December 19, 2020 • 27 mins
Victoria Myers breaks down how and why disordered eating leads to hypothalamic amenhorea (loss of period). She reframes what a period means for our health, and how important it is to be working to get a period, even if you're not concerned with fertility.
About Victoria:
Victoria Myers is the dietitian and owner of the virtual private practice and online education center Nourishing Minds Nutrition. They specialize in empowering women to ditch diets, regulate hormones, heal digestion and learn to practice wellness without obsession. She is also the host of the popular intuitive eating and wellness podcast, the Nourishing Women Podcast. Her mission for her community is to help them let go of the unhealthy obsession with eating healthy, make peace with their body and live their lives to the fullest.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Maybe that's Lisa and We're just two girls that want
to have a conversation with you. Dear sixteen year old Andrea,
Hey gorgeous, Dear younger Lauren. Each episode is stories from people.
I would deprive myself by myself obsessively because I was
eating healthy. I couldn't understand that I had a problem
with food. Losing my period scared me the most. My
story starts when I was around seven. That's when I
(00:24):
started to hate my body. Body image is like our
inner picture of our outer self. Healthy behaviors play a
much bigger role at all health than the actual number
on the scales. Internal dialogue could be so powerful and
often it's super negative and critical in a way that
we wouldn't talk to other people that we care about.
When you start to share your story, that gives other
(00:44):
people the courage to share theirs. I know you would
be proud now of how far you have come in
your relationship to food, exercise, and to yourself. I felt freedom,
I've gained relationships. I've found my true sense of self worth.
There's one thing I need you to take away. You're
going to be okay, okay, Lisa and I are excited
(01:05):
to have Victoria Myers back on. If you missed our
episode with her, she was on previously talking about intuitive
eating and ibs. We had an amazing conversation, so we're
pumped to have her back on to talk about how
to get your period back, which I personally have never
dealt with, but I know others listening may or it
(01:27):
might be something that they have a loved one has
gone through, So this could be a perfect episode to
share with someone. I know we have a lot of
moms that have daughters and this is a real thing.
It's a real concern, and I'll go ahead and say
Victoria's Instagram handle here, but we'll have it in the
show notes at Victoria Myers Underscore. And Victoria's definitely qualified
(01:47):
for what she is talking about. She is a podcast
host of her own nutrition Minds. You can check that out.
She is a registered dietitian, and she is the founder
of Nourishing Minds Nutrition. So Victoria, welcome back. Thank you
for having me. I'm so excited to be back again.
Before we jump in and go through all about how
(02:08):
this happens, why it happens, what the cause is something
that I've noticed with my friends I'm thirty two years old,
so I have a lot of friends a few years
younger than me, a few years older than me, and
some who have lost their period because of dieting, and
there was no concern while they were dieting and staying
in control of their weight and bodies. But when it
(02:30):
came time to think about having a baby, all of
a sudden, they were terrified and we're scrambling to get
their periods back and to learn about their bodies. So
I just thought it was super interesting to kind of
think if I was twenty and I lost my period
because of disordered eating habits, I might sweep that under
(02:52):
the rug. But when you're a few years older or
in your family planning years, all of a sudden, it
kind of bites you in the butt and you wish
you didn't do the things that you did. So, just
for anybody who's maybe not there yet, I want you
to be thinking about what that means for your body.
And while it might not be critical to fix it
(03:12):
in the moment, you don't want to get to the
point where you two are scrambling. Yeah, because your period
is your monthly report card, and you definitely want to
think of it that way, like it's telling you that
your body is safe and seen and heard and taken
care of. Truly, I will say that there are ramifications
for not having a period, even if you aren't trying
to have a baby. There's uh, you know, impasted your
(03:32):
bow density, it can affect your heart health. Estrogen is
very protective to our hearts. And I know like people
often see periods as like this annoying, a monthly thing
they have to deal with. But hopefully we can also
change that conversation to be an empowering message of like,
this is your body taking care of you, and also
appear it can be a wonderful, restorative time. I know
that sounds a little hippie of me, but it's true
(03:53):
it can be. So hopefully that helps shift someone's perspective
about their period too. Hey, can y'all quickly since I
know Victoria, you and Lisa both know the official term
for what we're talking about, but I want y'all to
say it out loud for everybody else because I, for
the life of me, cannot say it. I feel like
I'm going to invest saying it now that we're like
laughing about saying it round, so we're gonna talk today
about h A. So hypothalamic and nerrea. Boom. Now you
(04:17):
can like use that whenever you're talking about it and
sound super smart. Let's call it h A for the
purpose of today. I feel like, you know, so anytime
we say h A, we're talking about what victoria hypothalic
nerrea or a missing period. Okay, but it's missing period
due to h A. So hypotholgic and norrea is means
(04:38):
that you have once had a period and now it's
missing because there's technically a version called priory and norria,
which means you've never had your period before. But hypothogic
and norria means that you had a period and now
it's an it's missing in action. So h A is
you know a really interesting thing that there's this, you know,
I think we understand a lot of times with like
eating disorders, that there are gonna often be like a
(04:59):
missing pure There's also the female athlete triad where we
often like this kind of a known thing that a
lot of times athletes can lose their periods. But there's
this huge group of women that also superior is just
from disordered or de dieting behaviors alone can also And
the way you basically want to think of h A
is your body has stopped getting the fuel or the
(05:20):
necessary inputs it needs to create a cycle. There's a
lot of different mechanisms within the body, and I wouldn't
want to necessarily get super scientific in today's so because
that can get really boring really quickly. But basically think
of it like this, if your body is in a
famine mode of feast for famine, it thinks that it's
unsafe to produce a cycle right now. And there's a
(05:41):
lot of things that happen with your hypothelic put to
a terry internal access or your hp a access where
your body starts to shut down the pathway. So again
you can just think of as like your body isn't
getting what it needs, so it starts to shut down
these pathways. There's these like amazing reproductive neurals that tell
your body that it's just time to stimulate and mature
an egg, which leads to ovulation, which leads to your period.
