You can lose your period and still have hypothalamic amenorrhea, even if you are at “normal” weight.
If you have lost your period, be sure to download this guide that tells you exactly how to change your diet to get your period back.
When I first started doing my research and trying to figure out why I had lost my period, I came across some blogs that talked about it. But most of them were written by women whose bodyweight was relatively low. By low, I mean at the lower end of what is considered “normal” range on the BMI scale (normal is 18.5–24.9). There were also many women whose BMIs were below that, less than 18.5.
There were women who had done figure or fitness competitions and gotten their body fat percentages extremely low, even 14 or under. Together with that, also their bodyweight dropped quite a bit, so their BMIs were somewhere around 15-17.
There were runners whose BMIs were equally low, because they either thought lighter weight helps them to run faster (not necessarily true, because extremely low weight also takes away your strength and overall energy), or they just got so obsessed with being thin that they just ran a lot and ate minimally too maintain that skinny body.
There were girls who had gone through anorexia or other eating disorders or were struggling with disordered eating habits. Also their BMIs were anywhere between 15 to 19… all at “underweight” or low end of the “normal” bodyweight range.
That's what I found from blogs. All the more “formal” information, for what you may, for example, hear from your doctor, only confirms it: If you aren't underweight but have no period, you can't have hypothalamic amenorrhea. Worst case scenario, your doctor tells you not to worry and wants to put you on the birth control pill.
But DON'T do that.
Instead, start eating right… Read this guide to see exactly how.
Of course I was confused – why did I lose my period?
I was not underweight. Even at my lowest point about 10 years ago, my BMI was still around 19, so technically I wasn't underweight even then. (However, I now realize that I was very, very thin at BMI 19!)
When I searched online, I was able to find only a handful of stories from women who weren't that thin but had hypothalamic amenorrhea. There were a few examples of girls whose BMIs were around 22 or even more, but really just a few.
On one hand, I started to realize: It is possible to lose period even if you aren't underweight. It happens to girls whose BMI is “normal“!
[tweet_box design=”default”]It is possible to lose period even if you aren't underweight. [/tweet_box]
On the other hand, I still wanted to fight and deny it. I thought: These few girls must have been just exceptions… I'm different!
I thought I was different, because
So why did I lose my period then?
My acupuncturist wanted me to weigh myself, and I did it, after not having touched the scale for years. It showed 152 lbs, meaning that my BMI was 22.1.
Could I still have hypothalamic amenorrhea????
You don't have to be underweight or wear a size 0, to lose your period. As it comes out, it happens also to those whose BMI is 18.5-24.9, or is, in one word, “normal”.
It seems to be true that majority of girls who lose their periods have a BMI that puts them to “Underweight” category, or at least to the lower end of the “Normal” category. But it's not always the case.
This book proved it perfectly. The authors conducted a survey, and the results showed that
After reading this study, the picture cleared up for me a bit. I also started thinking back to my exercise, weight loss and dieting history, and found many things that pointed to hypothalamic amenorrhea.
There are a few things I learned (from the book and from my own experience) that showed me that low BMI isn't a good criteria for “diagnosing” hypothalamic amenorrhea.
If you’re someone who doesn’t have a period but isn’t underweight, know that you may still have hypothalamic amenorrhea. I was like that and despite of not wanting to admit it, that was exactly the case.
The cure? Commit to recovery fully, reduce physical, physiological and mental stress and your period will return. You don't only restore your cycle, you also take your health back.
Severe overtraining can cause loss of period, and you don't have to be underweight for that to happen.
If you need support on your journey to recover from overtraining or hypothalamic amenorrhea, you can apply to work with me.
https://kerstenkimura.com/work-with-me/
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Dear Kersten,
Thank you for taking the time to share your knowledge and experience with hypothalamic amenorrhea. I am so confused on what steps to take and your blog above does push me in the goin' all in direction.
