Disordered eating and missing periods

A missing menstrual cycle is a cause for concern, as it can signal an underlying health issue. One such connection is the relationship between disordered eating and the loss of periods. This is known as hypothalamic amenorrhea (HA).


As a disordered eating specialist, I’ve worked with many clients with missing periods. Sadly, a vanished menstrual cycle is often shrugged off as “just one of those weird things.” When actually, it’s a real sign that something is not right in your body.

This article will help bring clarity on whether your disordered eating is a root problem of your hypothalamic amenorrhea.

What is disordered eating?

Before delving into the connection with HA, understanding disordered eating is essential. Disordered eating encompasses a range of irregular eating behaviours, attitudes, and emotions surrounding food. This might be restrictive eating, binge eating, or purging. It’s to do with any behaviours or mindsets that revolve around food, your body, exercise, and eating.

Disordered eating doesn't always meet the textbook criteria for eating disorders. Many people never receive a diagnosis either. So I’m a fan of the term 'disordered eating' as it’s an umbrella term that encompasses all relationships with food that could do with improvement.

How does disordered eating impact menstrual health?

Disordered eating disrupts the whole body, including hormones responsible for the menstrual cycle.

Hypothalamic amenorrhea occurs when the hypothalamus (a region of the brain), perceives stress or inadequate energy availability over some time. This is simply an evolutionary mechanism: if there’s too much stress or not enough food, the body won’t waste energy on reproduction.

It’s chronic undernourishment, over-exercising, or stress that contributes to HA. One-off experiences of these may delay periods, but the body will calibrate.

Factors contributing to hypothalamic amenorrhea

1. An energy deficit

Consistent undereating or a calorie deficit signals to the body that there isn't enough energy to support normal bodily functions, including reproductive health. This could come from simply not eating enough, making up for food via exercise, or over-exercising in general.

2. Nutrient insufficiency

Inadequate intake of essential nutrients, especially carbohydrates and fats can lead to HA. Nutrient deficiencies from cutting out food groups are very common in disordered eating. This can lead to problems with hormone production, which impacts cycles too.

3. Stress and exercise

High stress levels, coupled with excessive exercise or rigorous workouts, further strain the body.

Signs of hypothalamic amenorrhea

A missing period is the most clear sign of HA. However, it's vital to recognise other associated symptoms that might indicate an underlying issue:

1. Low energy: Feeling constantly fatigued or lacking energy throughout the day.
2. Low moods and mood disturbances: Experiencing fluctuations in mood without apparent triggers.
3. Bone health problems: Decreased bone density, frequent injuries, or prolonged sore muscles.
4. Feeling cold: Unusual sensitivity to the cold.
5. Sleep disruptions: Struggling with sleep patterns and never feeling fully rested, no matter what you try.
6. Obsession with food: This could be thinking about food or the time, always feeling hungry, or obsessing about what you ate.

How to heal from disordered eating and hypothalamic amenorrhea

Recovery from hypothalamic amenorrhea involves a multifaceted approach addressing the root causes and embracing healthier habits. It includes:

  • Renourishment: Establishing regular and adequate meals is the foundation of healing HA. This also includes any weight restoration you might need in your recovery, too. 
  • Exercise modifications: Modifying exercise patterns, reducing intensity, and incorporating gentler forms of movement support the body's healing without adding stress.
  • Stress management: Integrating mindfulness, relaxation techniques, and developing new coping strategies beyond food and exercise can signal safety to the body, aiding in the resumption of the menstrual cycle.
  • Therapeutic support: As an eating disorder recovery coach and therapist, I help my clients with the deeper issues surrounding their relationship with food. Approaches like talking therapy, problem-solving, CBT, and DBT can be helpful when healing HA.
  • Professional help: Seeking guidance from disordered eating specialists like me or my team could be very helpful. Make sure the person you’re working with has enough experience to support your needs, as you deserve compassionate and whole-person care.
  • Self-help resources: You may find my podcast, The Ease With Food Podcast, helpful. It covers all aspects of relationships with foods, and I often have episodes covering HA specifically.

Taking steps and seeking support is a proactive step towards reclaiming a happy relationship with food and healing hypothalamic amenorrhea. Your journey towards recovery is unique and, with the right guidance and resources, you can recover from disordered eating and HA.

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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Edinburgh EH1 & London SW1W
Written by Shannon Western, Eating disorder & disordered eating, nutrition therapy
Edinburgh EH1 & London SW1W

Shannon is a Registered Associate Nutritionist and ACCPH therapist who specialises in helping people recover from disordered eating. She supports people with a person-centred approach that combines nutrition science, counselling, and Non-Diet Approaches like Intuitive Eating. She is available for one-to-one online support.

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