Hypothalamic amenorrhea recovery signs

If you’re Googling ‘hypothalamic amenorrhea (HA) recovery signs’, then most likely you’ve struggled with a missing period for too long, and you’re feeling hopeful that the signs you’re now seeing indicate recovery- and fertility! I hope you’re right!
Hypothalamic amenorrhea recovery signs and hope that you can get your period back

If you’re on the road to HA recovery, and hopeful that you can get your period back so you can improve your fertility, get pregnant, and grow the family of your dreams, then this is for you. 


We’re going to cover: 

  • what is hypothalamic amenorrhea
  • what causes hypothalamic amenorrhea
  • can hypothalamic amenorrhea be reversed
  • how long does hypothalamic amenorrhea recovery take; and 
  • the most promising hypothalamic amenorrhea recovery signs. 


If after reading this blog about hypothalamic amenorrhea recovery signs, you’re disappointed that your recovery is not as near as you had hoped, don’t worry, I got you. Read, The 5 Simple Steps to Recover Your Menstrual Cycle so You Can Get Pregnant.


What is hypothalamic amenorrhea (or HA)?

Amenorrhea is the technical term for missing your period for 3 or more consecutive cycles.

Hypothalamic amenorrhea (HA) means that the hypothalamus in your brain has told your ovaries to stop ovulating, and to (temporarily) shut down reproduction. It’s also known as functional hypothalamic amenorrhea or FAH. 


The HPO axis; How the hypothalamus communicates with the ovaries

When all is working as it should, it goes like this: 

  1. The hypothalamus sends hormonal signals  gonadotropin releasing hormone or GnRH) to the pituitary gland. 
  2. The pituitary gland responds to GnRH by sending follicle stimulating hormone (FSH) to your ovaries, stimulating the growth of follicles in your ovaries. 
  3. FSH causes the follicles (fluid filled sacs containing the egg), to grow. As they grow, they produce more and more estrogen. 
  4. When estrogen levels spike, the hypothalamus takes note, and tells the pituitary to then release luteinizing hormone (LH).
  5. LH triggers the release of an egg from one of the follicles from the ovaries into the fallopian tubes. 


These hormonal communication channels are collectively called the hypothalamic-pituitary-ovarian (HPO) axis. Hypothalamic amenorrhea is effectively a breakdown in these communication channels, or a dysregulation of the HPO axis. 


The HPO axis dysregulation 

Your brain’s number one priority is survival. If resources are scarce, or there’s a significant stressor to your system (be that a physical, mental or emotional stressor), your brain goes into survival mode.

Survival mode means that your brain prioritizes functions essential to survival, like your heart beating and your lungs breathing. 

Simultaneously, your brain shunts resources and precious energy away from less essential functions, like digestion, body temperature and reproduction. 

(This is why it’s so common to struggle with constipation and feeling cold, in addition to a loss of your period.)


Primary vs secondary hypothalamic amenorrhea

Primary amenorrhea is when you have not gotten your period by age 15. 

Secondary amenorrhea is when you have had a period before, but now you have missed three or more periods in a row. 

So, if you’re past puberty (and premenopausal), and going on 90+ days without a period, that counts as amenorrhea, or a missing period. 

Note: for both definitions of primary and secondary HA, it’s assumed menstruation has not been suppressed by exogenous hormones, like hormonal birth control. 


What causes hypothalamic amenorrhea? 

There are many potential causes of HA, including hormone imbalances, lifestyle and nutrition choices, medical conditions and physical abnormalities, which is why it’s important to work with an experienced healthcare professional, and not self-diagnose.

The most common cause of secondary amenorrhea is pregnancy, so start by taking a pregnancy test!

If you’re postpartum and lactating or breastfeeding, the hormones that support lactation (namely prolactin) can also suppress your period, making lactation another common cause of secondary amenorrhea.

If the above causes sound like a cruel joke because you’ve been desperately trying to get pregnant, you’re not alone and you’re in the right place.

Once your doctor has ruled out medical and physical causes of amenorrhea, the next place to look is diet and lifestyle. 

As explained above, in order to have a regular menstrual cycle, your brain needs to feel safe to reproduce. When you have been:

  • Under-eating
  • Over-exercise
  • Under-sleeping, or 
  • Over-stressing


For long periods of time, then the hypothalamus in your brain detects that you’re not safe and that resources are scarce, and it stops sending pro-ovulation signals to the pituitary gland. 

In turn, the pituitary gland stops sending FSH and LH to the ovaries, the ovaries stop developing follicles and ovulating, and the entire menstrual cycle gets stalled, and hypothalamic amenorrhea ensues.

To reverse HA, so you can start seeing hypothalamic amenorrhea recovery signs, see The 5 Simple Steps to Recover Your Menstrual Cycle so You Can Get Pregnant.


Can hypothalamic amenorrhea be reversed?