I have been off the pill for two years now and only had one (halfass) period half a year ago with Christmas (obviously I was elated!). My gynaecologist diagnosed me with PCOS but I never got a withdrawal bleed from the progestin challenge and all my hormones are on the low to very low side (including testosterone). I think it might me HA, but my dr. has never really heard of that and tells me my weight is great and my exercise normal. My bmi is about 20.5 and I never lost a lot of weight. I do not restrict eating although I do eat very healthy (and I have been a vegetarian since childhood). I exercise 3 times a week, heavy weights only, for about an hour.
I tried everything from vitex to dong quai to no coffee (hard!) to 3 months of acupuncture every week to daily meditation. I read the 'period repair manual' and many blogs and forums. I learned a lot but still have not regained a cycle. I am on the verge of going to the hospital to maybe start hormonal treatment and then found your blog. I would love to know if you think going all in might be the answer for me. I also just ordered the 'No period now what' book.
Thank you for writing all these very helpfull blog posts!
Hi Maria!
Thank you for reading :)
I'm sorry to hear that your doctor hasn't heard about HA. But quite honestly it's not very surprising, many doctors haven't... PCOS comes with very specific characteristics, like high androgen levels, excess hair in places that are unusual for women, etc. Do you have any of these symptoms?
Your BMI is on the lower side; eating "very healthy" as you say, is another red flag in my mind. It might be that you aren't getting enough calories.
I would start by simply starting to eat more, and taking off labels "healthy" and "unhealthy" from foods. I'm assuming that there are probably a lot of foods that you consider "unhealthy" and you may end up avoiding things that would actually be helpful.
It's true that 1 hour weights 3x/ week doesn't seem like a lot for most women with HA, but it might be a little too much at this point of your life. I would take a break from that too.
Let me know how it goes for you and you can also contact me via email if you have more questions!
Hi Kersten,
Thank you for your answer! I have none of the PCOS characteristics. So after reading this blog I have been 'all in' for two weeks now. No exercise and no food restrictions while eating a lot. After two weeks this is already getting easier! Thank you so much for this blog post. I guess I knew, but always reasoned that I was not extreme enough to be HA. I will let you know if in a few weeks or months my cycle has returned. I think it will!
Thanks again, Best, Maria
Oh, I'm SO glad to hear you started! Yes, let me know how it goes. It many take 3 weeks or 6 months, but it will happen! :)
Hi there, thanks for sharing your stories and information. I wanted to express my interest in the raw food women who have reported that they are simply able to conceive and ovulate without periods, because they say if you eat absolutely zero toxic substances like meat and dairy products and have zero intake of air pollution(almost impossible in major cities) it's believed that the intelligence of the womb will recognize that it does not require rebuilding the placenta, because it remains in optimal health!
Hi Samantha, thanks for your input. I personally don't think raw food diet is the answer. Eating only raw food will mean for most people that they will miss out on important nutrients that simply aren't present in raw foods. There are many excellent and very clean sources of meat and diary. Eating only raw food also means that it's extremely hard to eat 2500 calories a day that is needed to restore menstrual cycle, and if one tries to get this amount from raw foods only it means they will likely end up with digestive issues (like bloating).
Wow, thank you so much for this article. I lost my period when I was 16 and was put on birth control to regulate it. I was on birth control for 9 years and decided to get off to try and get pregnant. It's been a month and my period is MIA. I'm extremely actively but no longer underweight (i'm a good weight for my height). I've been convinced that my period is missing (and was missing at 16) because I have serious issues. This article has helped me relax a little bit about my situation. So far being off the pill hasn't caused any major concerns minus my period being gone. Thanks again for the great article.
Katie, you're welcome. I'm just curious to know what those serious issues are that are not letting you get your period... If can and want to talk, let me know! Also, the weight and height ratio isn't necessarily the whole truth... My weight was seemed to be totally normal too yet I had to gain a bunch to get my period.
