Hypothalamic Amenorrhea: A Helpful BINTO Guide to the Pituitary Gland

Have your periods stopped for several months? There are a number of things which can cause missed or irregular periods, which can include premature menopause, diabetes, or going on a new birth control method. One common cause, however, is functional hypothalamic amenorrhea. (Amenorrhea just means that you have stopped menstruating). This is often shortened to FHA.

What is Hypothalamic Amenorrhea?

FHA is caused when the hypothalamus stops producing gonadotropin-releasing hormone (GnRH). Without this hormone, your ovaries stop producing estrogen and you stop ovulating, and thus menstruating.

The hypothalamus is linked to the pituitary gland, which stores the hormones produced by the hypothalamus (which also produces other hormones, including the "love hormone" oxytocin) and regulates their release into the bloodstream.

What Causes Hypothalamic Amenorrhea?

The most common cause of hypothalamic amenorrhea is a simple one: Stress. High levels of cortisone cause the hypothalamus to stop releasing reproductive hormones.

FHA is also caused by low weight, low body mass percentage, losing weight too quickly, and athletic training. Because of this, it is often connected to eating disorders. This is a combination of stress and your body shutting down the reproductive system to save resources. Athletes generally find their cycles return to normal when they leave the most intense part of their training.

What are the Consequences of FHA?

Many women with FHA are, sadly, only too glad not to have to deal with periods. This means they may not seek help. This is particularly the case if it is linked to anorexia nervosa or another eating disorder, as many women with these disorders don't seek medical help.

Consequences include:

1. Infertility. Women who are currently suffering from FHA are unable to conceive until something is done to restore their cycles.
2. Skin and hair problems.
3. Declining bone health. Amenorrhea can cause bone loss in as little as six months.
4. Higher cardiovascular disease risk.
5. Depression and anxiety.
6. Reduced libido.
7. Vaginal dryness that can make sex painful.
8. Delayed puberty and onset of menstruation in young girls.

FHA can cause mental health issues in women who are trying to conceive; if amenorrhea accompanies attempting to get pregnant, women can become frustrated as hopes are dashed.

How is Functional Hypothalamic Amenorrhea Treated?

Some doctors prescribe birth control pills to fix FHA. Unfortunately, this does nothing to address the underlying cause and rather masks the problem. Obviously, it also does nothing to help restore fertility.

Instead, FHA has to be addressed holistically, and the treatment is likely to include:

1. Proper therapy for any underlying eating disorder.
2. Appropriate weight gain. While not every woman with FHA is underweight, most are. Recovery generally means eating at least 2500 kcal a day and increasing dietary variety.
3. Eliminating intense exercise, especially running. If you are an athlete in training, you need to step back and take a break. Most athletes can train to an elite level without actually experiencing amenorrhea, and it should not be considered normal. If your coach is repeatedly pushing you so hard it is affecting your health, then it is time to find a new coach.
4. Therapy. Many women with FHA have it because of bad habits, whether they have an eating disorder or not. Our society's obsession with weight loss is generally not helpful. A good therapist can help you get out of the habit of exercising excessively (which many women get into to deal with stress), fad dieting, etc.
5. Adding certain foods to the diet. Whole fat dairy is known to be particularly useful for helping a normal cycle resume. For women with lactose intolerance, consider nuts and oily fish. Make sure you are getting enough carbs; low-carb diets often cause menstrual problems.
6. If all else fails, fertility medications might be prescribed to help restore the cycle. However, restoring fertility often requires dealing with the underlying bad habits first and, in any case, excessive exercise and "healthy" eating is not likely to support a healthy pregnancy.

In general, Functional Hypothalamic Amenorrhea is primarily caused by psychological issues, and those must be addressed as part of a treatment plan. Whether or not you are currently trying for a child, you should focus initially on restoring your cycles and reproductive health and avoid hormonal contraceptives until they are stable (as they can mask continuing problems).

How does FHA Relate to Polycystic Ovary Syndrome?

While FHA and PCOS are separate conditions, it is possible to have both of them. In women and girls with both conditions, FHA is often diagnosed and the PCOS may be missed. Untreated PCOS can lead to infertility, diabetes, cardiovascular risks, sleep apnea, and endometrial cancer.

Because PCOS is so often associated with weight gain, it's not uncommon for women with PCOS to develop eating disorders, and then to give themselves FHA trying to manage their weight. PCOS  itself is often missed, especially until the symptoms become advanced. Symptoms include acne, obesity, excessive hair growth, and irregular periods. In many cases, male doctors miss the early signs of irregularity and painful periods, and this is even worse when it is comorbid with FHA.

An earlier diagnosis of PCOS can help women learn to manage their condition. This may require medication such as oral contraceptives and anti-androgens. This doesn't necessarily contradict the fact that oral contraceptives should not be used to manage FHA alone. Women with PCOS should also talk to a dietitian about a healthy diet to help support ovarian health, including appropriate supplements.

How Can BINTO Supplements Help Hypothalamic Amenorrhea?

Most doctors prefer not to prescribe medication for FHA, and medication seldom solves the problem. It might help prevent bone loss or it might force the cycle to start, but it seldom addresses the underlying cause. Therapy is often more effective, but for most people with FHA, a dietician offers the greatest help.

Supplements, when used properly, can help you recover from FHA faster and restore your fertility. Some you should consider are:

1. N-Acetyl-L-Cysteine (NAC). NAC has a number of health benefits, but relevant to this is that it can help improve addictive behavior, and thus may prove useful to people with eating disorders and that it helps support the ovulation cycle. It has been shown to potentially improve fertility in women with PCOS. Binto's NAC is vegan and gluten free.
2. Calcium. Calcium supports bone health and can help stave off the bone density issues caused by FHA. Besides, it is good for menstruation-related symptoms and your cycle in general.
3. Dehydroepiandrosterone (DHEA). DHEA is generally seen as an anti-aging treatment, but studies have shown that it increases successful conception rates in women being treated for infertility. It also increases your chances of carrying to term substantially. DHEA is a naturally occurring steroid that appears to improve egg quality. Again, our DHEA supplement is also vegan and gluten free, and contains no soy or sugar.

All three of these supplements can help you recover from FHA, with the help of your dietitian. They should be part of a healthy diet that is designed to help you regain a healthy weight.

BINTO provides supplement packs that are designed for you and your individual problem. Talk to us about your issues with irregular periods and FHA and we will put together a supplement pack that will help you restore your cycles and, if you are ready to take that step, increase your chances of conceiving.