What is Hypothalamic Amenorrhea?

Understanding Hypothalamic Amenorrhea: Causes, Symptoms, and Steps to Recovery

What is Hypothalamic Amenorrhea? 

Amenorrhea

Amenorrhea is the absence of a period. There are different kinds of amenorrhea, but the different diagnoses stem mostly from your menstrual cycle history before losing your period and your medical history, such as lab work.


Hypothalamic Amenorrhea

Hypothalamic amenorrhea, aka Secondary Amenorrhea or hypogonadotropic hypogonadism, is the absence of a period (3 consecutive months) in a woman who previously had a menstrual cycle. This is when the HPO (hypothalamic pituitary ovary) axis that controls the menstrual cycle becomes suppressed due an energy deficit due to common factors such as chronic undereating and over-exercising. It is important to note that not everyone who develops hypothalamic amenorrhea has a disordered relationship with exercise. It is the chronic energy deficit that suppresses the HPO axis.

When looking at labs to confirm hypothalamic amenorrhea, we are looking for:

  1. 3 consecutive months of no period

  2. Estradiol <50 pg/ml

  3. FSH <10 mIU/ml

  4. LH <10 mIU/ml

*You can download our lab guide here*

Common Symptoms of Amenorrhea

Common symptoms you may experience include:

  • Digestive issues such as constipation, food intolerances, bloating, etc.

  • Subclinical or clinical hypothyroidism resulting in hair loss, cold hands and feet, etc.

  • Trouble sleeping

  • Anxiety

  • Brain fog

  • Low resting heart rate

  • Osteoporosis/osteopenia

  • Low libido

  • Painful sex

Honestly, there are so many symptoms of hypothalamic amenorrhea because of the depletion of estrogen and progesterone along with other hormones such as thyroid, leptin, testosterone, etc. This is because these hormones have a systemic effect on the body thats leads to a wide variety of issues that may seem “unconnected”. 

Big takeaway: Sex hormones are not JUST for reproduction. 

   

Hypothalamic Amenorrhea Spectrum? 

There is also what we believe to be a spectrum of hypothalamic amenorrhea. This can look like cervical mucus becoming less and less with each cycle, cycles becoming longer over time (usually due to delayed ovulation), shorter luteal phases due to lower progesterone production, shorter bleeds during your period, and even spotting before ovulation, before your period completely disappears.

We have also seen women with irregular cycles who are mislabeled as having PCOS when it is actually delayed ovulation causing their periods to come every 3 months.

Big takeaway: Hypothalamic amenorrhea doesn’t just happen overnight. It develops over time due to a chronic energy deficit.

So You Have Amenorrhea, What Next?

If your labs and symptoms sound like your period could be missing due to hypothalamic amenorrhea, you’ll want to take action now.

Check out the recovery stories from our clients below and on our Google Reviews – women just like you are restoring ovulation naturally!


We also have over 250 episodes of recovery stories on our podcast, The Hypothalamic Amenorrhea Podcast.

Work With Us

Ready to heal Hypothalamic amenorrhea and restore ovulation and your fertility naturally? Learn more about our coaching services today.

Kristen Lee
Pregnancy Journey

Going through HA is such a hard journey to navigate alone. Thankfully I didn’t have to once I met Dani and she introduced me to Ashley! Ashley fully understood what I would need to do to recover,  not only with my body, but with my faith. Through coaching I regained period, and few my relationship with God. Through the process I was able to get pregnant naturally, and it’s the best thing that ever happened to me. I learned so much about my body and how resilient it is. Also, just how to take care of myself and that health is not what society paints it to be. Coaching with Ashley thanks to the HA Society has truly changed my life.

Halle Borchardt
Pregnancy Journey

After 5 years with an eating disorder and 5 years without a cycle, I was able to get pregnant NATURALLY! Ashley led me through their process to restore my cycles, taught me how to read my BBT chart, confirm ovulation, and get pregnant. I am so grateful for the coaching I did with Ashley.

I was diagnosed with PCOS at the age of 15 after losing my cycles, and because of the severity of that diagnosis came with an infertility diagnosis. The only solution offered was birth control and to try IVF if I wanted a family. After working with Ashley I not only realized I had HA but regained my period, manage my PCOS symptoms, and got pregnant naturally within the same year. HA Society resources and personal coaching with Ashley have changed my life and helped me overcome the diagnoses that I struggled with for over 10 years.

