Recovery from Anorexia, Infertility, and Hypothalamic Amenorrhea

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My story sharing the details of my journey with anorexia and infertility and how that led me to real food and ultimately my hypothalamic amenorrhea recovery.

smiling homestead family in overalls

What is Hypothalamic Amenorrhea (HA)?

Hypothalamic amenorrhea is a condition where, because of ongoing stress to the body, the signaling of the brain essentially tells the body to shut off menstruation. Fertility is one of the first functions a body will forgo when constantly under too much stress. In general, this is a condition seen in young women because one or more of the following:

  • There is severe a nutritional and energy deficit. This is often caused by under-eating and eating disorders where the body is simply not getting the calories and nutrients it needs.
  • Intense, long duration physical activity. Women with HA are often exercising for up to 2-3 hours every day. This is most common, but not limited to: dancers, runners, and high-performance athletes.
  • Extreme and chronic psychological stress. Our minds determine far more of physical state and reality than we give them credit for.

Generally, because of extremely low body fat levels and body mass index (BMI) the brain is not getting enough energy or nutrients to send the needed hormones that indicate for the body to release eggs and ripen follicles.

What are symptoms of Hypothalamic Amenorrhea?

  • Missed periods or very light periods
  • Low libido
  • Feeling cold often
  • Depression and anxiety
  • Difficulty sleeping (hot flashes are not uncommon)
  • Increased hunger
  • Low energy

My Story of HA Recovery

The above description of under eating and extreme exercise was me to a “T.”

From ages 15-25, I ate an extremely low calorie and low-fat diet. I was a cross country runner in high school turned marathon runner in college through my early 20’s. My normal, healthy weight prior was around 125 lbs. for my 5’-5” frame. But, during this time I fluctuated between 100 and 110 lbs., even dropping below 100 lbs. at times. I was fixated on my appearance and the number on the scale. 

before my journey with Hypothalamic Amenorrhea
When we got married in 2009.

Let me paint the picture. While I genuinely loved running, it was my obsession. I would be stressed if I wasn’t able to get at least an hour long run in each morning. I greatly restricted my calories by eating meager meals and avoiding fat. My typical routine consisted of fat-free yogurt for breakfast with only a half of a turkey sandwich on whole wheat bread with lettuce and tomato for lunch. I stopped menstruating at age 15 and was placed on the birth control pill from ages 18-25. My doctor believed this would bring my period back and no consideration was given my lifestyle and diet choices.

It was easy to justify what I was doing. My whole life I’d heard that low-fat, low-calorie everything was healthy. And exercise, even if it was a bit excessive,was good for you, right?! But I knew in my gut my habits were anything but healthy. I had every symptom listed above and was a textbook case for HA. 

I met my now husband near the end of college and he proposed my senior year. Something would have to change. Still I was scared to do the work to change it.  So much of my identity had become wrapped up in running and my slim appearance.

A few years into our marriage – if I EVER wanted to grow our family – I knew I needed to make some drastic changes. Step one, I went off the pill. Maybe that would be enough and my cycle would return? It didn’t…

The Work

In the spring of 2012, I made a commitment to change and my journey to hypothalamic amenorrhea recovery began. This was the hardest thing I’ve ever done and the most challenging few years of my life to date. 

BUT, looking back, these changes ultimately saved my life, our marriage, and has led us to where we are today. For that I am so thankful.

Berlin, summer 2012 - Hypothalamic Amenorrhea
Summer 2012 a few months into our real food journey.

I work in extremes – hence the extreme running regimen and diet I staunchly followed all those years. But this same personality allowed me to one day quit it all cold turkey. I stopped running and switched to walking and per the advice of a trusted friend, I radically changed my diet. At the time, I was stuck in a diet of extremely low calorie and low-fat foods, almost all of them coming from a package. She encouraged me to ask the question, “What has fed people for all the generations before us?” The answer – real food. Unprocessed meat, vegetables, fruits, nuts, and seeds.

This resonated with me.