(06:03):
Other things that can happen in addition to like your
your neurons not firing correctly anymore and your body going
into that Sandon mode is your hormones should just start
to decrease as Mentioning estrogen earlier is a really important
reason why you also want your period because it's very
protective to your bones into your heart help. But estrogen
is involved with your unine binding, is also involved with
the first half of your period, your filick, your phase,
(06:26):
and it helps tell your body it's time to ovulate,
which then tells your body to search your progesterone. And
often when we have h A, you have really really
low levels of estrogen and progestion. I've seen women with
postman and pousial ranges of estrogen and progesterone. And that's
another thing that happens is so not only are these
like HV access stops faunctioning correctly. It tells your neurons
(06:47):
and different components and chemicals in your body to stop
firing the things that needs to stem like the egg,
but also you just stop producing enough literal hormones to
have a cycle. And the main things that cause it,
we call them the big four practices food, exercise, sleep,
and stress. I will say above all the food is
the primary culprit of why period you can go missing.
So that means that you're not eating enough. That's like
(07:10):
the primary thing that you can think of is when
I say food intake, I mean you are not eating enough.
And it's really interesting. You can actually lose your period
from not eating enough with or without a low body
fat because that's a really big common misconception. People often
think you have to have a really really low body
fat and that's simply not true. You can just lose
it from calorie restriction alone. I'll also say calories are
(07:32):
probably most important when it comes to food intake, and
second after that is carbohydrates because we have glucose sensing
neurons in our ovaries and another reason why we can
really quickly lose loser period if we're not eating the carbohydrates.
So as an example, I've seen people maybe collorqually eat
enough from something like a keto diet, but then they
still lose their period because they're not eating any carbohydrates,
and they're really really important for your period. So that's
(07:55):
the food piece. With exercises, typically just someone is over
exercising exers I seem too much and that can cause
a lot of stress to the body and also cause
in an adequate food intake to exercise ratio, and that's
also part of why they lose their periods. And then
not quite as important but definitely important is stress levels.
Do someone's had like a big change of alife, they've moved,
they've gone across thease, they've had maybe a new job.
(08:18):
Stress levels can definitely cause a missing period. I would
say that's a little bit more common with just like
missing your period here and there, though u h A
is probably gonna be a little bit more specifically related
to food into exercise. And then I will say sleep
is really important too. Sometimes we see people have a
regular cycles if they're not getting adequate quality of sleep too.
So the big four is what I've had to your
(08:39):
body and again all these different pathways. Basically saying your
body starts to shut down and not produce a cycle
because it thinks it's in a famine or it's not
in a safety mode is the way I always describe it. So,
how many months of a missing period does it take
to diagnose or warrant and call it h A. I
believe it's three or more months. Yeah, okay, so I
assume at that point will need to seek medical attention
(09:03):
and get some help there. But what are some ways
or some steps people can take to help restore what's
been done. Yeah, so I agree. I think sing a
medical doctor is always something I'm going to advise as
you go see your O, B G. Y in and
talk to them about this. Occasionally PCUS can be part
of the conversation or not occasionally, but I will say
PCs can cause a missing period. We're talking specifically to
(09:24):
ahe A today though. I just mentioned that because sometimes
when people go to a doctor, they immediately get splashed
with the diagnosis of PCOS, and a missing period is
not only caused from PCs. Just wanted to mention that.
But the main thing, can you can you define PCOS? Yeah,
so polycystic over eat syndrome. It's when we have I mean,
there's a lot of different criteria. You have elevated androgens,
(09:45):
you also have a missing or a regular period, and
you have polycystic ovaries. Usually we're looking at twenty five
or more follicles on each ovary. Is what you need
to get diagnosed with it, and that can cause a
missing or a regular period. I know that's again it's
not the purpose of this converse ation, but h A
is a little bit different of what causes in the
same period in comparison. So you did say that body
(10:07):
fat does not necessarily have a correlation to h A. However,
what about weight changes, So do you need to go
through weight loss for hypothalmic a manorrhea to occur? Yeah, definitely,
Like weight loss can definitely contribute to h A. And
that makes sense to just from the energy and take perspective, right,
(10:28):
Like usually weight loss is happening because there's a calorie
restriction of some kind happening. But weight loss or like
especially like sudden weight loss can definitely also indicate to
your body that is again not in a safety time
and not a healthy time to produce the cycle. So
that's a good question. I mentioned this in the very beginning,
but I mentioned it doesn't have to be a low
(10:48):
body weight because there is this perception that you have
to be in a thin or small sized body to
have h A, and that's not always true, and you
can be in a variety of body sizes and experience.
Just to drive that point home and correct me if
I'm wrong, you can have a b M. I your
doctor says your your body mass index is overweight or
even obese, and you can still have hypothalmic amenorrhea likely
(11:10):
if you are restricting calories exactly. Yes, okay, and then
can we continue on with the possibly seeing O B
G y N or a medical professional, but being careful
of them immediately diagnosing you with something else because they
may not. I'm I'm wondering if my O B G
I N has ever really asked me about my food
(11:31):
intake or caloric intake. I mean, they definitely just want
to weigh me and make sure that I check whatever
box that is. But I'm just wondering if someone goes
and yes, you're right, they go to that appointment, will
they get the proper guidance? But let's say that they
know it's h A, are there other steps you could
share that they could take to help restore their period? Yeah,
(11:52):
And that was a really good point to make any
because sometimes, yeah, it's not so cut and dry off,
like someone's going to sit and ask you what is
your relationship with food like and what are you doing
with your exercise habits? And let's be real, a lot
of times these habits are praised. Orthorexy is definitely something
in any disordered eating where like women eating less and
exercising too much is often a praise think in our
(12:13):
in our society specifically, so really good point to make.
I mean, this does sound so simple, why I understand
it's not at all. It's why like we've worked one
and one with people on this, but you need to
eat more and exercise less. That's the basics behind fixing
h A. But eating more. I don't know if we
talk about calorie ranges here, I can share some of that,
but it's usually eating an appropriate amount of calories to
(12:34):
restore h A. And then with exercising, typically what we're
looking at. Not everyone can take an exercise break all that.