I'm a bit of hypochondriac so i'm worried I have PCOS, ovary failure or something of the sort. I've been researching ovaries issues like crazy and convincing myself something is wrong. Coming across your article give me a bit of comfort because when I was younger the doctor believed hypothalamic amenorrhea was the issue. The reason why I had a hard time accepting that is because they never ran any blood tests so no one knows for sure. For me stress + exercising a lot is something I need to work on because I believe this will affect my period negatively. I'm worrying about not getting my period and i'm not going to get my period because i'm worrying and it's a vicious circle. Thanks for listening!
Katie, I totally get you. It can be a vicious cycle for sure. Some women say that they can't stop exercising when they have HA because that would cause them too much stress. However, the stress response we get from exercise is often more impactful than the mental stress when we can't work out. Instead, we can find ways to reduce our stress in different ways that don't require physical activity (or at least not working out).
If you'd like to chat and help you figure out if it can be HA, let me know :) It's better to deal with it as soon as possible!
Hi how many calories should I aim for to get it back?
I recommend around 2500. Here's a good video about this topic where I talk about counting calories and other important things about nutrition and hypothalamic amenorrhea! https://www.youtube.com/watch?v=iT3V2M2ZKuI
Let me know if you have questions! :)
Hi, I've never commented on something like this before, but I'm genuinely curious on what others in similar situations may think.
I'm an early 20s female. I DO have stress issues, depression, anxiety, etc. I DO have eating issues, not like the average restrictive disorder, but more like really picky eating. I am not underweight though, I believe my BMI ranged from 21-22, average body fat percentage too. I have bloodwork done regularly since I take daily medication for depression and anxiety, and my doctor likes to stay on top of any damage to my organs that could cause in the long term. My iron, thyroid hormones, blood sugar, and other commonly checked levels are all perfect.
I started taking Yaz birth control when I was a preteen, so I was approaching 10 years of usage when I stopped around a month ago. For the last at least 3 years (max of 5 years) I have had absolutely no period, but my doctor didn't seem worried when I told her a while ago during a routine pap smear. I stopped the birth control partially because I plan on starting a family in the next couple of years and I heard of people taking a little while after birth control to get their hormones back to normal. However, the major reason was I just feel a little uncomfortable with the idea of not having a period for so long even though my doctor wasn't worried, and thought maybe it was the birth control that eventually made it disappear.
Mostly just looking for opinions from others if they think this could be a hormone issue or if they are in a similar situation. I know its only been a month after stopping, so it's completely possible I will start my period again soon. I don't have any excess hair growth that might be associated with PCOS. Additionally, even before I started birth control, my period wasn't particularly heavy, I would call it a regular to light flow. Lasting maybe 5 days, in 27-28 day intervals.
Yes, sometimes it may take time for the body to start menstruating after stopping the Pill. However, if you didn't get your monthly bleed even on the Pill, then I do think something is hormonally wrong. As I mentioned in this article, you don't need to be underweight to lose your period due to hypothalamic amenorrhea, this weight that is normal on the BMI scale may simply not be right for YOU.
If your plan is to start a family in the next few years, I would really start figuring out NOW why you aren't getting your period, as getting a solid ovulation and menstruation and getting pregnant can take time! If you have any questions, please feel free to contact me! :)
Hi! I also haven’t had a proper menstrual cycle (although the majority of my life) since this time last year. I’ve been to the doctors but they say it’s not a concern unless I am trying to get pregnant and have dismissed it as PCOS. This isn’t reassuring as I would like to have a normal cycle as it seems natural and healthy.
I am a normal weight at present (114lbs at 5’7) but similarly slightly on the lower side of normal. I am also really active but this is so beneficial to my mental wellbeing as also physical as I am type 1 diabetic. It’s also means I eat very clean with limited sugar and carb intake and have recently gone veggie. In the past I have suffered from ED and have therefore been at a low weight for a lengthened period of time which my body may be sensitive to.
