Hypothalamic amenorrhea- Lose the exercise or go on birth control pill?

cazzybear1740

Hello!
I have an appointment with my doctor to discuss my non- existent periods as I suspect I have Hypothalamic amenorrhea. I am a healthy weight but do exercise 6 days a week. I love my lifestyle and rare for most people; I'm very happy with my body! I don't want children which is why I haven't been bothered about my cycles before. I now know the importance of my cycles and want to sort this.

For those who have had this but do not want children- can I get oestrogen from the birth control pill and carry on my lifestyle or do I need to stop running/training and eat more and change who I am 😣

viajera99

From the words and emoji you used, it's clear how you feel, but this is a question for your doctor.

Fuzzipeg

I think, I hope I hear you. If the problem is with hypothalamus output why the Birth Control? Could be a sticking plaster. I lost faith in my allocated NHS doctors. I know what I am about to say will be scoffed at. Please consider finding a doctor who takes a functional approach. Such a doctor would take the same tests as you have already done but will go father to establish how you can achieve the best balance for yourself, prompting all systems to work in unison. Our bodies should be balanced.

As an aside. last night here in the UK there was an interesting programme on the Contraceptive Pill. (it questioned its safety and looked into possible side effects.) One issue addressed was, weight gain, they said it can be because the body retains fluid but also extra oestrogen can cause embryonic fat cells to form, though these should not become full-blown fat cells unless there is something "other" going on in the woman's system. One thing I found worrying was the instances of the pill being taken in persons who develop depression. The programme did day it was a correlation not causation though the question hangs in the air, can the pill tip some of us towards depression? From the programme too, A doctor over here is suggesting, there is no need to take a 7 day break in the pills, the only purpose is to have a bleed which he says is not essential. He also suggested the 7 day break was put in to pacify the Church saying the pill only reflects a woman's normal cycle. The 7 day break makes the first of the next packet of pills essential because 7 days is enough to let an ovary start to function and day 8 is critical, when many breakdowns in contraception happen.

I hope you are able to achieve an answer you are happy, really comfortable with. All the very best.

misskarne

Fuzzipeg wrote: »

A doctor over here is suggesting, there is no need to take a 7 day break in the pills, the only purpose is to have a bleed which he says is not essential.

Yes, that's right. I was on the pill straight for quite a while because my cramps were so bad I could hardly function.

I had to stop only because of the potential increased stroke risk in women who get migraine with aura on the pill. I'm on the shot now. No period. It's great!

collectingblues

BC only masks the issue.

Have you considered fueling your exercise and making sure you’re getting adequate nutrition? HA is generally considered an energy availability issue.

I’d request a meeting with a dietitian, preferably one who has a background in sports nutrition and performance.

cazzybear1740

Thank you for taking the time to reply. Balance is what I want to achieve. I know I need to listen to my body and yes, taking more oestrogen is like putting a plaster on it and that is not healthy either, so thank you for highlighting that. And of course it would probably bring on a different set of issues too. I want to be healthy more than anything else, I guess I just never thought it would mean exercising less and eating more!

TavistockToad

cazzybear1740 wrote: »

Thank you for taking the time to reply. Balance is what I want to achieve. I know I need to listen to my body and yes, taking more oestrogen is like putting a plaster on it and that is not healthy either, so thank you for highlighting that. And of course it would probably bring on a different set of issues too. I want to be healthy more than anything else, I guess I just never thought it would mean exercising less and eating more!

what are your stats and how much exercise are you doing?

cazzybear1740

I've been eating between 1700-1800 cals a day plus exercise cals. I workout six times a week was more cardio based but now more strength training-all at home. My Mac's are 50 % carbs, 30% fat and 20% protein. Ive never struggled with diet or weight. I use the app to make sure I'm getting enough protein as I'm not much of a meat eater and take iron supplements etc. This was the doctors first idea that it was iron but blood tests show big improvement. I never asked to have my oestrogen checked though but if it was low naybtthey thought it was because of the iron levels.

collectingblues

Are you sure that's the right amount of calories for you? You don't share your height and weight, but I'd be surprised if your TDEE is only in the ballpark of 2000-2100 calories, with the amount of exercise you describe. I mean, I'm 5'4", upper 120s, and don't workout that much, and *my* TDEE is 2200...

