What Is The Best Diet for Hypothalamic Amenorrhea?

Nutrition

Sep 30

If you’re wondering the best way to eat for HA, the short answer is this: in abundance.

Hypothalamic amenorrhea is the absence of a woman's menstrual cycle (period) due to under-eating, over-exercise and stress, usually for 3+ months.

When women discover that this is exactly what is happening to them, they dive into how to get their period back and are often surprised and maybe even nervous to discover that they need to eat more and gain weight in order to recover their missing period.

The research tells us that when we eat in a calorie deficit and exercise a lot to keep us in that deficit and add stress or societal pressure on top, we need to eat in a surplus to undo it all and get our period back. 1

But what does eating more actually look like? What is the best way of eating to return our cycle?

At the end of the day, an individualized approach to eating is best for you. What worked for me to get my period back isn’t the exact recipe you need. Allowing people to tell you that there is one stock standard way to recover isn’t true...but the one fundamental of HA recovery is the same for everyone: you need to eat more calories. There is no arguing with that.

Now that that’s out of the way, let’s dive into a few of the different approaches to eating in a surplus for recovery that you can take. This will allow you to make the decision for yourself – because nutrition is personal.

How Effective is “All In” for HA?

All In is a term coined by Dr Nicola Rinaldi and it essentially is a method. Eat over 2500 calories a day in any and all foods and do absolutely zero exercise. This is extremely effective for the vast majority of women to return their missing cycles. Women everywhere thank this method for returning their cycle.

The method promotes eating foods you may have restricted in the past in abundance: fries, burgers, candy – you name it.

This can be a challenging way to recover for some people because eating that way is something that many people have fears around. A direct opposition to eating this way is what got them HA in the first place...maybe you relate? So asking people to go All In straight off the bat is very challenging.

Now if you can jump on board with this method and it’s the way to go for you, more power to you. If eating an access of treats isn’t something you subscribe to, that’s ok, there are other ways to eat to recover. As someone who helps women optimize their cycles, get pregnant and feel great...I also don’t 100% subscribe to that method but I definitely take the fundamentals of eating in abundance and resting as a guiding principle.

One thing I want to note though is that recovery is a time to test your hang ups around food and work towards developing a new, omre sustainable relationship with food. So, if you’re a ‘clean eater’ who has a lot of distress when it comes to eating processed foods for example, that mental strain may be holding you back from recovery. We need to get you eating some of those fear foods too.

How Effective is a Whole Foods Approach for HA?

I personally believe that a whole food approach to HA recovery is the best way. I define whole foods as minimally processed, grown and harvested. I don’t consider eating an abundance of fast food or candy as eating a whole food diet, although it’s still totally reasonable and encouraged to eat those things from time to time, even daily if you want.

The vast majority of your meals should have nutrition in them, that’s all I’m saying here. We can combine the evidence found in the all in method of recovery (eating 2500+ calories and including processed food to get there) with a whole food approach to ensure that you’re eating enough micronutrients (vitamins and minerals) and getting the macronutrients (carbs, proteins and fats) that you need.

Research shows us that protein is important for healthy menstrual cycles 2. When I work with clients, I often find that they struggle to optimize their cycles immediately after getting their first period and the most common culprits are delayed ovulation, missed ovulation and short luteal phases (the second half of your cycle). Hoping to get pregnant after recovery? Well, ALL of these things need to be in check for that to happen.

Delayed ovulation frankly remains an issue with stress and under-eating, while short luteal phases are often related to stress, elevated cortisol levels and under-eating protein. Focusing on processed foods is a sure-fire way to under-eat protein, so consider eating more quality protein like grass fed beef, pasture raised chicken and pork and game meat over eating more shakes and fries. Vegetarian? Do your best to get whole food sources of protein like tofu or a high quality protein powder. Check out our vegetarian episode of The HA Podcast for tips from vegans and vegetarians about recovery.

How Effective is Removing/Adding Food Groups for HA?

Every now and then with a client, we will play with food groups, and this is something I did with myself too. We usually visit food groups when we’ve been working on recovery for over 3-6 months with little to no signs of recovery OR if we have a recovered period but the cycle isn’t optimal yet we track this using FAM for HA’ers)

For example, although dairy and carbs are great, sometimes we can weed out an inflammatory response by temporarily removing them from the diet.