I don’t appear to have the PCOS symptoms ie. excessive hair not the classic symptoms of endometriosis. Your blog and the responses have therefore come as a massive reassurance and has encouraged me to take w few of your suggested steps to restore a cycle.
Any other recommendations based on anything of the above would be much appreciated as it is a massive anxiety for me which consequently probably doesn’t help the issue itself! Thanks you ☺️☺️
Hi Katy!
Did your doctor run tests to confirm your PCOS? Common signs of PCOS are usually, as you mentioned, facial hair, but also severe acne, elevated androgens and of course polycystic ovaries. Without these, and especially knowing your ED and exercise past, it's more likely HA.
I'm quite sure your ED past is contributing to your amenorrhea. I understand that because you're diabetic, you can't eat as many carbs, but try to really get your calories up with the foods you can eat. I respect your choice to be vegetarian, but I'm also concerned that cutting out another major food group is not making things any better!
Yes, exercise is beneficial for your mental wellbeing, but it can cause more harm than good. In other words, when done in excess (for YOUR body and in YOUR current situation), negative effects on the physical health outweigh the positive effects on your mental health. I hope this helps!
If you need more help, be sure to check out my program as well - it has all you need to know to recover. https://kersten-kimura.teachable.com/p/get-your-period-back
Xo,
Kersten
Hi
My daughter is 22 and weighs 57 kilos .. her BMI is 20 .She has just recently lost her periods ( 2 months ago ).
3 months ago she noticed that her weight had increased a bit so she decided to go on a 1200 calorie diet and upped her exercise intensity in the Gym . She lost around 2 kilos and her periods stopped .
3 years ago she was diagnosed as having anorexia and her weight was much less than it is now but she still got her period then ..
So I am confused how come her weight was very low few years back and still had her period while now she is 14 kilos heavier but lost her period
It’s very difficult to convince her to eat 2500 calories a day .. I only managed to convince her to eat 1800 calories a day and to replace her gym with walking and yoga
Do you think this could be enough ..I really don’t know what to do
Please help
Hi Ghada!
I think the reason is this: She's a grown up woman now, but three years ago, she was still a girl. Her caloric needs have changed. Her body needs more resources (aka, fat percentage, little more weight) than she did when she was still a teenager.
It can also be that her anorexia and long time starvation have caused her body to become more sensitive so now she needs a higher fat percentage for her body to function properly. 1200 calories a day is incredibly low.
Sure, you can start out by 1800 calories, but if this is not enough, you need to have her eat more. Food is really the main thing! You can also check out my program that has all the other steps that she should take every day, to get her period back. You can find it here: https://kersten-kimura.teachable.com/p/get-your-period-back
I hope this helps! Good luck!
Hello! I find this article pretty interesting as I myself haven't got my period for around three months now and I really need help.
A little back-story first, I was 16 when I started dieting to lose weight, which I did. However, it was pretty fast (around 20 in two months or so). I am not underweight nor I have too low body fat percentage, but I am at the low end of the healthy weight range. Right now I am on a second type of hormonal pills to help trigger it as the first ones did't work.
I cut back exercise and eat more, but still nothing. It honestly scares me as I don't want to put on weight and want to maintain my current physique. Do you have any advice? What can I do?
Hey!
Unfortunately, our BMI may not be a very good indicator of our health at all. You say that you aren't underweight or have too low bf %, but they may be too low for YOUR body. I too had a BMI of 22.1 an never had flat abs, yet I still had HA and had to put on weight to recover.
I understand that you don't want to lose your physique - no one does but sometimes we have to do what's better for our health.
I'm not sure what pills you are taking. Is it Provera? Birth control? If BC then they do not trigger natural menstruation, ever. You need to get your period back naturally, BC doesn't hep you with that.
I'm working with women with HA. Please fill out this form if you're interested in learning more!
https://kerstenkimura.com/work-with-me/