Overcoming Hypothalamic Amenorrhea: Riley’s Experience

I’m excited to have a guest post for you today from one of my best friends, Riley. She offered to share about her experience with hypothalamic amenorrhea (HA), working through No Period Now What, and finding a healthier balance with food and exercise. This is something that’s close to my heart, as well, as I experienced HA throughout high school and my first year of college, but Riley’s experience is much more recent!

Riley and I randomly met on a flight from North Carolina to Illinois during the summer before our first year of college together at UNC-Chapel Hill and have been best buds since. We’ve run thousands of early morning miles together over the past five years and share a love for great food, cooking & BYO-dinner dates, and deep conversations. Riley has a huge heart for other people, is a great listener and empathizer, and is one of most genuine friends a girl could have.

I’m proud of her for fighting for her health and prioritizing her overall well-being. I have a feeling that her story is one that many of you will connect with or find insightful. Of course, Riley isn’t a doctor, so please consult a medical professional for any personal health recommendations. Here’s Riley!

It’s amazing what a difference a year can make. At the end of June in 2018, I was in Atlanta finishing up training to become a high school teacher. I was also slowly driving myself crazy by obsessing over exercise and food.

As a lifelong athlete, I’d always prided myself on being fit and healthy, which led to some disordered eating in high school and college, but never to a full-blown eating disorder like anorexia or orthorexia. On the contrary, I was so terrified of “having an eating disorder” that I never skipped a meal and always had afternoon and pre-bed snacks.

At the beginning of college– I’m the “A!”

What I’d refused to admit to myself for years, however, was that any form of food control or restriction is unhealthy and problematic. In my quest for optimal “health,” I’d lost what it meant to eat “normally” and was devoting way too much mental energy to analyzing food and exercise. It’s funny what we can talk ourselves into, especially those of us with very driven, competitive personalities.

After the City of Oaks half-marathon in 2015 with Liv and our friend, Kristen

In early 2018, I had a resting heart rate of 48; I’d never had a natural period; and I had a constant need for productivity, including rarely ever sitting down. In retrospect, I can clearly see that I was not exemplifying the picture of good health.

Even at the time, I knew that I was doing a disservice to my body and mind, but I couldn’t seem to make sustained lifestyle changes. I was able to justify my behavior because I was happy overall, I had a thriving social life and strong friendships and familial relationships, I got great grades and plenty of sleep. I had enough energy to accomplish my goals and bounce from one activity or obligation to the next.

Plus, I’d been maintaining this status quo for 8+ years, so how could anything be wrong? I knew that it was a problem that I’d never naturally started my period, and I was freaked out that my heart rate had dropped so low, but I was still in denial.

A hike in spring 2018

Periodically, I would cut back on my running mileage for a few weeks or add in a couple of extra snacks throughout the day, but somehow I inevitably dropped those changes and reverted back to my old, intense food and exercise regimes.

Fast forward to July 6, 2018. I’d been at teacher training for 6 weeks working 12-hour days, running each day at 4:45 a.m., lifting weights and/or going for long walks every evening, and subsisting off of college dining hall food, namely oatmeal and salads. I was absolutely obsessed with food.

And then it hit me: I was starving. Not in that one-time “wow, I’m so hungry I could eat a horse” way, but in a “my body has been in an 8-year energy deficit that is compounded by very insufficient food intake for the past month and a half” way.

On my final night of teacher training, I read two hours worth of intuitive eating and amenorrhea blogs, including one that referenced No Period Now What (NPNW) by Dr. Nicola Rinaldi. I realized that the book was written for women just like me: women who suffer from period loss, known as Hypothalamic Amenorrhea (HA), due to a restrictive relationship with food (often combined with over-exercising).

I ordered NPNW to be shipped to my house that weekend and committed to immediately quitting running and other intense forms of exercise for as long as it took to recover my period. I was finally ready to get my health back.

NPNW is about 600 pages long. I read it in 2 days; I couldn’t put it down! For the first time in my life, I felt like I was reading about myself on every single page.  

I’d always differentiated my contentious relationship with food/exercise from those of other women with eating disorders. I ate three meals plus snacks every day, I treated myself regularly to sweets (I could never say no to ice cream!), and I didn’t vilify foods like carbs or fats. I would happily eat out at restaurants, and I never tracked calories or macros or measured out my food. I was able to convince myself that I was healthy; therefore I didn’t need to make drastic changes to my habits or lifestyle.

NPNW flipped that notion on its head. It became clear to me that my lack of menstruation (HA) was a serious health hazard with far reaching and potentially irreversible consequences. I’d always feared infertility because I want kids more than anything, but I was less aware of the serious implications regarding bone health and heart issues.

The book combined scientific evidence with testimonials from women with HA from diverse backgrounds. Each time a new woman shared her experience, I found myself thinking, “This is me!” or “I know what you mean!” or “I’ve felt/experienced/dealt with this!” It was an incredible relief to feel understood at such a deep level. There’s something extremely empowering about knowing that you’re not alone in your struggle.

Not only did the book give me numerous women with whom to relate, but it also prescribed a very simple plan to recovering my period, which the author calls “going all in.” In essence, if you suffer from HA, you can regain your cycle by eliminating all high-intensity exercise and intentionally increasing caloric intake significantly. 