No one is saying that you need to reduce your exercise. But if you're not willing to eat *more* and give your body *all* the fuel that it needs -- which means eating *all* of your exercise calories -- then yes, you may find it easier to cut back.

TavistockToad

cazzybear1740 wrote: »

I've been eating between 1700-1800 cals a day plus exercise cals. I workout six times a week was more cardio based but now more strength training-all at home. My Mac's are 50 % carbs, 30% fat and 20% protein. Ive never struggled with diet or weight. I use the app to make sure I'm getting enough protein as I'm not much of a meat eater and take iron supplements etc. This was the doctors first idea that it was iron but blood tests show big improvement. I never asked to have my oestrogen checked though but if it was low naybtthey thought it was because of the iron levels.

Workout 6 x a week doing what? 'Cardio' could be a 20 minute walk or a 10 mile run?

Height, weight?

Fuzzipeg

I have just looked to see what if any medically supported information was available on line. The endocrine society suggests the full panel and prolactin, these tests would show other reasons for amenorrhea. They also suggest low heart rate, low blood pressure, even accessing electrolyte levels have influences. MRI scan was also suggested. They do find an increasing number of cases where there is an eating disorder, particularly anorexia. The page I found touched on low body fat and low carb intake as possible factors too.

You may find more information to help you on the, "Hormone Health Network" arm of the site. It makes a great difference if someone has never menstruated or has lost menstruation.

I'd not considered osteoporosis to be something which can go hand in hand with hypothalamic amenorea. I connected it to low thyroid hormones, particularly, Human Growth Hormone (being the third, hardly ever tested) which controls the growth and repair of bones and every cell, even in the adult, levels reduce as one ages, making it generally something affecting us elderly but anything which can edge one into this situation needs exhorstive investigations.

Wishing you all the very best, that you discover the right answeres for yourself

Pollymopol2

The exact same thing has happened to me, I was on the pill for 2 years and when I came off it, no periods! I kept getting put off by my GP and eventually after 3 years of no periods I got tested for PCOS with negative results, but they did find that my oestrogen levels were really low. I took up running within these 3 years and now am a consistent runner. I've lost about 2 stone (11stone to 9stone - 5'7") since starting the pill and now (about 5 years). I got told by the endocrinologist to either go on the pill again, or reduce exercise because he believed this and my weight loss have caused the amenorrhea. Running is my thing and it makes me happy, I didn't want to lose that for the chance that my periods might not come back naturally. I chose to go back on the pill for my own health and the ensure that I had withdrawal bleeds to make sure my uterus and bones stay healthy....to be fair though I hate it, I came off the pill because I didn't want to be taking synthetic hormones, but at the moment I think it's the best thing to do. To go too long without a period also has detrimental effects on your health.

cazzybear1740

collectingblues wrote: »

Are you sure that's the right amount of calories for you? You don't share your height and weight, but I'd be surprised if your TDEE is only in the ballpark of 2000-2100 calories, with the amount of exercise you describe. I mean, I'm 5'4", upper 120s, and don't workout that much, and *my* TDEE is 2200...

No one is saying that you need to reduce your exercise. But if you're not willing to eat *more* and give your body *all* the fuel that it needs -- which means eating *all* of your exercise calories -- then yes, you may find it easier to cut back.

Thank you for your replies. Sorry for forgetting the obvious!
I'm 5ft 2in and just under 8 stone last time I checked but I don't have scales, as I just judge by how I am feeling and look instead. So if I'm still hungry then I will just eat more, I do prefer to eat healthy but I don't restrict the amount I have, if I'm hungry then I will just eat more that day.

I will do a 4 mile run one day, 20 minutes on the bike another day and the other four days doing weighted lunges, squats and core for 45mins -1hr.

cazzybear1740

Fuzzipeg wrote: »

I have just looked to see what if any medically supported information was available on line. The endocrine society suggests the full panel and prolactin, these tests would show other reasons for amenorrhea. They also suggest low heart rate, low blood pressure, even accessing electrolyte levels have influences. MRI scan was also suggested. They do find an increasing number of cases where there is an eating disorder, particularly anorexia. The page I found touched on low body fat and low carb intake as possible factors too.

You may find more information to help you on the, "Hormone Health Network" arm of the site. It makes a great difference if someone has never menstruated or has lost menstruation.