My biggest fear was that I was going to balloon up to obesity if I stopped running and changed my diet. But fear often keeps us from believing what we know is true. How could real, nourishing foods steer my body wrong? If I’m feeding it properly, my body will know what to do. I had to keep telling myself “I’m not going to get obese from eating a diet primarily vegetables, fruits, and meats.”

My sisters wedding in 2014 at my highest weight gain.

My Real Food Journey

Overnight, I threw away all the packaged and processed foods in our kitchen and pantry.  Then, I went to the store to stock up on all the veggies. I remember my stomach screaming at me after those first few huge salads that I had. It took time for my body to adjust, detox, and eventually welcome these new and nourishing foods. I channeled all that energy that I had been putting toward running into figuring out how I could eat these real, whole foods and make them taste great.

I learned that I should source my food locally and began to be a regular at our farmer’s market. I was reaching out to local farms about buying a ¼ of a cow and ½ of a pig, fresh milk, and joining a CSA for produce (Community Supported Agriculture).  We planted some tomato plants and carrot seed in our little yard. I was hooked.

It was also during this time that I went to a few doctors to get their opinion on what was going on. This was the most frustrating part of the journey. Over the next 2 years, I saw at least 5 doctors from family practice, reproductive endocrinologists, and ob/gyn. None of them listened to me. I was told that:  It must be pcos. It wasn’t because of my weight. I was healthy. I needed to go on metformin. I needed to take clomid.

At this point after a ton of frustration and tears, I realized that if I was going to regain my fertility naturally, I was going to need to do it myself and be my own advocate.

Hypothalamic Amenorrhea - at my highest weight
My sisters wedding in 2014 at my highest weight gain.

Let Food Be Thy Medicine

The next year was spent trying to awaken my body’s inner senses again – an innate wisdom and power to heal. To eat nourishing foods when I was hungry and to eat until I was genuinely full. To do gentle movement. To rest and sleep a lot.

I gained 30-35 lbs in that one year. I went up several sizes. I got rid of everything in my closet and spent a lot of time in thrift stores trying to find clothes that I felt good in. I cried a lot. But slowly, over the course of that year, the symptoms started going away.

I was no longer cold all the time. My hair was growing in thicker. I found that I could laugh again. I was sleeping better and not waking up drenched in sweat. And almost exactly one year after my journey began, my first cycle returned.

From there it took another full year of having regular, but quite long, cycles before I was able to get pregnant for the first time. That pregnancy resulted in a miscarriage and it was another full year before I got pregnant with our first child (of now three!)

I learned that my body needed to begin to trust me again. For that to happen, I had to actually gain weight higher than what my body’s normal setpoint, or my ideal, healthy weight. Only once that happened was my body able to trust me and begin sending the necessary hormone signaling to start cycling again. This regulated after a few years and my body began to release that extra weight and find that happy spot where my body feels comfortable. 

Me today, fall 2021 after three babies!

Ultimately, this journey to getting pregnant and growing our family has been the most shaping experience in my life so far. It’s our journey into food and later farming. It’s our journey into slowing down and learning ancestral skills. It’s our journey into homesteading and growing and raising the most nourishing foods possible for our family. And it’s our journey toward healing – our bodies, our lands, and our broader communities.

If you can relate to any part of that story, or find yourself struggling with similar things, we’d love to hear from you!

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  1. Hi Joelle,

    Just found your lovely website this evening. I was also a distance runner for many years. I developed Hashimotos thyroiditis, and ended up in the ER 3 times while pregnant with our son. My condition was not detected for many years..it was an incredibly difficult journey. I also had to give up running, change everything i thought I knew about diet and exercise, and this fall our family started homesteading. 🙂 With diet and supplement monitoring, as well as strength training & red light therapy, I am doing so much better than 6 years ago.
    I am excited to learn from your YouTube channel, just wanted to reach out and thank you for sharing your story. Hope you are encouraged by mine, and God bless. Thank you for being brave enough to reorder your priorities in life.

    1. Wow, Lara!! Thanks for sharing! There’s such power in stories and I really appreciate you sharing yours with me. So glad that you are doing better and found things that worked for you.

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