the body responds by turning off non-essential processes like reproduction.

Interestingly, men don’t have this same biological response. While their testosterone levels can fluctuate, they don’t experience a complete hormonal shutdown like women do, simply because their bodies don’t need to prepare for the caloric demands of pregnancy.

What You Can Do to Restore Your Period

The solution to Hypothalamic Amenorrhea often comes down to one thing: eating more. For many women, increasing their daily calorie intake to at least 2500 calories—along with consuming at least 200 grams of carbohydrates—can restore ovulation within a few months. However, it’s important to remember that it can take time for ovulation to resume, as it follows a 100 days to ovulation cycle (it takes 100 days for your follicles to mature and then eventually complete the process of ovulation).