Kyler Petterson
Pregnancy Journey

Letters from
happy clients

hypothalamic amenorrhea fertility client

“Sooo this happened this morning - I spot faded line?” – Megan

“Working with Dani and Mishi in the Restore Program has transformed the trajectory of my life in amazing ways. I struggled to address that I needed to change my lifestyle, and this was finally the push that I needed. I never once felt judged or looked down upon, instead, I have been greeted with nothing but kindness and love from every member of the HA Society. As a young woman in my 20s, I feel that I have made the investment of a lifetime. Not only do I have my period back, but I am now equipped with the knowledge of how to understand my cycle and support a lifestyle that is truly healthy. This journey has been one of the hardest things I have ever gone through, and I am so thankful that the amazing women of the HA Society had my back!” -Lindsey, successfully recovered

“This afternoon we had our first ultrasound. I was so so so nervous because I almost feel nothing and was so afraid for miscarrying but we saw a beautiful heartbeat and a tiny little bean of just 7 weeks. 5th of March we will have another ultrasound and than I can finally share my news with more people. Still want to thank you so much because I could never imagine this a few months ago. Your advise truly changed everything in my life”
- NB, successfully pregnant!

"I AM STILL IN SHOCK! I had HA/a missing period for 7 years and was consistently on birth control. After 3 weeks of working with Dani and going ALL IN, I got my first recovery period. That very next cycle, I got pregnant NATURALLY! Is HA recovery easy? No. But not being able to start my own family would have been worse. I could not have done it without Dani or the women in the HA society!" — Kaitlyn, successfully pregnant!

“At my first consult with Dani I was blown away with the knowledge and confidence she had about HA recovery. After 1-2 months of working with Dani, my number one goal was accomplished. I was pregnant! Dani gave me the peace of mind that I was doing everything in my power to achieve my goal. Dani looks at the whole picture, and always has your back.” – Allie, successfully pregnant!

"I am so grateful for Dani. Her enthusiasm and knowledge about HA and the menstrual cycle cannot be understated! After meeting with several medical and nutritional professionals, Dani was the first person to demonstrate a genuine interest in my whole story. Her curiosity and non-judgmental approach is rare and refreshing. In addition to providing me with invaluable support and a wealth of knowledge, she also validated my confusion and uncertainty – and helped me work through it. With a history of PCOS diagnoses, I found it difficult to fully embrace HA. Rather than writing this off as “HA-denial”, she was understanding and we explored my history with a fine-tooth comb. She introduced me to the fascinating world of cycle tracking and was able to relate to me with her own personal anecdotes. Dani has given me an appreciation for my body and the confidence to understand my cycles. She’s the best!” - Megan, successfully pregnant!

"Working will Dani was the "push" I needed to fully embrace the all-in process and commit to recovering my period. I could not wait for our call each week, because it forced me to dig deep, think hard, and truly reflect in ways I wouldn't have been able to on my own. Not only did I come out of our time together with a recovered period, but I also gained new insight and motivation for the trajectory of my life both professionally and personally. Dani's energy and wit will basically keep you laughing at all times, but her ability to genuinely listen and reflect with you is where the real magic happens." – Abby, successfully recovered!

“I was worried that spending money on a “coach” would be too much (after I've already regretted the amount of money I spent on PCOS medication and hospital appointments that turned out to be pointless because I don't even have PCOS) but it was one of the best decisions I have made for my health.”
– Lujain, successfully recovered

"Working with Ashley did more than just heal my body. Ashley helped me heal my relationship with food, exercise, and with my faith. Ashley is the type of woman that will be your light in the dark place of HA Healing. Working with Ashley was the biggest blessing. She truly has your best interest in mind, and she will always be honest with you. She is more than an abundance of healing or knowledge, she is a support system and a testament to faith. I am so thankful I had the chance to work with her. She becomes more than a coach, she becomes a friend." – Kristen, successfully pregnant!

“I learned a TON and this was super helpful. It has been a big reality check for my overall health and the role stress/sleep/lifestyle factors are playing. So cool to see how much info you can get from your cycle!” – Shannon, successfully recovered!

“Thank you so much for the support you’ve given me over the last 4 ish months as I’ve embarked on HA recovery. You helped me through so many mental roadblocks when it came to recovery and taught me all about my charting my cycle. My mindset and outlook have truly improved so much and you forced me to dig deeper into myself.

I feel like you’ve equipped me with the tools to move forward and continue to be successful in monitoring my cycle and using the feedback from it to make adjustments need be in the future if anything starts looking off again.”

— Kayla, successfully recovered

Be part of our 98%

98% of our clients successfully recover their cycles through our program.

The 2% who don’t are:

  • women with premature ovarian insufficiency, a condition we also work with but that takes many years to recover from.

  • women who choose not to continue the program past 1 month.

By starting this program, you are committing to taking the steps required to recover quickly and be part of that 98%.

Dealing with amenorrhea and fertility challenges?

Let’s discuss your situation and see if coaching is a good fit for you.

More happy clients!

We have helped countless women regain their fertility.