That's my gold standard. I usually prefer a small time
frame of an actual exercise break, but sometimes that's not
possible for all people all the time. Exercise addiction is
a real thing. So then we just focus on reducing
overall exercise or let's say taking out high intensity interval
(12:55):
training and just focusing on walks or yoga or something
like that to get their period back. I think it's
so interesting about as it sounds really easy, but the
reality is is like those are really hard things to
work through, and I think that's where like working one
one can be so helpless because I swear more of
my job at least, I wonder if you feel to say, like,
I feel like my job is more talking about the
mental assets of life so challenging than it is like
(13:15):
just giving someone like a cali arrange and telling them
not to exercise, Like it's never that simple. It's always
like talking through why we're so stress or worried or
anxious about things, or why we have the fear of waking.
Like that's I feel like such a huge part of
my job. Yeah, and when it comes to a period,
it can further the stress and anxiety when that report
(13:36):
card comes and you're doing all the things that your
dietitian tells you, you're eating more, you're exercising less, and
then your period still isn't coming back, and that can
kind of put you into a cycle of feeling like
a failure, having more stress, furthering the loss of period
by way of that stress part of the equation, especially
(13:57):
if you are in family planning mode and that is
on a timer. Yeah, I think that's a good point.
And my thing with the fertility too, is like if
you're doing this work in addition with fertility treatment, like
I'm going to support you with whatever decision you make,
because some people have the time to wait for h
because it can take six plus months to heal from right,
and then some people don't have that time at always
(14:19):
really want to honor and respect that, but I still
always encourage doing this work. In addition, if you are
doing something like fertility treatment, because it is so important
to heal just because again it's your body knowing that
it's safe and taking care of my personal experience, I
lost my period when I went off of birth control.
Same here is that h I don't think of it
(14:39):
as h I think if it more like post birth
control signings, That's the way I would personally describe it.
But I do think if it's an extended period of time,
it is probably more likely that it is h A
and you may have always had h A, but the
birth control pill disguised that, which is like, oh my gosh,
I could made another episode in itself, right, like how
the birth control pill like just gives us withdrawal blieds.
It's not the same thing as a natural monthly cycle,
(15:02):
and it can be really confusing because it makes you
think that you know you're good and you're having a period,
but it's not the same thing. So so if you're
having a regular period on birth control, it's not that
it's a false good report card in theory, not necessarily,
but you can't say this is my report card, I'm
doing everything great because it's synthetically happening. Would ud be
(15:24):
the right word. Yeah, So you're on typically some amounts
is different for every birth control people. You're on a
synthetic amount of ashagen and progester and it's not the
same as the like the beautiful epps and flows of
your natural monthly period, and that causes whenever we saw
taking it, when we start taking the sugar pills, a
withdrawal bleed, and that's not the same thing. Now I'm
going to say, like just to be real clear, like
(15:46):
I have no qualms with birth control, Thank goodness we
have it, that say, you know, but so important for
so many years of my life because I didn't have
an unwanted pregnancy. So I'm not hating on it at all,
but it's important to understand, like it's not the same thing,
So it's not hating on it as also like understanding
its purpose and that's not giving you the same thing
as a pill. I will also say, just real quick,
(16:06):
sometimes with eating disorder recovery, uh, this is different than
what we've been talking about disorder eating with Sometimes you
actually want someone to take something like synthetic estrogen or
birth control as they are to underweight so much so
where it's going to take a long time to get
their period back, and that can be protected to their
bones into their heart health until we know they're safe
to get their period back. So there's always caveats, of course,
(16:27):
but most of the time we want to work to
get back that natural monthly period. Such an important distinction. Yes. Yeah,
in the beginning you said something about how we really
want to change the conversation around periods, and I think
this will open the conversation up to all listeners, even
if you're not going through loss of period. And for me,
(16:47):
this has been such a wonderful way to take my
health back because when I lost my period because of
birth control all of a sudden, I didn't have that
report card coming in and it came back within about
six months, and I did some things that I'm not
going to mention here because it might not be applicable
to everybody. And I don't want to confuse everybody, but
when I started getting it back, it really changed my
(17:09):
mind about periods and my own health. And even with
my now husband boyfriend then, you know, we were high
fiving each other when I was getting my period, which
is a complete opposite framework of you know how I
was in my early twenties of my period. You know,
a boyfriend you know wasn't celebrating it either. So you know,
it's just so amazing to think about how wonderful the
(17:31):
body is and really double think or check in with
ourselves when we're quick to complain about something that it's
doing just because we're conditioned to complain about what it's doing.
So I personally love my period. I'm also not one
of those people that gets crazy cramps, so I know
that that it could be very uncomfortable experience for a
lot of people, But for me, I feel so womanly
(17:54):
and good and in charge of my health when I
get that as a read on my body. Okay, I
love that so much and I'm going to echo that completely.
I love my period. I'm actually on my period right now,
and I'm like, hell, yeah, girl, I'll get your your
body is doing good, like I genuinely like get excited
when it happens. I also, I don't know how much
you guys talk about the period, so maybe people aren't
(18:15):
familiar with this. There's this whole idea of like cyclic living,
and we talk about that with our clients because intuitive
eating is really about going with the seasons of life
and going with the epp and flow of life. And
I love this idea of being very introspective and like
really not having a lot on my calendar when I'm
on a period, and that changes as I go towards opulations.
So I just have always looked at it as this
(18:36):
really fun way to connect deeper, more profoundly with my body.
And yeah, of course sometimes I'm more moody on certain
parts of my cycle and I get annoyed, but overall
it's just allowed for a greater appreciation for like being
a woman, because our period is actually like our like powerhouse.
It's not like the negative thing that we have to
deal with every month, something you also said earlier, and
I love that. By the way, I think I might
(18:58):
start implementing a little to that into my life of
when I am in my period, what is my schedule
look like? And how can I give myself that permission
to just step away from certain activities or things. But
I also want to say to you said something earlier
about with your clients and when they have h a
and really getting to the root of why they got there.
(19:22):
I'm paraphrasing kind of what you said to get to
what I want to ask you is like, Okay, let's
get to the root of why you feel like you
need to look that way anyways. So for some of us, yes,
like Lisa, there was a time in her twenties where
she could sweep no period under the rug because the
root of the problem was society has told us we
need to look like this. So as women, one of
(19:45):
the many sacrifices that ends up on the table is
the loss of our period. So just for anybody that
maybe hasn't lost their period, but they're listening to this,
and hopefully they can walk away with an appreciation of
just how complex our bodies are and how everything is
working together at this crazy level that we can't I
(20:06):
can barely even comprehend every organ and depends on this
and that in the breakdown of whatever, and when we're
destroying our bodies for this gain or what by society
standards a short term gain, but like the long term
effects are not worth it. They're not worth it at all.
