I’d Rather Be Healthy-Ish Than Have Hypothalamic Amenorrhea
The year I took healthy too far — losing my happiness, my hair and my period.
It all started on Netflix.
First came “Forks Over Knives,” followed by “Hungry For Change,” and finally “What the Health.” These three documentaries rocked my world. They triple-handedly overhauled the way I thought about food.
I grew up eating heavily buttered white bowtie pasta. When I was feeling adventurous I would sprinkle on a smidgen of parmesan cheese. Before you call child services, rest assured my parents did their due diligence. But sometimes kids are twerps: they’ll do, say and eat what they want. All parental objections to my diet (or lack thereof) were futile.
In my final year of secondary school, my culinary horizons broadened. I started putting whole wheat toast and scrambled eggs into my belly (audacious, I know). I moved away for university and my palette became that of a brand new person. Quinoa, spinach, broccoli, avocado — you name it, I ate it. I smashed greek yogurt, salmon fillets, steamed veg etc. I joined a competitive cheerleading team, became best buddies with the school gym and fell in love with fitness and healthy eating.
It wasn’t until 2015, my final year of uni, that the sphere of Netflix documentaries sucked me in. By this time, I considered myself a very health person. I was content with my body, my diet and my overall health.
Then came the films. My eyes were opened to the world of a Whole Foods Plant Based Diet. According to the Center for Nutrition studies…
Sounds promising right? The diet, popularized by Dr.Colin Campbell, is backed by pretty damn bulletproof science. Eating whole foods and eliminating animal products has been proven to offer incredible long-term health benefits.
I was already conscious of my sugar consumption and had become avoidant of processed foods whenever possible. However, greek yogurt, eggs and “lean” cuts of meat were staples in my diet. According to the aformentioned docos & research, those were ruining my life.
I dove in. Cold turkey, I cut out all animal products, oil and refined grain products.
For some people, that level of diet revolution may have been rash — for me it felt right. Within a week, I noticed improvements in my energy, mood and digestion. I didn’t even know how bloated I was, until suddenly I wasn’t. Dropping dairy did wonders for my digestion and going stark on gluten made me feel unbelievably fresh in the AM. Foregoing fish and chicken breasts opened my eyes to the world of tofu, falafel and legumes.
By 2017, I’d lost 10 pounds and gained heaps of healthy habits that turned this whole WFPB thing from a diet into a lifestyle.
Obsession is defined as an idea or thought that continually preoccupies or intrudes on a person’s mind. Unknowingly, I became obsessed with my diet, my body and my health. I wouldn’t put a piece of food in my body unless it was the “healthiest option.” I would watch my friends eat pizza, bacon or cupcakes and feel disgusted. They would offer me a bite and I would feel genuine fear. I developed rigid rules. I completely lost the plot of the WFPB lifestyle. My mind was occupied with dont’s rather than do’s. I did NOT eat this, I did NOT cook that. I went from focusing on the healthy foods I could eat, to villifying fearing and escaping everything I couldn’t eat.
The feedback from my friends was confusing. Throughout my military diet stage, I simultaneously became full-on with fitness. I went to the gym every day. A “bad week” for me meant going five days out of seven. I would do up to an hour of cardio every day, combined with weight training. Looking back, I wasn’t consuming NEARLY enough food to support that kind of activity level. It took a long time for me to admit, but my low carb, low fat, veggie-based diet couldn’t have been giving me more than 1200 calories a day. Subtract anywhere from 300–500 calories per workout and what do you get? A body in starvation mode.
What did that look like? It looked good — and that was the issue.
I’d never seen my abs so defined. I’d never had such slim thighs. People noticed. Strangers complimented my shape and my friends asked what amazing fitness program I’d found. I credited my diet, workouts and willpower. This positive reinforcement kept me in overdrive for about 6 months.
Then my body had enough.
Fastforward to January 2018. My hair started falling out, my scalp was getting waxy, my circulation sucked. I was scared, confused and overwhelmed. I was furious at my body. I treated it like gold (or so I thought) and this is how it repaid me? I also hadn’t seen my period in ages.
