In today’s age of social media and 24/7 connectedness, diet culture has sunk its claws even more deeply into our daily consumption and habits. The pressure to be thin has affected people for a whole host of reasons (which is not going to be delved into here), but there is one that is very present and close to those here at Recharged PT: your fertility.
Today, we are going to be addressing how a combination of under-eating and over-exercising can result in a condition called functional hypothalamic amenorrhea (FHA) – and what this means for your reproductive health.
Functional Hypothalamic Amenorrhea (FHA)
Let’s start with the basics. Amenorrhea is when you don’t get your period and can be divided into two types. Primary amenorrhea is when a girl going through puberty does not have her period by the age of 16 due to hormonal, anatomic, and other factors. Secondary amenorrhea is when you have not had your period in 3 or more months in an otherwise “health appearing” person. FHA falls under this category.
FHA occurs when you don’t get your period because of your hypothalamus, a small area deep in the brain responsible for vital functions like regulating your heart rate, body temperature and circadian rhythms. It is also vital in communicating with the endocrine system (aka your hormones) via the pituitary gland. The hypothalamus is responsible for releasing gonadotropin-releasing hormone, which begins the hormonal cascade that starts your cycle. If this hormone is not released, you may have absent or irregular menstruation and ovulation.
The hypothalamus is very “open-minded” to stress and may stop working for a variety of reasons. The main ones include:
Caloric restriction and under-eating
Over-exercising
Poor mental health and excessive stress
Low body fat percentage and/or a history of disordered eating or an eating disorder like anorexia
Usually, there is no one factor that induces your hypothalamus to go on strike – but a combination. Your brain interprets that your body is in survival mode and stops all functions that are “non-essential” (e.g., your cycle) to shift all available resources towards “essential” systems (e.g., breathing and keeping your heart pumping).
As noted above, irregular or absent periods for 3 or more months is the primary sign of FHA. However, other symptoms can include depression and anxiety, insomnia, constant hunger, feeling fatigued, vaginal dryness, and low sex drive. FHA is a diagnosis of exclusion after your healthcare provider has screened for any thyroid or adrenal disorders as well as pregnancy.
Diagnosis of FHA may include checking your hormone levels, a complete blood panel and an MRI of the pituitary gland to see how it is functioning.
As it is possibly unlikely you can get pregnant with undiagnosed FHA and recovery (which we will address in next month’s post), seeing your healthcare provider is essential.
Chronic amenorrhea not only affects fertility but is a risk factor for cardiovascular disease, low bone density, and mental health disorders like anxiety and depression.
Even if you never plan to have children, a regular cycle is vital to a person’s long-term health as it is a “quick read” of hormone balance and communication. And having healthy hormones is one of the best things you can do for your body – you both deserve it.
<3 The Recharged Performance Therapy Team
https://www.rechargedperformancetherapy.com
References
https://my.clevelandclinic.org/health/diseases/24431-hypothalamic-amenorrhea
https://pmc.ncbi.nlm.nih.gov/articles/PMC7418467/
https://www.mayoclinicproceedings.org/article/S0025-6196%2823%2900282-3/fulltext
https://www.endocrine.org/clinical-practice-guidelines/hypothalamic-amenorrhea