And I think it's just comes back to understanding that,
(20:27):
like not eating enough calories or not eating enough overall,
is it worth it to lose your health over And
we're being told this guy's of it's for your health.
You're taking these boots out of your diet, or you're
not eating a particular way, or maybe you're just overall
like not you know, you're doing a caloristriction diet. But
my question back to people's like, is that really about
your health? Is that truly value based and aligning for
(20:48):
you to do, because this doesn't seem to be giving
you your health if you're developing digestive issues or more
of those, or you're losing your period, like you might
be doing it because you think certain foods are in
play metorier they shouldn't eat X, Y and Z foods,
or you should be on a caloristriction diet because that's
just what we think health is right now. But is
that really health? Like? Is that really And again, having
(21:09):
your peer to me is like one of the main
vital signs that stuff from Lisa Henderson. Jo actually calls
it the fifth botal sign, and I couldn't agree more.
I think that's such a great way to think of
it as like one of your signs of health. And
you know, thank goodness for somebodies that show up and
not everybody gets that warning sign. Maybe if you've got
gastro intentional issues that show up because of your eating disorder,
(21:31):
or you have h A show up because of your
eating patterns, thank your body. Maybe in the moment, it's
frustrating because you're so desperate too. I'm just categorizing, but
let's say it's because you want to be thin. You're
so desperate to weigh a certain amount or something. But
thank goodness, your body is functioning at a level that
it can give you the warning. Because other people, their
(21:53):
body may not give them the h A warning, but
there's still serious problems going on, like it may show
up just down the line. I'm just kind of thinking
of trying to have gratitude. It's unfortunate if you have
h A, but how amazing that your body sent you
a signal that you need help. Yeah. I really like
that perspective, and similar to a digestive issues right, like
(22:13):
when I was experiencing really bad digestive issues, that was
a sign that something was off with my body, and
saying when I lost my peered after getting off the
bark until pill and I would even say to this day,
I haven't had a missing period since I got my
peered back all those years ago. But I will get
digestive issues out how flare ups whenever I'm in a
lot of stress in my life, and it's always a
reflective time for me be like, Okay, you're obviously stressed
(22:35):
out about something, because IBS obviously isn't just cost and
just sort of eating it can we cost from you know,
stress and anxiety we know so linked to that too.
So I just always use my symptences like Okay, obviously
something's going on, like check in time victoria, like how
is your life going? Is there something where you are
too stressed out about something? And you can always like
if you are still strongly disordered eating, I aviously check
in with your food, your exercise habits as always, if
(22:57):
you're experiencing more sentence or if your peer goes think
those are the first things you always want to ask yourself,
but it is it's a great way to reflect and
ask yourself where you were at your journey. I lost
my period for a month during COVID, and I thought
I had to be pregnant because I haven't had a
missing period in a long time. And I mean I
must have spent four hundred dollars on pregnancy tests. And
(23:17):
I went to the doctor and without I I wrote
a blog about this, but without even uh knowing anything
about my baseline weight or anything. She told me that
I should just lose weight, just blanket statement. Told me that, yeah,
I think I had gained like to myself. I think
I don't weigh myself, but I think I went on
a scale there. I forget the story exactly I wrote
it in the blog, but yeah, that I mean Amy's jobs,
(23:40):
both of your jaws dropped, and that so did my
you know, Instagram audiences. Um when I told that story.
But and and go ahead and read the blog. It's
on my side or a link it I guess below.
But I will say I actually didn't plan on telling
the story. I forgot about it until we were kind
of talking about it. But it's so important to not
go with and get statements from your healthcare providers and
(24:02):
really know your own body because it was just stress
and it made you know, that was the first time
in my life a healthcare provider had said that to me,
and I actually appreciated being in the shoes of many
of the people that I work with because it just
totally invalidates everything else and it makes you feel to
blame and you know it first of all, was unrelated
(24:24):
to that, and second of all, just was such an
unhelpful suggestion. And you know, I think why my jaw dropped.
I'm sure why so many people listening is because you know, Lisa,
you know you benefit from thin privilege unless something I
love that you talked so much about. So it's so
concerning to me because if someone says that to you,
imagine who else they're saying it to you and into
why didn't they stop and ask you? How is your stress?
(24:46):
What's going on in your life? Is there any like
have you had any major transitions or challenges? Have you
had any changes you're eating an exercise habits. I understand
like there's so much medical complications that like they're not
given enough time or education kind of stuff. That's just
super a super saddening to hear that honestly, because like
that was such an opportunity to ask questions rather than
how you to lose weight, especially how to lose weight,
(25:08):
And it came from like a much more gentle place
than where it kind of sounds like it's coming from.
You know. It was like, sometimes our bodies are very
sensitive to small weight changes. Therefore a few pounds could
get you back to you know, your period, So it
was more gentle than you know, no, just go home
and lose weight. There was a little bit more basis,
but nonetheless, you know, I just think it's so important
(25:30):
for everybody to bring their own power to every appointment,
whether that's with a registered dietitian or a doctor and
recognize that blanket advice like that is just so unhelpful.
And the real reason I brought this up was because
stress has a profound impact on our bodies period and
we do not talk about that enough. We go so
(25:51):
quick to the weight and you know, by focusing on
my stress management techniques, my next period returned. So there
we were. Yes, I appreciate sharing it because agains stressed.
I couldn't agree more. I just such a big advocate,
like what's your shows? I was like what's your anxiety
levels like, because that makes such a difference in our
health in so many ways. We just don't give enough credit.
And it's so funny because I think we've wrapped up
(26:13):
the first episode talking about that, but it's just true.
It really is so important that we understand and we
make peace with that. And I understand stress and anxiety
is harder to deal with, and you know, eliminating a
food or doing a protocol or trying to do when
it comes to hormones, so often people are elimiting foods.
That's why I mentioned that they think I have a
missing period, that must mean I'm eating something inflammatory, but oftentimes,
(26:36):
especially with h A, not oftentimes, almost always with a specifically,
that is not at all why you have a missing period.