Time for a quick digression to discuss my history with Aunt Flow — my period. It was gone, long gone.
I had been on the pill since I was 16 years old. We had a pretty great relationship for about 8 years until I finally took a break. I found myself in a long-distance relationship and realized that I could temporarily stop my daily BCP popping. Right away, I realized I was better off, off the pill. I felt happier, my digestion improved and my head just felt clearer. I decided not to start it again. Six months post-pill, I decided to see my GP after my period failed to return. He assured me that this was normal. Many women’s bodies take time to adjust, after the BCP’s pseudo hormones are halted. He told me it could be up to a year before my cycle returned. I was relieved and embraced my total lack of bloodshed.
Now onwards to 2018. It had officially been a year since I stopped the pill. No period. Hair falling out. I started Web MD’ing and became scared that something serious might be happening. I went to a women’s health specialist. When I told her it had been a year without a single drop of spotting, her expression said it all. She was concerned. She ordered a bunch of blood work.
About a week later I got a call from a nurse. With a semi-serious tone she informed me that my androgens were high and I needed to book an internal ultrasound as soon as possible. Not fully understanding why or what we were looking for, I obliged.
Three days later I found myself at a clinic full of pregnant women. I felt out of place and unclear about my doctor’s motivations. Nevertheless, I went in to see my ultrasound tech. She must have sensed my confusion and began to clarify what I was having done.
“You’re about to have an internal ultrasound. I’m going to be examining the condition of your cervix and examining your ovaries for cysts.”
The word cysts was immediately unsettling. I didn’t really know the gravity of an ovarian cyst, but I likened it to something in the family of tumours.
To say I was thrown off by what happened next would be an understatement. The ultrasound was like a live stream of my lady-parts. One at a time, my ovaries appeared directly in front of me. The ultrasound tech had inserted a small camera through my hoo ha. The image was broadcast directly in front of me on a small monitor.
I didn’t know what exactly an ovarian cyst would look like. However, when I looked at the monitor, I knew it was not kosher. My ovaries looked like they’d been in a gun-fight. They had more holes in them than a cheese-grater. My heart sunk. I looked at the ultrasound tech and started bawling. She handed me tissues and started explaining. She confirmed that these were in fact cysts. “But there’s so many! what does that mean!?” I was shook. She began counting. Each ovary had about 35 cysts. She explained that these cysts were a result of my menstrual cycle, or lack thereof.
Each month a woman’s ovaries release an egg. It travels down the fallopian tubes into the womb (uterus). The egg forms inside the ovary inside of a structure known as the follicle. It contains fluid that protects the egg as it grows. Sometimes, for various reasons, the follicle doesn’t release an egg. It may fail to discharge the fluid, causing it to swell and become a cyst.
These cysts can either be functional or pathological.
My ultrasound tech informed me that all of my cysts were functional. For the first time in the appointment, I exhaled. Functional sounded good. My ovaries were packed full of cysts, however they were all small and not at risk of rupturing.
“So why are there so many? what do I do? what does this actually mean?” I stared blankly at the tech.
“I’ll be sending the results back to your doctor, but I feel comfortable telling you that along with your high androgens, you will be diagnosed with PCOS.”
PCOS = Polysystic Ovarian Syndrome. A disease characterized by multiple ovarian cysts paired with amenorrhea (lack of period), and or high androgens, and or a slew of other physical symptoms.
I had heard of PCOS. Not frequently or in depth, but I’d heard of it. My mental image of PCOS was a super overweight woman with excess hair all over her body. I was confused. I couldn’t have been further from that mould.
I went back and met with my original doctor. She confirmed the ultrasound tech’s opinion and told me I did in fact have PCOS. I asked her what the treatment was. She told me that there wasn’t exactly a “treatment” but we needed to find a way to regulate my hormones to prevent long-term damage to my bones and reproductive organs.
“Your best bet is to start taking the birth control pill again.”
Que puzzled expression.
