What causes hypothalamic amenorrhea?

Have you noticed that you are no longer getting your period or only have very light bleeding/ spotting?

Are you finding that you feel cold a lot, lack energy or are feeling very tired?

Have you experienced low mood, been feeling anxious or had trouble sleeping?

Have you recently lost quite a bit of weight, dropped to a low body fat percentage, experienced a lot of emotional stress or embarked on a new diet or exercise regime?


If you answered yes to all of these questions then you may be dealing with hypothalamic amenorrhea. Hypothalamic amenorrhea is a condition that occurs in women of reproductive age and it is a condition that causes an individual to lose their period (or just experience light spotting at the time of their period). The National Institute of Clinical Excellence (NICE) recommends diagnosing the condition upon "the cessation of menstruation for 3–6 months in women with previously normal and regular menses". So it isn't just the occasional late or missed period, it describes losing your period for several consecutive months.


The cause of the disruption in the menstrual cycle is a shift in hormone balance within the body. The hypothalamus, which is a gland in the brain that regulates body processes, slows or stops releasing gonadotropin-releasing hormone (GnRH) . GnRH is the hormone that starts the menstrual cycle. As the condition affects the release of hormones regulating the menstrual cycle, it very often also causes problems with ovulation and fertility too. Many women will seek to address their hypothalamic amenorrhea when they are looking to get pregnant or are keen to conceive in the future.


WHAT CAN CAUSE HYPOTHALAMIC AMENORRHEA?

Often individuals end up with hypothalamic amenorrhea from doing things that they consider "healthy". They may begin a very gruelling exercise regime in order to try and get into shape or they may cut out all carbs/ sugars or fats from their diet in the pursuit of "good health". However both food restriction and too much exercise can be stressors on the body. In order for the body to prioritise fertility, to ovulate regularly and to have regular periods - it needs to know that it is a good time to conceive i.e. that there isn't too much stress on the body and that resources aren't too scarce. Each of the following factors can communicate to the body that it isn't a good time to conceive/ that times are tough and that reproductive functions should be shut off:


Over-exercising and/or not eating enough

Whilst gentle movement and exercise is great for mental and physical health, exercise also puts stress on the body. If a women is doing too much exercise, the body assumes that times are tough and that is isn't a good time to prioritise reproductive functions. Exercise can especially have a very negative effect on fertility when someone is also restricting or limiting the types of foods or amounts of foods that they are eating. A body in a calorie deficit will just be prioritising staying alive and will not allow for non-essential functions such as reproduction.