It's not because you're eating specific foods. Is because you're
not eating enough and you're probably exercising too much. Well,
that was incredibly helpful, and as a reminder, we'll put
all of Victoria and her nutrition practices information in the
show notes below. Victoria, thank you for being such a
(26:57):
wealth of knowledge and sharing your beautiful energy with us.
Thank you, thank you so much for having me. I
really appreciate it. M HM
Maybe that's Lisa and We're just two girls that want
to have a conversation with you. Dear sixteen year old Andrea,
Hey gorgeous, Dear younger Lauren. Each episode is stories from people.
I would deprive myself by myself obsessively because I was
eating healthy. I couldn't understand that I had a problem
with food. Losing my period scared me the most. My
story starts when I was around seven. That's when I
(00:24):
started to hate my body. Body image is like our
inner picture of our outer self. Healthy behaviors play a
much bigger role at all health than the actual number
on the scales. Internal dialogue could be so powerful and
often it's super negative and critical in a way that
we wouldn't talk to other people that we care about.
When you start to share your story, that gives other
(00:44):
people the courage to share theirs. I know you would
be proud now of how far you have come in
your relationship to food, exercise, and to yourself. I felt freedom,
I've gained relationships. I've found my true sense of self worth.
There's one thing I need you to take away. You're
going to be okay, okay, Lisa and I are excited
(01:05):
to have Victoria Myers back on. If you missed our
episode with her, she was on previously talking about intuitive
eating and ibs. We had an amazing conversation, so we're
pumped to have her back on to talk about how
to get your period back, which I personally have never
dealt with, but I know others listening may or it
(01:27):
might be something that they have a loved one has
gone through, So this could be a perfect episode to
share with someone. I know we have a lot of
moms that have daughters and this is a real thing.
It's a real concern, and I'll go ahead and say
Victoria's Instagram handle here, but we'll have it in the
show notes at Victoria Myers Underscore. And Victoria's definitely qualified
(01:47):
for what she is talking about. She is a podcast
host of her own nutrition Minds. You can check that out.
She is a registered dietitian, and she is the founder
of Nourishing Minds Nutrition. So Victoria, welcome back. Thank you
for having me. I'm so excited to be back again.
Before we jump in and go through all about how
(02:08):
this happens, why it happens, what the cause is something
that I've noticed with my friends I'm thirty two years old,
so I have a lot of friends a few years
younger than me, a few years older than me, and
some who have lost their period because of dieting, and
there was no concern while they were dieting and staying
in control of their weight and bodies. But when it
(02:30):
came time to think about having a baby, all of
a sudden, they were terrified and we're scrambling to get
their periods back and to learn about their bodies. So
I just thought it was super interesting to kind of
think if I was twenty and I lost my period
because of disordered eating habits, I might sweep that under
(02:52):
the rug. But when you're a few years older or
in your family planning years, all of a sudden, it
kind of bites you in the butt and you wish
you didn't do the things that you did. So, just
for anybody who's maybe not there yet, I want you
to be thinking about what that means for your body.
And while it might not be critical to fix it
(03:12):
in the moment, you don't want to get to the
point where you two are scrambling. Yeah, because your period
is your monthly report card, and you definitely want to
think of it that way, like it's telling you that
your body is safe and seen and heard and taken
care of. Truly, I will say that there are ramifications
for not having a period, even if you aren't trying
to have a baby. There's uh, you know, impasted your
(03:32):
bow density, it can affect your heart health. Estrogen is
very protective to our hearts. And I know like people
often see periods as like this annoying, a monthly thing
they have to deal with. But hopefully we can also
change that conversation to be an empowering message of like,
this is your body taking care of you, and also
appear it can be a wonderful, restorative time. I know
that sounds a little hippie of me, but it's true
(03:53):
it can be. So hopefully that helps shift someone's perspective
about their period too. Hey, can y'all quickly since I
know Victoria, you and Lisa both know the official term
for what we're talking about, but I want y'all to
say it out loud for everybody else because I, for
the life of me, cannot say it. I feel like
I'm going to invest saying it now that we're like
laughing about saying it round, so we're gonna talk today
about h A. So hypothalamic and nerrea. Boom. Now you
(04:17):
can like use that whenever you're talking about it and
sound super smart. Let's call it h A for the
purpose of today. I feel like, you know, so anytime
we say h A, we're talking about what victoria hypothalic
nerrea or a missing period. Okay, but it's missing period
due to h A. So hypotholgic and norrea is means
(04:38):
that you have once had a period and now it's
missing because there's technically a version called priory and norria,
which means you've never had your period before. But hypothogic
and norria means that you had a period and now
it's an it's missing in action. So h A is
you know a really interesting thing that there's this, you know,
I think we understand a lot of times with like
eating disorders, that there are gonna often be like a
(04:59):
missing pure There's also the female athlete triad where we
often like this kind of a known thing that a
lot of times athletes can lose their periods. But there's
this huge group of women that also superior is just
from disordered or de dieting behaviors alone can also And
the way you basically want to think of h A
is your body has stopped getting the fuel or the
(05:20):
necessary inputs it needs to create a cycle. There's a
lot of different mechanisms within the body, and I wouldn't
want to necessarily get super scientific in today's so because
that can get really boring really quickly. But basically think
of it like this, if your body is in a
famine mode of feast for famine, it thinks that it's
unsafe to produce a cycle right now. And there's a
(05:41):
lot of things that happen with your hypothelic put to
a terry internal access or your hp a access where
your body starts to shut down the pathway. So again
you can just think of as like your body isn't
getting what it needs, so it starts to shut down
these pathways. There's these like amazing reproductive neurals that tell
your body that it's just time to stimulate and mature
an egg, which leads to ovulation, which leads to your period.
(06:03):
Other things that can happen in addition to like your
your neurons not firing correctly anymore and your body going
into that Sandon mode is your hormones should just start
to decrease as Mentioning estrogen earlier is a really important
reason why you also want your period because it's very
protective to your bones into your heart help. But estrogen
is involved with your unine binding, is also involved with
the first half of your period, your filick, your phase,
(06:26):
and it helps tell your body it's time to ovulate,
which then tells your body to search your progesterone. And
often when we have h A, you have really really
low levels of estrogen and progestion. I've seen women with
postman and pousial ranges of estrogen and progesterone. And that's
another thing that happens is so not only are these
like HV access stops faunctioning correctly. It tells your neurons
(06:47):
and different components and chemicals in your body to stop
firing the things that needs to stem like the egg,
but also you just stop producing enough literal hormones to
have a cycle. And the main things that cause it,
we call them the big four practices food, exercise, sleep,
and stress. I will say above all the food is
the primary culprit of why period you can go missing.