“But, I don’t understand. Isn’t the pill just fake hormones? How would that help my real hormones or stop the cysts? How would I even know if I got my period back”
The discussion that followed was unsatisfying. At the time, I didn’t know nearly as much about PCOS, hormones or the BCP as I do now. I didn’t understand the right questions to ask or what to believe. The idea of starting the pill just didn’t sit right with me. I told her I needed time to wrap my head around all this.
Thank god I took that time. I never started the pill again and I’m so grateful I didn’t. My interest in health and wellness had previously led me to dabble in reading about naturopathic and alternative medicine. I decided that before I started the pill again, I would educate myself about PCOS and become more informed about my reproductive system as a whole. Not to mention, I still had serious concerns about my hair and overall health.
That’s when I found about HA, Hypothalamic Amenorrhea.
Trying to find a formal definition of HA for this article was way more challenging than I expected. To my understanding, HA is not as well understood or discussed in modern medicine as it should be.
Amenorrhea is defined as a lack of period. This can be either primary (never happened) or secondary (happened but then bailed). Hypothalamic amenorrhea is when a woman’s menstrual cycle is disrupted due to changes in the hypothalamus. The hypothalamus is in the center of the brain and regulates your menustral cycle (as well as sleep, body tempertature and hunger). This important bit of your brain releases something called GnRH (gonadotropin-releasihng hormone) which stimulates the release of LH (lutenizing hormone) and FSH (follicle-stimulating hormone). When a woman develops HA, the hypothalamus stops releasing enough GnRH, which in turn slows down LH and FSH production, ultimately stopping ovulation.
In other words…
HA can occur due to stress, lack of eating (or specifically extreme carb restriction OR restriction of fats) and or overexercising. In my search for clarity about PCOS I discovered an article called “Is It PCOS or Hypothalamic Amenorrhea or Both?” The article, penned by an Australian women’s health specialist Lara Briden, opened my eyes to the HA and PCOS correlation.
Briden suggested that PCOS can be misdiagnosed. According to Briden…
That night, I ordered Uber Eats. I ate an entire pizza.
It was time to chill out and feed my body.
Over the course of the next few months I made it my mission to get my period back. I bought Briden’s book along with “No Period, Now What.” I completely stopped lying to myself about how “healthy” I was or how “perfect” my diet was. I started eating. I raised my intake of healthy fats dramatically. I ate peanut butter, avocado and coconut products every single day. I ate heaps of complex carbs. I stopped fearing all grains and finished every single plate of food infront of me. I listened to my body and stopped pretending I was full before I actually felt it.
I relaxed about the gym. I’m still very active, however I don’t force myself to workout at 5am if I don’t feel like it. I don’t do HITT training to punish myself, I do it when I genuinely crave a challenging wourkout. I shifted from focusing on hours of strenuous cardio to prioritizing walking, jogging, yoga and pilates. I now move my body because it makes me feel good, not because I want to shrink it.
I still follow a primarily WFPB diet. However, I’ve been known to eat the occasional egg and if there’s a cheese dip at a party, I’m probably gonna dive in. I now eat healthy because I love my body and want to support it. I focus on putting in good food, not cutting out almost everything.
I started taking a variety of supplements including Zinc, Magnesium, b12 and Selenium. These are all minerals that support healthy hormones, and tend to be lower in vegetarian / vegan diets. That being said, I have done extensive research on them and would recommend you do the same before beginning any supplement regime. I changed my diet, my mind, my mineral levels and my exercise routine. The result?
After getting my first period in years, I met with a gynaecologist who confirmed that my original PCOS diagnosis was in fact false. I never had it, and likely never will. I’d encourage anyone who is diagnosed with PCOS not to take it as law. If you fall into the category of “lean PCOS,” and think you may be under-eating or overexercising, I’d encourage you to speak to your doctor about Hypothalamic Amenorrhea.
**UPDATE** — After my first miracle period, my cycle didn’t just come around like clockwork. The second coming of Aunt Flo took four more months. Recovering from HA isn’t easy. You can’t just turn it off like a light switch. Like too many lady-brains, I still struggle sometimes to love my body and give it what it needs. However, I value my health and happiness as a team and continue to move forward in my recovery month by month.
I’d Rather Be Healthy-Ish Than Have Hypothalamic Amenorrhea
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