What is it?
Hypothalamic amenorrhoea is the loss of the menstrual cycle due to the hypothalamus (a structure in the brain) receiving information that it is no longer safe to create hormones such as, gonadotropin-releasing hormone (GnRH) responsible for reproduction. (1) This results in a loss of oestrogen, which can have detrimental effects on our health (2).
There are two types:
Primary: The absence of period entirely by age 16.
Secondary: The absence of 3 or more periods in a row after previously having a menstrual cycle (pregnancy and other causes such as PCOS need to be ruled out).
What causes HA?
Eating habits: restriction, being in an energy deficit, or long periods without eating ie fasting or irregular eating patterns (3).
Exercise: high levels of exercise and high intensity types of exercise (4).
Weight loss: while a low BMI is common in HA, the biggest predictor is weight loss (IMPORTANT: you can have a “normal BMI” and HA can still occur) (5).
Stress: Chronic or acute stress result in increased secretion of adrenaline and cortisol which interfere with our reproductive hormones (6).
Basically - too much stress will put our body in “flight or fight” mode and our body will prioritise life preserving functions and shut down non essential ones, such as menstruation.
Consequences of HA:
Bone loss with increased risk of osteoporosis due to loss of oestrogen
Increased CVD risk (also due to loss of oestrogen)
Dry skin, hair, nails
Loss of libido
Increased depression and anxiety
Infertility
Role of a Dietitian in HA:
Assisting with healthy weight gain
Increasing energy intake, with a focus on carbohydrates and fats
Help with implementing regular eating
Improving relationship with food
Ensuring adequate calcium intake for bone protection
Identifying and reducing high frequency and intensity of exercise
Identifying and reducing stress levels
Period gone missing? Book a consultation here!
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