So that means that you're not eating enough. That's like
(07:10):
the primary thing that you can think of is when
I say food intake, I mean you are not eating enough.
And it's really interesting. You can actually lose your period
from not eating enough with or without a low body
fat because that's a really big common misconception. People often
think you have to have a really really low body
fat and that's simply not true. You can just lose
it from calorie restriction alone. I'll also say calories are
(07:32):
probably most important when it comes to food intake, and
second after that is carbohydrates because we have glucose sensing
neurons in our ovaries and another reason why we can
really quickly lose loser period if we're not eating the carbohydrates.
So as an example, I've seen people maybe collorqually eat
enough from something like a keto diet, but then they
still lose their period because they're not eating any carbohydrates,
and they're really really important for your period. So that's
(07:55):
the food piece. With exercises, typically just someone is over
exercising exers I seem too much and that can cause
a lot of stress to the body and also cause
in an adequate food intake to exercise ratio, and that's
also part of why they lose their periods. And then
not quite as important but definitely important is stress levels.
Do someone's had like a big change of alife, they've moved,
they've gone across thease, they've had maybe a new job.
(08:18):
Stress levels can definitely cause a missing period. I would
say that's a little bit more common with just like
missing your period here and there, though u h A
is probably gonna be a little bit more specifically related
to food into exercise. And then I will say sleep
is really important too. Sometimes we see people have a
regular cycles if they're not getting adequate quality of sleep too.
So the big four is what I've had to your
(08:39):
body and again all these different pathways. Basically saying your
body starts to shut down and not produce a cycle
because it thinks it's in a famine or it's not
in a safety mode is the way I always describe it. So,
how many months of a missing period does it take
to diagnose or warrant and call it h A. I
believe it's three or more months. Yeah, okay, so I
assume at that point will need to seek medical attention
(09:03):
and get some help there. But what are some ways
or some steps people can take to help restore what's
been done. Yeah, so I agree. I think sing a
medical doctor is always something I'm going to advise as
you go see your O, B G. Y in and
talk to them about this. Occasionally PCUS can be part
of the conversation or not occasionally, but I will say
PCs can cause a missing period. We're talking specifically to
(09:24):
ahe A today though. I just mentioned that because sometimes
when people go to a doctor, they immediately get splashed
with the diagnosis of PCOS, and a missing period is
not only caused from PCs. Just wanted to mention that.
But the main thing, can you can you define PCOS? Yeah,
so polycystic over eat syndrome. It's when we have I mean,
there's a lot of different criteria. You have elevated androgens,
(09:45):
you also have a missing or a regular period, and
you have polycystic ovaries. Usually we're looking at twenty five
or more follicles on each ovary. Is what you need
to get diagnosed with it, and that can cause a
missing or a regular period. I know that's again it's
not the purpose of this converse ation, but h A
is a little bit different of what causes in the
same period in comparison. So you did say that body
(10:07):
fat does not necessarily have a correlation to h A. However,
what about weight changes, So do you need to go
through weight loss for hypothalmic a manorrhea to occur? Yeah, definitely,
Like weight loss can definitely contribute to h A. And
that makes sense to just from the energy and take perspective, right,
(10:28):
Like usually weight loss is happening because there's a calorie
restriction of some kind happening. But weight loss or like
especially like sudden weight loss can definitely also indicate to
your body that is again not in a safety time
and not a healthy time to produce the cycle. So
that's a good question. I mentioned this in the very beginning,
but I mentioned it doesn't have to be a low
(10:48):
body weight because there is this perception that you have
to be in a thin or small sized body to
have h A, and that's not always true, and you
can be in a variety of body sizes and experience.
Just to drive that point home and correct me if
I'm wrong, you can have a b M. I your
doctor says your your body mass index is overweight or
even obese, and you can still have hypothalmic amenorrhea likely
(11:10):
if you are restricting calories exactly. Yes, okay, and then
can we continue on with the possibly seeing O B
G y N or a medical professional, but being careful
of them immediately diagnosing you with something else because they
may not. I'm I'm wondering if my O B G
I N has ever really asked me about my food
(11:31):
intake or caloric intake. I mean, they definitely just want
to weigh me and make sure that I check whatever
box that is. But I'm just wondering if someone goes
and yes, you're right, they go to that appointment, will
they get the proper guidance? But let's say that they
know it's h A, are there other steps you could
share that they could take to help restore their period? Yeah,
(11:52):
And that was a really good point to make any
because sometimes, yeah, it's not so cut and dry off,
like someone's going to sit and ask you what is
your relationship with food like and what are you doing
with your exercise habits? And let's be real, a lot
of times these habits are praised. Orthorexy is definitely something
in any disordered eating where like women eating less and
exercising too much is often a praise think in our
(12:13):
in our society specifically, so really good point to make.
I mean, this does sound so simple, why I understand
it's not at all. It's why like we've worked one
and one with people on this, but you need to
eat more and exercise less. That's the basics behind fixing
h A. But eating more. I don't know if we
talk about calorie ranges here, I can share some of that,
but it's usually eating an appropriate amount of calories to
(12:34):
restore h A. And then with exercising, typically what we're
looking at. Not everyone can take an exercise break all that.
That's my gold standard. I usually prefer a small time
frame of an actual exercise break, but sometimes that's not
possible for all people all the time. Exercise addiction is
a real thing. So then we just focus on reducing
overall exercise or let's say taking out high intensity interval
(12:55):
training and just focusing on walks or yoga or something
like that to get their period back. I think it's
so interesting about as it sounds really easy, but the
reality is is like those are really hard things to
work through, and I think that's where like working one
one can be so helpless because I swear more of
my job at least, I wonder if you feel to say, like,
I feel like my job is more talking about the
mental assets of life so challenging than it is like
(13:15):
just giving someone like a cali arrange and telling them
not to exercise, Like it's never that simple. It's always
like talking through why we're so stress or worried or
anxious about things, or why we have the fear of waking.