As you might guess, such lifestyle changes will likely result in weight gain, which is kind of the point. The female body needs fat to produce and regulate hormones, and those of us with too little body fat (even if our BMI is in the “normal” range), will always fail to menstruate.

I was finally so exhausted with over-analyzing food and exercise that resting, indulging, and consequently gaining weight was not as scary a thought as it once would have been. This realization definitely confirmed that going all in was the right choice for me. 

Half marathon in 2014

Eliminating high-intensity exercise from my life was surprisingly easy. Like I said before, I was an avid runner (40+ miles per week) and an incredibly physically active person, always walking, biking, lifting, etc. throughout the day.

While there were days that I missed my morning run, more often than not, I was grateful for slower mornings and less exertion. During recovery, I continued to walk regularly and to do gentle yoga. My body had been begging me to slow down and take a break—I was finally listening! 

Through this experience, I learned that what I loved most about exercise were moving my body and getting outside. Previously, I’d only considered high-intensity workouts as exercise, which led to significant under-fueling given how much general activity I do on any given day. 

Drastically increasing my calorie intake was a mixed experience. Since I was already eating full meals and snacks, I really had to push myself to eat denser, heartier foods. Sometimes I was absolutely ravenous throughout the recovery process and eating until I was satiated could feel great, or it could feel out of control. Sometimes I was forcing myself to eat when I was mentally but not physically hungry.

One memory that sticks out comes from the very first weekend of going all in when I ate the first really different food from my typical repertoire: an egg and cheese biscuit from Sunrise Biscuit Kitchen in Chapel Hill, NC. Let me tell you: that egg and cheese biscuit was the best thing I’d remembered eating in a very long time. This tiny experience that would have been a non-factor to many people was a huge step for me.

As silly as it sounds, I was facing some of my biggest fears head on and surprise, surprise: I was a-okay. In fact, I was healing my mind and body in ways that I hadn’t even known I needed.

I continued the recovery process with support from my friends and family, my headstrong determination to finally see this through, and the HA support group on Facebook that’s affiliated with NPNW.

After 3.5 months of going all in and gaining 15-20 pounds, I got my first-ever natural period in late October! I was absolutely overjoyed and in awe of my body’s resilience. And honestly, I barely noticed the additional weight. If anything, I actually think that I look healthier and stronger now than I did at the beginning of this process.

Surfing in June 2019, post-recovery

Moreover, I benefitted significantly from confronting weight gain and learning to truly appreciate my body for what it does rather than how it looks.

Deciding to stop exercising and to embrace total food freedom was the best thing that I’ve ever done for myself. Both my physical and mental health improved as a result, and now I approach health and fitness with a new and improved mindset.

Aside from recovering my period, here are some other benefits from going all in that I continue to embrace and receive today:

1. More flexibility and freedom to just say “yes” to everything fun and social without calculating what time I’d need to get up to fit in a workout or planning around mealtimes
2. More consistent energy and food-related satisfaction throughout the day
3. A drastic increase in libido (I thought I was “broken” when it came to desiring physical intimacy…turns out that my body was in survival mode and I just didn’t have enough estrogen!)
4. I feel more feminine and attractive (which now includes a rockin’ butt if I do say so myself!)
5. My legs are physically stronger (because they’re no longer twigs) so I can power lift more, shoot a basketball more easily, and hold my ground in pick-up soccer better
6. I’m less cold all the time
7. I relax and sit down more readily and happily because I no longer feel the constant need to be moving and using up energy
8. I’ve redefined health to include things like rest days, pizza, and yoga instead of running when my body needs it. Life’s just easier with a less analytical, intense mindset

Recovery is not an easy process, but it is so worth it. Post-recovery, I still think about the types of food that I’m putting into my body and about how I’m choosing to move and be active. However, all of those thoughts and decisions are less mentally consuming than they were previously.

I have way more important things in life to focus on, like my relationships, my job as an educator, and my future plans. For years I’ve wanted food and exercise to be a part of my life rather than controlling my life, and I finally think that I’ve reached that point.

Selfie with my students in May 2019 (post-recovery). They’re what really matters, so I’m glad that I can focus wholly on them now!

If HA or food or exercise are weighing more heavily on you than you’d like, I highly recommend No Period Now What. The facts and testimonials in that book got me through the hardest parts of recovery and allowed me to stay resolved when I wanted to throw in the towel.

The last thing I want to note about recovery is that it’s important to remember that it’s a process. During the first 2 months of going all in, I thought frequently, “Am I doing this right? What if I didn’t eat enough today? What if that walk was too strenuous for my recovering body?” Those thoughts were just as exhausting and toxic as the food and exercise thoughts I’d been having before!

I had to intentionally decide to stop analyzing and doubting whether I was doing the right thing, and truly believe that this process was going to work. Once I fully trusted my body to heal itself, I knew that there was a light at the end of the tunnel and my period arrived shortly thereafter.

Summer 2019

Today, one year later, I’m back to running and lifting, but I listen to my body more readily. I’m currently on a trip to Maine, my favorite place in the world, eating delicious ice cream and lobster with butter, and I’m spending my days thinking about anything but food and exercise. My relationships with my sisters are stronger, I’m more patient with others, and I’m just happy.

I’m so grateful for the freedom that the recovery process gave me—life’s just too short to sweat the small things!