Recently I’ve had a number of women come to see me about Functional Hypothalamic Amenorrhea (FHA).
What is Functional Hypothalamic Amenorrhea (FHA)?
FHA is a condition characterized by the absence of a menstrual period for three or more months in a woman of reproductive age, due to the breakdown in communication between the hypothalamus, pituitary and ovaries, also known as the hypothalamic-pituitary-ovarian axis.
This condition is absolutely something to be concerned about and thus I felt compelled to write about it this week.
As many of you know, my journey into the land of women’s hormonal health began when I was a teenager dealing with a rather finicky period. She would bless me with her presence every 2 or 3 months and she always came with a vengeance!
Not knowing that this was a sign of a hormonal imbalance, I just “dealt” with it. When I’d finally had enough of feeling like crap, I went to the gynecologist who promptly put me on the pill to “regulate” my hormones. Problem solved!
I was getting a period every month and it was lighter and totally pain free. Celebration! However, at the time I had no idea that the period I was getting each month wasn’t actually a real period! Ha, my poor young and naive 19 year-old self!
Fast-forward a couple of years: I was still on the Pill but having all sorts of other issues – dry skin, hair and nails, joint pain, chronic yeast and urinary infections, you name it!
Who would have guessed that the Pill could be causing all of this?
A girl can only handle so much and this girl had reached her Pill threshold, so I decided to ditch hormonal birth control altogether and take a more natural route, AKA no birth control. I DON’T RECOMMEND THIS if you’re having sex ladies. I was not at the time! 🙂
It took a couple of months to get my period back on track but when it came on it’s own I totally celebrated. By then I was doing weekly acupuncture, eating A LOT better and working out somewhat consistently, all of which played a big part in my post-Pill recovery.
Now that you know my experience prior to and after the pill, I’d like to elaborate a little bit on the causes behind Functional Hypothalamic Amenorrhea.
Causes of Functional Hypothalamic Amenorrhea
- The Pill! You knew that was coming right? So here’s the secret about hormonal birth control that your doctor is most likely not letting you in on. Most Pills are low-dose, meaning that they are giving you very low doses of whatever hormone they’re made of. You’ve been told that’s a good thing but it might not be. The problem is that most women require greater amounts of hormones (than their Pill is providing) in order to function at their optimal level. Joint pain? Caused by too little circulating estrogen. Low sex drive? Too little testosterone. See my blog post on that hot topic! I’m a huge proponent of non-hormonal birth control like the Fertility Awareness Method.If you need guidance around coming off hormonal birth control, I’ve created the ultimate step by step protocol to help you transition off hormonal birth control (the pill, patch, IUD, implant etc) and take back control of your hormones, your body and your life. I invite you to check out my Ditch Your Birth Control Protocol here.
- Disordered eating: When our bodies don’t get the necessary nutrients (namely Fat and Protein) to make hormones, then hormone levels drop. When estrogen and progesterone drop, our periods become erratic and eventually cease to exist. Hormones are made from cholesterol and many of us need sufficient dietary fat and cholesterol in order to make the right amount of hormones.
- Over-exercising: We’ve consistently been fed the message that we need to work out like mad women in order to be “healthy.” The problem with this is too much exercise can actually have the opposite effect and cause harm to our bodies. Here’s the reasoning: A little bit is okay but when we cross the physical and emotional stress threshold, we end up producing too much of the stress hormone cortisol. This hormone is good in small amounts to get us through daily life, but when we produce cortisol in large amounts over long periods of time, our bodies break down. Over-exercising causes too much cortisol and thus a breakdown in hormonal function.
So those are the 3 biggies! Today however, I want to focus on the Pill because most women who take hormonal birth control don’t realize it’s potentially detrimental effects. This is because they are never informed about the side effects to their menstrual health and ultimately to their fertility.
FHA caused by hormonal birth control
The chemicals in the pill essentially “switch off” your hypothalamus and it eventually stops communicating with your pituitary gland. Your pituitary then stops communicating with your ovaries.
FYI: Your hypothalamus’ job is to release Gonadotropin-Releasing Hormone (GnRH) to the pituitary gland. Your pituitary then sends Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) to your ovaries.
This in turn causes your ovaries to produce estrogen and progesterone. Estrogen and progesterone then send a signal back to the hypothalamus to slow down the release of its hormones. This is a tidy little feedback loop.
On the pill though, the hypothalamus basically says “well, someone else is doing my job so I don’t need to do it anymore.” It is essentially forced into early retirement.
In the book “A Couple’s Guide to Infertility,” the author Gary S. Berger confirms this phenomenon. He says, ” Long-term pill users may not menstruate or ovulate after they stop using the pill. This condition, known as post-pill amenorrhea, occurs because the pill disrupts the natural rhythmic flow of hormones from the hypothalamus to the pituitary to the ovaries. This may pose a special problem for older women who have been on the pill for many years because their ovaries may have become resistant to resuming ovulation.”
Now, I’m going to bet your doctor didn’t share that valuable nugget with you as she/he wrote your pill prescription. In addition to the disruption of your hormones, the pill actually changes the way your gut functions, which can then cause nutritional deficiencies and chronic yeast infections.
Scenario: You’re thinking of coming off the pill or you’ve come off the pill. You’re freaking out because you have no idea what will happen or you’re already experiencing some scary stuff. E.g. not getting your period back, raging acne, mood swings, etc.
How to come off hormonal birth control the right way
- Start by incorporating more protein into your diet. Remember, hormone manufacture requires protein. Make sure you’re consuming a source of protein at each meal and snack so that you keep your blood sugar balanced. I love eggs, wild-caught fish, organic beef and chicken, and lamb.
- Increase your consumption of healthy fats. Hormones also need fat! Pregnenolone, the “mother hormone” is synthesized from cholesterol. You should aim for a source of healthy fat in each meal. E.g. avocado, walnuts, wild-caught salmon, coconut oil, coconut butter, sardines, sesame seeds, chia seeds.
- Up your intake of B vitamins. Remember what I said above about the pill and nutritional deficiencies? Well, the B-complex of vitamins is hit the hardest. And guess what? We need B vitamins to have a functional menstrual cycle. Hello folate (B9)! Foods high in B vitamins are beans – the ‘B’ in beans stands for B vitamins 🙂 Also consider a B-complex supplement.
- Start mending your gut. Remember what I said about the pill changing the way your gut functions? Basically the pill has an antibiotic effect on your gut – yes, it can kill of the good bacteria, which makes you susceptible to all kinds of stomach problems. Start to incorporate probiotic-rich foods like sauerkraut and kim-chi to help rebuild your good gut flora.
- Slow down on the exercise. If you are doing strenuous exercise every day or even every other day, consider reducing the intensity. Start doing yoga, tai chi, qi gong, meditation. All of these practices reduce stress and ultimately cortisol.
- Get some help if you think you need it. If you have been dealing with the after-effects of the pill for more than 3 months then get some guidance. I recommend my Birth Control Protocol where I will show you exactly how to come off the pill and regain control of your hormones and your life.