Like that's I feel like such a huge part of
my job. Yeah, and when it comes to a period,
it can further the stress and anxiety when that report
(13:36):
card comes and you're doing all the things that your
dietitian tells you, you're eating more, you're exercising less, and
then your period still isn't coming back, and that can
kind of put you into a cycle of feeling like
a failure, having more stress, furthering the loss of period
by way of that stress part of the equation, especially
(13:57):
if you are in family planning mode and that is
on a timer. Yeah, I think that's a good point.
And my thing with the fertility too, is like if
you're doing this work in addition with fertility treatment, like
I'm going to support you with whatever decision you make,
because some people have the time to wait for h
because it can take six plus months to heal from right,
and then some people don't have that time at always
(14:19):
really want to honor and respect that, but I still
always encourage doing this work. In addition, if you are
doing something like fertility treatment, because it is so important
to heal just because again it's your body knowing that
it's safe and taking care of my personal experience, I
lost my period when I went off of birth control.
Same here is that h I don't think of it
(14:39):
as h I think if it more like post birth
control signings, That's the way I would personally describe it.
But I do think if it's an extended period of time,
it is probably more likely that it is h A
and you may have always had h A, but the
birth control pill disguised that, which is like, oh my gosh,
I could made another episode in itself, right, like how
the birth control pill like just gives us withdrawal blieds.
It's not the same thing as a natural monthly cycle,
(15:02):
and it can be really confusing because it makes you
think that you know you're good and you're having a period,
but it's not the same thing. So so if you're
having a regular period on birth control, it's not that
it's a false good report card in theory, not necessarily,
but you can't say this is my report card, I'm
doing everything great because it's synthetically happening. Would ud be
(15:24):
the right word. Yeah, So you're on typically some amounts
is different for every birth control people. You're on a
synthetic amount of ashagen and progester and it's not the
same as the like the beautiful epps and flows of
your natural monthly period, and that causes whenever we saw
taking it, when we start taking the sugar pills, a
withdrawal bleed, and that's not the same thing. Now I'm
going to say, like just to be real clear, like
(15:46):
I have no qualms with birth control, Thank goodness we
have it, that say, you know, but so important for
so many years of my life because I didn't have
an unwanted pregnancy. So I'm not hating on it at all,
but it's important to understand, like it's not the same thing,
So it's not hating on it as also like understanding
its purpose and that's not giving you the same thing
as a pill. I will also say, just real quick,
(16:06):
sometimes with eating disorder recovery, uh, this is different than
what we've been talking about disorder eating with Sometimes you
actually want someone to take something like synthetic estrogen or
birth control as they are to underweight so much so
where it's going to take a long time to get
their period back, and that can be protected to their
bones into their heart health until we know they're safe
to get their period back. So there's always caveats, of course,
(16:27):
but most of the time we want to work to
get back that natural monthly period. Such an important distinction. Yes. Yeah,
in the beginning you said something about how we really
want to change the conversation around periods, and I think
this will open the conversation up to all listeners, even
if you're not going through loss of period. And for me,
(16:47):
this has been such a wonderful way to take my
health back because when I lost my period because of
birth control all of a sudden, I didn't have that
report card coming in and it came back within about
six months, and I did some things that I'm not
going to mention here because it might not be applicable
to everybody. And I don't want to confuse everybody, but
when I started getting it back, it really changed my
(17:09):
mind about periods and my own health. And even with
my now husband boyfriend then, you know, we were high
fiving each other when I was getting my period, which
is a complete opposite framework of you know how I
was in my early twenties of my period. You know,
a boyfriend you know wasn't celebrating it either. So you know,
it's just so amazing to think about how wonderful the
(17:31):
body is and really double think or check in with
ourselves when we're quick to complain about something that it's
doing just because we're conditioned to complain about what it's doing.
So I personally love my period. I'm also not one
of those people that gets crazy cramps, so I know
that that it could be very uncomfortable experience for a
lot of people, But for me, I feel so womanly
(17:54):
and good and in charge of my health when I
get that as a read on my body. Okay, I
love that so much and I'm going to echo that completely.
I love my period. I'm actually on my period right now,
and I'm like, hell, yeah, girl, I'll get your your
body is doing good, like I genuinely like get excited
when it happens. I also, I don't know how much
you guys talk about the period, so maybe people aren't
(18:15):
familiar with this. There's this whole idea of like cyclic living,
and we talk about that with our clients because intuitive
eating is really about going with the seasons of life
and going with the epp and flow of life. And
I love this idea of being very introspective and like
really not having a lot on my calendar when I'm
on a period, and that changes as I go towards opulations.
So I just have always looked at it as this
(18:36):
really fun way to connect deeper, more profoundly with my body.
And yeah, of course sometimes I'm more moody on certain
parts of my cycle and I get annoyed, but overall
it's just allowed for a greater appreciation for like being
a woman, because our period is actually like our like powerhouse.
It's not like the negative thing that we have to
deal with every month, something you also said earlier, and
I love that. By the way, I think I might
(18:58):
start implementing a little to that into my life of
when I am in my period, what is my schedule
look like? And how can I give myself that permission
to just step away from certain activities or things. But
I also want to say to you said something earlier
about with your clients and when they have h a
and really getting to the root of why they got there.
(19:22):
I'm paraphrasing kind of what you said to get to
what I want to ask you is like, Okay, let's
get to the root of why you feel like you
need to look that way anyways. So for some of us, yes,
like Lisa, there was a time in her twenties where
she could sweep no period under the rug because the
root of the problem was society has told us we
need to look like this. So as women, one of
(19:45):
the many sacrifices that ends up on the table is
the loss of our period. So just for anybody that
maybe hasn't lost their period, but they're listening to this,
and hopefully they can walk away with an appreciation of
just how complex our bodies are and how everything is
working together at this crazy level that we can't I
(20:06):
can barely even comprehend every organ and depends on this
and that in the breakdown of whatever, and when we're
destroying our bodies for this gain or what by society
standards a short term gain, but like the long term
effects are not worth it. They're not worth it at all.
And I think it's just comes back to understanding that,
(20:27):
like not eating enough calories or not eating enough overall,
is it worth it to lose your health over And
we're being told this guy's of it's for your health.