I'd not considered osteoporosis to be something which can go hand in hand with hypothalamic amenorea. I connected it to low thyroid hormones, particularly, Human Growth Hormone (being the third, hardly ever tested) which controls the growth and repair of bones and every cell, even in the adult, levels reduce as one ages, making it generally something affecting us elderly but anything which can edge one into this situation needs exhorstive investigations.

Wishing you all the very best, that you discover the right answeres for yourself

Thank you for your detailed reply! I am going to look at your site suggestions, that is such a great help. Really appreciate it!

cazzybear1740

Pollymopol2 wrote: »

The exact same thing has happened to me, I was on the pill for 2 years and when I came off it, no periods! I kept getting put off by my GP and eventually after 3 years of no periods I got tested for PCOS with negative results, but they did find that my oestrogen levels were really low. I took up running within these 3 years and now am a consistent runner. I've lost about 2 stone (11stone to 9stone - 5'7") since starting the pill and now (about 5 years). I got told by the endocrinologist to either go on the pill again, or reduce exercise because he believed this and my weight loss have caused the amenorrhea. Running is my thing and it makes me happy, I didn't want to lose that for the chance that my periods might not come back naturally. I chose to go back on the pill for my own health and the ensure that I had withdrawal bleeds to make sure my uterus and bones stay healthy....to be fair though I hate it, I came off the pill because I didn't want to be taking synthetic hormones, but at the moment I think it's the best thing to do. To go too long without a period also has detrimental effects on your health.

Yes to this! Thank you for taking the time to reply. I am happy to eat more but losing exercise just feels like a part of me. It makes me happy and I do look forward to it each morning! It's just getting that balance right! I don't think eating more will have a huge effect as I've never fluctuated in my weight and always been a size 10 but I'm going to increase my food intake just incase. I definitely exercise more than I used to so think this will play a bigger role so maybe a mix of dialing that down and more grub is a good place to start. I hope you manage to find a balance too 😊

misshealthydoc

Please go to the doctor (endocrinologist and/or OBGYN with specialization on hormones) and get a full hormone panel (including LH, FSH, prolactin, testosterone, DHEAS, estrogen, but also thyroid hormones such as fT4, fT3, TSH). Missing periods (if the diagnosis is hypothalamic amenorrhea or not) is a sign that something is not right within your body and can have detrimental effects on your life (osteoporosis, ability to conceive if you change your mind, effects on thyroid health etc..). Basically, the pill just covers the symptoms, but ignores the underlying problem. If I were you, I would do what it takes to get my body to a healthy, fully functioning version again (probably means more food, less stress, less strenuous exercise or no exercise etc..), after all health should be our number one priority hope you get well soon!

cazzybear1740

misshealthydoc wrote: »

Please go to the doctor (endocrinologist and/or OBGYN with specialization on hormones) and get a full hormone panel (including LH, FSH, prolactin, testosterone, DHEAS, estrogen, but also thyroid hormones such as fT4, fT3, TSH). Missing periods (if the diagnosis is hypothalamic amenorrhea or not) is a sign that something is not right within your body and can have detrimental effects on your life (osteoporosis, ability to conceive if you change your mind, effects on thyroid health etc..). Basically, the pill just covers the symptoms, but ignores the underlying problem. If I were you, I would do what it takes to get my body to a healthy, fully functioning version again (probably means more food, less stress, less strenuous exercise or no exercise etc..), after all health should be our number one priority hope you get well soon!

Thank you for your reply! Yes I completely agree. I've had a few days to process all this new information and have decided to stop exercising for now and eat more. I was quite upset at the thought of this but it won't be forever where as the damage could last forever! It's reminding myself why I did all this exercise to start with; to be healthy...which I no longer am! I really appreciate your information on the hormones that need checking. I have the doctor next week so will ask then. Thank you again 😊

keslafe

Hi. I understand this comment is from years ago, but I'm curious to know if you found any resolve? I'm going through the same... have been for over a decade (I'm 34) with incredibly low estrogen.

kshama2001

keslafe wrote: »

Hi. I understand this comment is from years ago, but I'm curious to know if you found any resolve? I'm going through the same... have been for over a decade (I'm 34) with incredibly low estrogen.

I'm assuming an endocrinologist diagnosed you with "incredibly low estrogen" - what was their advice?

If not, do see a specialist. I've gotten MUCH better care for my anemia since I started seeing a hematologist.