I’m so passionate about this topic, I had to make it a two-parter! In Part 1 I talked about how my so-called “healthy habits” turned unhealthy. My eating and exercise had gotten to the point where I was messing with my hormones so deeply that I lost my period. That’s right, I was in my 40’s and had lost my period. I never once stopped to ask, “is it the excessive exercise? Is it the way I’m eating?”
When I went to my doctor about my absent period, I was told to “just take birth control and that will fix it.” There were no questions about my diet or my lifestyle. Big mistake! I needed to get to the root of it, and luckily over time, I did. I started to educate myself on why my period vanished in the first place, and started making changes that helped restore me to my state of normal. Whether your goal is pregnancy, or a regular menstruation cycle, I want to help get you there.
Each and every woman suffering from hypothalamic amenorrhea needs to approach it from a whole-person perspective. Multiple factors need examining to get to the root cause of the underlying issues. The approach should be individualized because everyone is different. For many of you, it also means you’ve got to heal your mindset! If you’re not changing your mindset around this stuff, you’re likely going to slip back into old habits, that old dieter’s mentality. Even if you have the right information, if you battle your own brain and thoughts, overcoming it becomes impossible…. which leads me to orthorexia’s role in this.
Addicted to Health
Have you heard of orthorexia? It’s the addiction to being healthy and eating healthy. Any time your desire to be healthy reaches a level of addiction, it means it’s disrupting your life. From a psychological standpoint, some disagree on whether or not orthorexia is a mental health problem because there are so many co-occurring psychological issues. There may be some Anorexia Nervosa (AN), there may be some Obsessive Compulsive Disorder (OCD), and other compounding factors. But what’s agreed upon is that orthorexia is an obsessive focus on being healthy. Obsessively thinking about how to eat “clean” and obsessively holding onto a diet regimen (paleo, keto, etc.).
Let’s discuss some of the signs that you or someone you love might be suffering from orthorexia. It might show up as obsessive thoughts about whether something is healthy or unhealthy. There might be a noticeable increase in the consumption of supplements, herbal remedies, probiotics, or whatever the latest health trend is. There might be certain foods that are just unacceptable to you, ultimately leading to fewer and fewer food choices. Everything feels unsafe, like it could make you unhealthy, so you start limiting the variety. You’re eating the same thing every single day for lunch. You fear what might happen if you have something other than your “safe” foods.
For some it even presents as an obsession about how the food is prepared, so dining at restaurants is distressing. Others don’t let anyone prepare food for them. It’s also not uncommon for someone with orthorexia to be overly concerned with the sterilization of utensils and the way the food is being handled. The difference between this being a “good thing” and a “bad thing” is when it becomes an obsession. We want a healthy relationship with food. Someone who has orthorexia does not know how to practice balance; it’s obsessive.
Addicted to Exercise
Orthorexia also presents as over-exercising or exercise addiction. Now, let’s be clear about something: exercise addiction is very different from someone who loves to exercise and for whom it’s part of their daily routine. Someone with a healthy relationship with exercise doesn’t worry about skipping a day due to a scheduling conflict, or perhaps a cold. But if someone’s addicted, missing a day destroys them. It might even send them into a downward spiral of anxiety or depression. They want to exercise at all cost, regardless of how their body feels, or whether they’re sick or injured. In fact, they’ll cancel social plans and just about anything else before they skip their workout.
That was totally me! I exercised every day for hours on end, and I didn’t think anything of it! It’s so easy to normalize and justify our behaviors, especially when everyone around us and everything that we see about exercising and eating healthy (hello, social media) tells us it’s ok. Think about how often your social media gets bombarded with fitness and healthy food… it becomes obsessive and disordered. Yet we normalize it because it’s everywhere and everyone’s doing it.
Side effects of exercise addiction can be pretty serious. If you’re not allowing your body to rest or recover, or you’re working out for hours and hours beyond what’s considered safe or healthy, there are consequences. Things like: throwing off your metabolism, your hormones, and pushing your body to the point where it no longer prioritizes reproduction or your menstrual cycle (aka hypothalamic amenorrhea.)