“I can’t say enough amazing things about Ashley Smith and the HA Society! Together, they literally changed my life and all for the better. I started working with Ashley in September 2021, after suffering from HA for nearly 10 years. Before working with her, I thought I had tried everything to get my cycle back and conceive (including years of fertility treatment and two rounds of IVF). Through Ashley’s expert coaching and incredible compassion, I realized I had done everything except give up complete control. Ashley taught me how to let go of the strict timeline in my head and trust the healing process. She gave tough love when I needed it and grace when I was grieving the recovery process. She was (and still is) there whenever I needed her, especially on my hardest days. She help me put together a game plan and held me accountable to my weekly action plan, all while giving me so much wisdom along the way. After 3 months of total rest and eating all the foods, I finally got my cycle back! Then, on my second recovery cycle my husband and I found out we were pregnant! I am still in total disbelief and filled with so much gratitude. My RE had told me that getting my cycle back was extremely unlikely, let alone getting pregnant naturally. Well here I am! I wouldn’t have been willing to put in the work without the help of Ashley and the HA Society. I’m forever grateful for these amazing women!” — Hayley S, successfully pregnant!


"I decided to start this path with Ashley because I felt stuck with the recovery process and I needed an extra support. There’s no “one size fits all” recovery plan and I loved that she listened to my story and understood what areas to work on and how to improve them. My biggest problem is chronic stress and and poor care of my mental health, we’ve most focused on this aspect, but without forgetting the other the other parts of the process (food, exercise). Thanks to her assignments I’ve been and I’m still able to make a lot of progress! Ashley is above all a wonderful person of great humanity who has learned much from her HA personal experience. I always feel 100% understood during our meetings, which is what made me feel safe and I trust her in such a delicate moment in my life."
Simona, successfully recovered!

"Ashley is fantastic. She has been so helpful in identifying the deeper issues for me and supporting me to come up with a manageable plan, with achievable goals. She has such a down to earth, genuine approach, which I really appreciated. She validated a few things for me. I think I needed someone who I knew had been through the same thing and was essentially on the other side/pregnant. Talking to someone who "gets it" was helpful and less work for me and allowed me to take steps towards my goals more quickly perhaps. I was already in a certain mind frame, taking action and changing behaviors, but struggling mentally."
Hayley, successfully recovered

I so so so appreciate everything you’ve done for me and all of the women — there weren’t any resources like this even 5 years ago so this is truly wonderful. Thank you for all of your help and knowledge. I’ll still be following along from the sidelines! You’re amazing!! – Jillain, successfully pregnant!

“At long last the day has arrived…MY PERIOD STARTED!!!! YAHOOO!!!!! I think I’m still slightly in shock! It’s been one hell of a journey, but I’m beyond proud of this moment. First ovulation + real period in 15 years!!! I never thought I’d be so darn stoked to see blood haha! I wanted to say a HUGE thank you for all of your support and guidance along this journey! Both since I started coaching but also all of the inspiration and information you’ve provided through your podcast that I’ve been listening to since the day I figured out I had HA. I don’t think I would have been able to persevere without you and the HA society and all that I’ve learned as a result! So thanks a million! Time to celebrate!!!” – Ali, successfully recovered!

“I'm excited to be off on my own and I'm really confident knowing I got every necessary skill at hand. I want to thank you for everything you've done for me, it's truly been a blessing to work with you. You're the best and I couldn't have done it without you.” - Lena, successfully recovered!

“Thank you so much for the content that you [Ashley] and Dani do, I believe it's the only reason I was able to do this without medication!” – Ashley, successfully recovered

“But here is the biggest THANK YOU!!!!!!!!!! I can possibly send through an email. I've now had THREE periods with 35-ish day cycles. This is the most regular I have ever seen my periods, including the first two years before I went on the pill. I owe so, so, much to your guidance. I've carried it all with me and will continue to do so (because I know I still have a long way to go)! I also want to take a minute to remind you of the speed at which my first bleed made its appearance... I believe it was within 4 weeks of us working together?! Crazy. It just goes to show how powerful what you are teaching us is. The sheer power of food (haha). Teaching us to unlearn so many beliefs about ourselves that are so deeply embedded. I definitely feel connected to everyone in the HA Society, even though I never actually showed my face there much, which I'm also sorry for. I could see that people's experiences are all unique but have such similar roots at the same time.”
- Sophie, successfully recovered

– Shawna

“I can’t thank you enough for the time you’ve spent helping me progress mentally and physically through recovery and for creating the HA society. It’s given me the support and accountability/education I needed to keep pushing forward even when things got tough. The community you’ve built and the great content you put out has helped me through all phases of my recovery and I just really am so grateful.”

— Kayla, successfully recovered!

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