Is it even possible to enjoy hypothalamic amenorrhea recovery? 

In most cases, yes! You can recover from HA (see hypothalamic amenorrhea recovery signs below) and get your period back, so you can get pregnant! 

While there are potential medical and physical reasons why you may have lost your menstrual cycle, many of those underlying causes are treatable. 

In my clinical practice, 9 times out of 10, the underlying cause is due to factors that are well within your control to change – things like diet, exercise, and stress management. 

How long does hypothalamic amenorrhea recovery take?

How long does it take for hypothalamic recovery signs to start showing up? This is the million dollar question- and the answer largely depends on YOU. 

  • How committed are you to making sure you’re eating enough to fuel your current lifestyle AND to provide the nutrients needed for recovery? 
  • How committed are you to truly reducing your stress levels – not through more exercise, but through genuinely calming practices that bring the stress hormone (cortisol) down? 


If you can stick with the recommended lifestyle adjustments, it typically takes 3-6 months to see hypothalamic amenorrhea recovery signs. 

The exact amount of time depends on your genetics, activity levels, and of course, your commitment to recovery. If you’re only half in, progress will be delayed. If you want to hypothalamic amenorrhea recovery signs more quickly, then go all in. 


Hypothalamic amenorrhea recovery signs

Here’s what to look for to determine if you’re seeing hypothalamic amenorrhea recovery signs: 


  1. Better sleep. As hormones rebalance, many women find they’re able to fall asleep better, then sleep more soundly, and then wake up feeling more refreshed. 
  2. Increased energy. For the women that I work with to help them recover from HA, one of the first recovery signs that they report is improved energy levels. Even if they didn’t describe themselves as tired previously, they notice improvement in their energy – especially in the afternoon and evening. 
  3. Increased appetite. For many with HA, they have suppressed their hunger cues for so long, they’re no longer discernible. With recovery, comes that grumbling, achy or hollow feeling in your tummy, letting you know your body needs nourishment.
    1. Do not push away or ignore these hunger cues. Increased appetite is a great sign that HA recovery is near! 
  4. Better digestion. This means less constipation, less bloating and gas, and more regular (daily!) bowel movements. As your body recognizes it has enough food to survive, it will prioritize digestion. Increased food also means increased fiber and increased waste to eliminate!


Since HA is defined by missing your period, you probably would have guessed that hypothalamic amenorrhea recovery signs are focused on menstrual cycle signs. 

You wouldn’t be wrong, but it’s important to note that the missing period is just one of the symptoms of the underlying HPO axis dysfunction. 

The underlying cause of the issue is that your brain is in survival mode – and this comes with many repercussions, beyond a missing period and loss of fertility. 

Once your body starts feeling safe enough to reproduce, other bodily functions and systems also improve in their function. That’s why the hypothalamic amenorrhea recovery signs listed above, like better sleep, digestion and energy, often come first. 

All of that said, there are a few hypothalamic amenorrhea recovery signs that are more specific to your menstrual cycle. These include: 

  1. Increased cervical mucus (a.k.a. Cervical fluid): As you recover from HA, your body produces more estrogen. In response to estrogen, you produce more cervical mucus – which you’ll likely start to notice on your toilet paper or on your underwear. 
    NOTE: If you’re monitoring for hypothalamic amenorrhea recovery signs, it’s a good idea to insert a (clean!) finger into your vagina daily to monitor for cervical mucus. 
  2. Increased breast tenderness. When in the depths of HA, your reproductive hormones are basically flatlined. As you recover, hormonal shifts can cause symptoms typically associated with PMS – like tender breasts. 
  3. Increased moodiness. See above – as hormones begin to shift, so too can our mood, which can show up as increased teariness, irritability, anger or all of the above. These mood fluctuations should be temporary and improve as your hormones restore balance. 
  4. Cramping. If you have reached the point of HA recovery that your body is ready to ovulate, then it’s common to feel a mild twinge or cramp in your lower abdomen, where you think of menstrual cramps occurring. If the cramping is only one side, than it’s likely to be a sign of ovulating (because each cycle, you only ovulate from one side or the other)


A final note about recovery from HA

Hypothalamic amenorrhea recovery is not linear. People recover at different rates, and often see different signs. 

The hypothalamic amenorrhea recovery signs described above do not necessarily occur in any particular order. It’s common to see some HA recovery signs, but not necessarily all of them. 

Whatsmore, women often report that their HA recovery ebbs & flows, meaning they see signs of recovery, but then they fade, only to return again in a few weeks or months. 

As best you can, try to be patient and keep on keeping on. The more consistent you can be with the recommended lifestyle adjustments, the better. 

None of this easy and you shouldn’t have to go it alone. 

If you want support and trustworthy, step-by-step guidance to lead you to HA recovery, so you can optimize your fertility and establish a healthy relationship with food to pass down to your kids, then let’s chat. 

Contact me today to learn more or to start your fertility journey