Now, not all of these things were happening to me, but I definitely had some of the symptoms related to food and exercise. You don’t need to be showing all of these signs and behaviors, but maybe you have a light mix of several? I think you know deep down whether or not it’s become obsessive for you. For me, orthorexia and my over-exercising led to a condition known as hypothalamic amenorrhea. That’s when I had an irregular period, had all of these symptoms, and my hormones were out of whack.
One of the ways I started to heal my hypothalamic amenorrhea was by educating myself. I didn’t even know I had problems with exercising or with orthorexia, or even hypothalamic amenorrhea. But I realize in retrospect that I definitely did! Once I started understanding what to look for and increased my awareness, that’s when I became motivated to make changes. Taking control occurred when I understood how my metabolism worked. I didn’t know the uniqueness of how my body healed and what my body needed. I was just trying to do what everyone else was doing!
Here’s what I want you to understand: you can fix this, and you deserve relief. There is a way to live your life and have a healthy relationship with both exercise and food! There’s a way to deal with stress that doesn’t have to come from exercise. There’s a way to be healthy other than obsessively thinking about what you can and cannot eat. If you’re hearing a voice inside of your head that’s telling you, “this is a problem and I don’t want to think about it and I don’t want to talk about it,” that may be a sign that you need treatment. You might be experiencing an eating disorder. Treatment and the help of a professional may just save your life.
Some of you might be suffering from hypothalamic amenorrhea or orthorexia unknowingly, and there’s no shame in that. It’s something you can address and fix. If you can’t let go of some of your behaviors alone, consider some support. There are so many great resources and communities to help you get through this. But step one is self-awareness.
Focus on mindset. As I said before, self-awareness was the most important step in healing my hypothalamic amenorrhea. My mindset needed to change. Once I began tackling that, I was able to shift my perspective on my eating and exercise habits. Every woman has a unique body, and every case of hypothalamic amenorrhea presents itself for different reasons. Whether it’s due to one factor alone, or a combination of insufficient energy intake, over-exercising, stress levels, or not enough body fat – it’s important to bring awareness to your current diet and lifestyle habits. So, I can’t sit here and give you an X, Y, Z plan, because again, everyone is unique.
Focus on your nutrition. Can your diet be optimized? Do you need more nutrient-dense food choices? More calories? More carbs? Eating enough is so important, especially if your exercise is frequent and intense. Laura Briden, an expert in hormone health, summarizes this the best:
“Under-eating shuts down ovulation, and that’s true even if you have a healthy body weight (BMI). Your hypothalamus cares less about body fat and more about whether you eat enough to keep up with your activity level…If you don’t eat enough, your hypothalamus thinks you’re in a famine and makes the helpful decision to halt reproduction.”
Focus on lifestyle. Our lives tend to run on the stressful side. Do you have stress management techniques in place? We know stress wreaks havoc on the body, and our reproductive system is no exception. In fact, if stress is running your life, it’s likely you’re experiencing at least some degree of hormonal imbalance. Then think about adding an obsessive workout routine on top of it, which puts more stress on the body! Hypothalamic amenorrhea expert Laura Schoenfeld says:
“We tend to think of stress as an emotional state, but in many female athletes, the physical stress of competition and training can create high cortisol production at the expense of estrogen production. Lowering the intensity and frequency of your workouts can help lower cortisol and boost estrogen synthesis to recover from amenorrhea.”
My period didn’t come back overnight! Regaining a monthly cycle, balancing hormones and your hypothalamus takes time and patience. By implementing the right tools and practices for you, the goal is to regain menstruation within three to six months. If it’s taking longer, you might need to dig deeper into other potential causes, or work with a health professional, if you’re not already. My hope is that by sharing my own story, I can help you with yours. Be sure to check out Part 1 if you missed it. To hear my full story, listen to my podcast episode: Is Your Health Obsession Unhealthy? Warning Signs of Orthorexia and Hypothalamic Amenorrhea.