Another example is that, often, my clients are under-eating protein so we up it to 1 gram per pound of bodyweight and do our best to hit that daily. That would be an example of adding more of a certain food group in, like animal products.

If you’ve been working on recovery for 3-6 months with NO signs of progress it could be time to try playing with your food groups. Remember this is temporary and you should be tracking your progress and making changes as you go if you’re working on recovery by yourself instead of with a coach.

Need help with this process? Try using my Period Recovery Game Planner. This planner walks you through how to figure out your nutrition plan (as well as your exercise, mindset and stress management) for recovery and then it helps you revisit your nutrition plan weeks or months later to ensure you’re moving forward and not getting stuck with a plan that isn’t working.

How effective is focusing on just supplementation VS diet?

In my experience in practice both with myself and with clients...not effective. You can’t ‘out supplement’ your amenorrhea. Supplements are great but without a consistent caloric surplus and without enough actual nutrition from actual food, supplements are not going to get you anywhere.

Supplements are often taken in the hope that they will be able to replace whatever nutritional imbalance you may be experiencing, but this is simply not true. They are called supplements because they are just that: supplementation along with real nutrition.

Now, I talk about the supplement regime I underwent with my nutritional therapy practitioner (because coaches need coaches too) in this article and YouTube video so you can check out what supplements may be in your future if you end up working with a professional, but I stress in that article that supplementation should be individualized for you and paired with good nutrition.

How Effective Is Focusing On Just Exercise Reduction VS Diet?

In practice with clients I have seen this be successful, but it really depends on what that individual's diet looks like already. If you’re reducing exercise or stopping altogether but only eating 1200 calories this is unlikely to trigger the brain and hormonal signals you’re looking for to kick start ovulation.

If you’re currently eating plenty of calories (a number which is individual to you but the research tells us that 2500 cals is good for recovery with no exercise) and choose to stop exercise and see if it restores your period you’ll have more success with this approach.

You may be thinking “ok well what about 1700, 1800, 2000, 2200 calories…” and this is where we have to be realistic. It depends on your starting weight, height, history with eating and genetics. Maybe that’s plenty of calories for you but maybe not. If you’ve had hypothalamic amenorrhea for a while, a calorie surplus is even more crucial for recovery.

I don’t condemn people for trying to recover their period while trying only one area of approach at a time, I just stress that you must be willing to change your approach when you realize that it’s not working. So, if you choose to stop exercising but continue in a calorie deficit to see what happens...make sure you’re willing to also check in after a certain amount of time about whether or not it’s working and add more calories in if you’re not seeing progress.

How to Choose the Right Approach For You

Choosing your personal approach to recovery comes down to what you’re willing to do and where you’re willing to start. What, if you start today, isn’t going to be considered overreaching and cause you to quit shortly after? That’s the #1 thing.

Where are you willing to start and what areas are you willing to track progress on and keep making changes in the right direction over time?

Of course keep in mind that the less you’re willing to do, the slower recovery is for you and a large part of your recovery relies on courage and bravery. Just mix that with realism – how can you strike a balance between determination and slow and steady? Don’t get me wrong, MANY women are ready to go full on, all in, do all the things from the get-go and you may be that person too.

Where To Start With Recovery

If you’re stuck on where to start with recovery I have a few recommendations for you.

The HA Society is a community for women going through recovery together. With weekly community coaching calls, an entire resource library and personal coaching advice in the DM’s from myself, this is a perfect place to start with a group of women who “get it”. Visit The HA Society and join today!
Working with a recovery coach. A 1:1 Coach will help you build a plan to recover but also be a guide and shoulder to lean on through the challenges. This is something we specialize in so I highly recommend you visit out our 1:1 coaching page.
This is what The Period Recovery Game Planner (below) is for. It helps you figure out your recovery plan, track progress, assess and make adjustments to your plan so that you keep moving forward. Definitely check that out, it’s a very affordable tool to kick off your recovery with.

Period Recovery Game Planner

$37.00

Can one guide really change the game? Actually, yes.

The Period Recovery Game Planner is your primary tool for figuring out WHY you have hypothalamic amenorrhea and what your next steps are going to be to treat it and get your period back.

This guide covers every foundational thing you need to have in place in order to recover AND most importantly, makes sure you’re not missing anything.

So grab a cup of tea and a snack, get comfortable and dive in to building your own hypothalamic recovery plan thanks to the guidance and tools inside of this planner.

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