Hypothalamic amenorrhea: Missing periods despite a healthy lifestyle

They eat very healthily, do a lot of sport, meet up with friends and feel completely happy and full of energy. But one thing is missing: menstruation. Read here why she is missing!

You feel completely healthy, watch your diet, do sports and are always busy in your job, relationship and everyday life. And although you do everything perfectly, you miss something every month. The period is missed. If pregnancy is ruled out, the cause may be hypothalamic amenorrhea , among other things .

What is hypothalamic amenorrhea?

Amenorrhea is the absence of a period. Hypothalamic amenorrhea occurs when the hypothalamus, a part of the brain, does not produce enough gonadotropin (GnRH), which in sufficient concentration stimulates the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Without LH and FSH, no egg cell can mature in the ovary, which means that there is no ovulation and therefore no period. Thus, a woman is infertile at that time.

Causes of hypothalamic amenorrhea

  1. Sport
    Several times a week you sweat during strenuous and exhausting workouts and do endurance and high-intensity training. You regularly go to your limits or beyond. However, as good as sport is for your health, it can also cause a lot of damage. Sport is pure stress for the body. If he does not have enough time to regenerate, the stress level remains permanently high, causing the body to shut down hormone production and he does not feel ready to keep a pregnancy.
  2. Nutrition
    A healthy diet is the be-all and end-all at any age. However, healthy does not mean only eating vegetables and avoiding chocolate etc. A one-sided diet with too few calories causes deficiency symptoms of vitamins and minerals. Too little fat also ensures that fewer hormones are formed. Hypothalamic amenorrhea is often associated with eating disorders such as anorexia nervosa and orthorexia.
  3. Weight and
    loss Hypothalamic amenorrhea mostly affects women whose BMI is below 20. However, amenorrhea can also set in if you drastically lose weight over a short period of time.
  4. Stress
    Both psychological and physiological stress can promote amenorrhea. A pregnancy cannot be sustained in a body with increased stress levels, which is why the body reduces its hormone production there.
  5. Genetics
    Recent studies have found that some women are more prone to missed periods.

These are the consequences

  • temporary infertility
  • increased risk of osteoporosis and osteopenia (precursor to osteoporosis)
  • cardiovascular diseases
  • Depression, anxiety, mood swings
  • Fatigue dips, exhaustion and chronic fatigue
  • hair loss
  • brittle fingernails
  • decreased libido
  • bad sleep

Diagnosis of hypothalamic amenorrhea

The doctor will determine the amenorrhea by exclusion diagnosis. In addition to questions about nutrition, sport and lifestyle, he also checks body weight. A blood test usually follows to check hormone levels. If there is a lot of prolactin and too little LH compared to FSH, the diagnosis of hypothalamic amenorrhea is certain.
Prolactin is made in the pituitary gland and is always present in the body. Before childbirth, the hormone promotes breast growth. After birth, it ensures that there is enough breast milk. At the same time, it suppresses hormone production and thus ovulation, so that there are no periods.

Treatment – this is how the period comes back

The first step toward recovery is to take a small self-inventory and make lifestyle changes. Reduce stress and instead build regular rest periods into your daily routine. The sports program should also be shut down. Eat more, especially carbohydrates and fats, and get enough vitamins and minerals from fruits and vegetables. The doctor can also prescribe medications that trigger ovulation. Most of the time, however, this only works if lifestyle adjustments have already been made. In total, it can take up to six months before menstruation starts again and comes regularly.

Crystal Waston MD

Crystal Waston has a degree in Cross Media Production and Publishing. At vital.de she gives everyday tips and deals with topics related to women's health, sport, and nutrition.

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