You're taking these boots out of your diet, or you're
not eating a particular way, or maybe you're just overall
like not you know, you're doing a caloristriction diet. But
my question back to people's like, is that really about
your health? Is that truly value based and aligning for
(20:48):
you to do, because this doesn't seem to be giving
you your health if you're developing digestive issues or more
of those, or you're losing your period, like you might
be doing it because you think certain foods are in
play metorier they shouldn't eat X, Y and Z foods,
or you should be on a caloristriction diet because that's
just what we think health is right now. But is
that really health? Like? Is that really And again, having
(21:09):
your peer to me is like one of the main
vital signs that stuff from Lisa Henderson. Jo actually calls
it the fifth botal sign, and I couldn't agree more.
I think that's such a great way to think of
it as like one of your signs of health. And
you know, thank goodness for somebodies that show up and
not everybody gets that warning sign. Maybe if you've got
gastro intentional issues that show up because of your eating disorder,
(21:31):
or you have h A show up because of your
eating patterns, thank your body. Maybe in the moment, it's
frustrating because you're so desperate too. I'm just categorizing, but
let's say it's because you want to be thin. You're
so desperate to weigh a certain amount or something. But
thank goodness, your body is functioning at a level that
it can give you the warning. Because other people, their
(21:53):
body may not give them the h A warning, but
there's still serious problems going on, like it may show
up just down the line. I'm just kind of thinking
of trying to have gratitude. It's unfortunate if you have
h A, but how amazing that your body sent you
a signal that you need help. Yeah. I really like
that perspective, and similar to a digestive issues right, like
(22:13):
when I was experiencing really bad digestive issues, that was
a sign that something was off with my body, and
saying when I lost my peered after getting off the
bark until pill and I would even say to this day,
I haven't had a missing period since I got my
peered back all those years ago. But I will get
digestive issues out how flare ups whenever I'm in a
lot of stress in my life, and it's always a
reflective time for me be like, Okay, you're obviously stressed
(22:35):
out about something, because IBS obviously isn't just cost and
just sort of eating it can we cost from you know,
stress and anxiety we know so linked to that too.
So I just always use my symptences like Okay, obviously
something's going on, like check in time victoria, like how
is your life going? Is there something where you are
too stressed out about something? And you can always like
if you are still strongly disordered eating, I aviously check
in with your food, your exercise habits as always, if
(22:57):
you're experiencing more sentence or if your peer goes think
those are the first things you always want to ask yourself,
but it is it's a great way to reflect and
ask yourself where you were at your journey. I lost
my period for a month during COVID, and I thought
I had to be pregnant because I haven't had a
missing period in a long time. And I mean I
must have spent four hundred dollars on pregnancy tests. And
(23:17):
I went to the doctor and without I I wrote
a blog about this, but without even uh knowing anything
about my baseline weight or anything. She told me that
I should just lose weight, just blanket statement. Told me that, yeah,
I think I had gained like to myself. I think
I don't weigh myself, but I think I went on
a scale there. I forget the story exactly I wrote
it in the blog, but yeah, that I mean Amy's jobs,
(23:40):
both of your jaws dropped, and that so did my
you know, Instagram audiences. Um when I told that story.
But and and go ahead and read the blog. It's
on my side or a link it I guess below.
But I will say I actually didn't plan on telling
the story. I forgot about it until we were kind
of talking about it. But it's so important to not
go with and get statements from your healthcare providers and
(24:02):
really know your own body because it was just stress
and it made you know, that was the first time
in my life a healthcare provider had said that to me,
and I actually appreciated being in the shoes of many
of the people that I work with because it just
totally invalidates everything else and it makes you feel to
blame and you know it first of all, was unrelated
(24:24):
to that, and second of all, just was such an
unhelpful suggestion. And you know, I think why my jaw dropped.
I'm sure why so many people listening is because you know, Lisa,
you know you benefit from thin privilege unless something I
love that you talked so much about. So it's so
concerning to me because if someone says that to you,
imagine who else they're saying it to you and into
why didn't they stop and ask you? How is your stress?
(24:46):
What's going on in your life? Is there any like
have you had any major transitions or challenges? Have you
had any changes you're eating an exercise habits. I understand
like there's so much medical complications that like they're not
given enough time or education kind of stuff. That's just
super a super saddening to hear that honestly, because like
that was such an opportunity to ask questions rather than
how you to lose weight, especially how to lose weight,
(25:08):
And it came from like a much more gentle place
than where it kind of sounds like it's coming from.
You know. It was like, sometimes our bodies are very
sensitive to small weight changes. Therefore a few pounds could
get you back to you know, your period, So it
was more gentle than you know, no, just go home
and lose weight. There was a little bit more basis,
but nonetheless, you know, I just think it's so important
(25:30):
for everybody to bring their own power to every appointment,
whether that's with a registered dietitian or a doctor and
recognize that blanket advice like that is just so unhelpful.
And the real reason I brought this up was because
stress has a profound impact on our bodies period and
we do not talk about that enough. We go so
(25:51):
quick to the weight and you know, by focusing on
my stress management techniques, my next period returned. So there
we were. Yes, I appreciate sharing it because agains stressed.
I couldn't agree more. I just such a big advocate,
like what's your shows? I was like what's your anxiety
levels like, because that makes such a difference in our
health in so many ways. We just don't give enough credit.
And it's so funny because I think we've wrapped up
(26:13):
the first episode talking about that, but it's just true.
It really is so important that we understand and we
make peace with that. And I understand stress and anxiety
is harder to deal with, and you know, eliminating a
food or doing a protocol or trying to do when
it comes to hormones, so often people are elimiting foods.
That's why I mentioned that they think I have a
missing period, that must mean I'm eating something inflammatory, but oftentimes,
(26:36):
especially with h A, not oftentimes, almost always with a specifically,
that is not at all why you have a missing period.
It's not because you're eating specific foods. Is because you're
not eating enough and you're probably exercising too much. Well,
that was incredibly helpful, and as a reminder, we'll put
all of Victoria and her nutrition practices information in the
show notes below. Victoria, thank you for being such a
(26:57):
wealth of knowledge and sharing your beautiful energy with us.
Thank you, thank you so much for having me. I
really appreciate it. M HM
Feeling Things with Amy & Kat News
Host
Amy Brown
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