This post may contain affiliate links. Please read our disclosure policy.
After many years of not having a period and working with hundreds of women, here’s my personal and clinical experience on how to get your period back naturally.
It starts like this: one month, you don’t get your period.
You know you aren’t pregnant, so your missing period doesn’t seem like a big deal. Truth be told, it’s kind of convenient.
But then one month turns into three, and then six. Suddenly you can’t remember when your last period was. Is this really ok?
For thousands of women, this is how hypothalamic amenorrhea (HA) begins. And while it happens to many, it’s not normal. The good news is, losing your period often has a clear root cause, and there are things you can do to recover and get your period back naturally.
Jump to:
What is Hypothalamic Amenorrhea?
Hypothalamic amenorrhea is a condition where normal menstrual cycles stop due to eating too few calories, working out too much, or stress (and often due to a combination of all three). Your hypothalamus is an area in your brain that controls reproduction. When your body receives signals that it is under stress, your hypothalamus stops stimulating the release of reproductive hormones that control menstruation.
Aside from not getting your period, hypothalamic amenorrhea is a sign your body doesn’t have all the resources it needs to function properly. With energy in a deficit, your body will shut down what is considers to be unnecessary functions, including your menstrual cycle.
At its root, hypothalamic amenorrhea is a condition of energy imbalance. You’re putting out more than you’re taking in, and your body sees this as a stressor. Research shows stress is a powerful inhibitor of reproductive function. When our body is under chronic stress, it downregulates hormone production, including sex hormone and thyroid hormone production.
While losing your period is often the first sign something is wrong, it can lead to long-term issues down the road.
Causes of Hypothalamic Amenorrhea
Typically, there are a number of different factors that contribute to hypothalamic amenorrhea. Here are some of the causes:
- Emotional or physiological stress
- Long term caloric restriction
- Poor nutrition
- Low body fat (note: this is highly individual)
- Exercising too much
- Having a disordered relationship with food or an eating disorder
Is It Your Weight?
A common myth about hypothalamic amenorrhea is it only happens to college athletes or those who are suffering with eating disorders who are very lean or underweight. But the truth is, it can happen to anyone who winds up in an energy imbalance.
There’s no magic number—be it hours of exercise per week, body fat percentage, or weight—that will make you lose your period. It is completely individual to you and your body.
While having a lower body fat percentage can play a part, you don’t have to be underweight according to the BMI chart to lose your period, you just need to be under the weight that is right for you. This means even a “healthy” weight can trigger hypothalamic amenorrhea if it is too low for your body.
In fact, the majority of women I meet who lose their period think they’re just “being healthy.” If this is what happened to you, remember: it’s never healthy to lose your period. When your period is missing, it’s a sign that there is some imbalance in your body.
Why Losing Your Period Matters
When you’re of childbearing age, a regular menstrual cycle is an important indicator of your health. In fact, according to some experts, your menstrual cycle is your 6th vital sign.
Losing your period is like a big, blaring siren warning you that your body is experiencing an imbalance. Even if right now, the only symptom is your period missing, hypothalamic amenorrhea is a sign that there is a bigger issue going on.
It can occur alongside hormone imbalances, hormonal acne, and thyroid disorders, and adrenal dysfunction.
Even if you don’t want to have kids now or ever, your body needs a menstrual cycle for healthy hormone production. Ovulation is necessary for the production of estrogen. If you’re not ovulating, estrogen levels will drop and your risk of osteoporosis and stress fractures increases.
The bottom line is that women of childbearing age need to be ovulating regularly to stay healthy. When your period has gone missing, there is a root cause, and that root cause is likely creating other dysfunction in the body.
Hypothalamic Amenorrhea Diagnosis
If your period unexpectedly disappears, you should always talk with your doctor. Don’t just assume it’s hypothalamic amenorrhea (or anything else).
There’s no blood test or scan that can tell you if you have it. Instead, it is diagnosed through exclusion. To determine if you have it, your doctor will first need to rule out other causes of missed periods:
- Are you pregnant? This one is pretty self-explanatory, but it should always be ruled out first.
- Do you have PCOS? Polycystic Ovarian Syndrome is another major cause of missing periods and irregular ovulation, but it’s not the same as HA (and they don’t usually occur at the same time). PCOS is a disorder caused by excess androgens, where HA is caused by energy imbalance.
- Are you using hormonal birth control? Some hormonal birth control methods (like the Pill, ring, shot, and hormonal IUD) can cause you to stop bleeding entirely, even during the “placebo week.” But the absence of bleeding you might have on the Pill isn’t the same as HA, as HA is about the absence of ovulation, not just the absence of blood.
If you and your doctor conclude you do have hypothalamic amenorrhea, the next step is to start making shifts that will allow you to get your period back naturally.
What About Birth Control?
After you’ve been diagnosed with hypothalamic amenorrhea, your doctor might suggest starting hormonal birth control pills. Unfortunately, this does nothing to solve the root issue.
I’m just going to be honest: this makes absolutely no sense.
The hormonal birth control pill works by stopping ovulation, but if you have hypothalamic amenorrhea, you’re already not ovulating.
All the Pill might be able to do is give you a monthly “pill bleed,” which is not the same as a true period caused by ovulation, and doesn’t have the same health benefits.
And even if you do get a “pill beed,” it doesn’t mean it’s resolved. Remember, hypothalamic amenorrhea is caused by an energy imbalance. Taking hormonal birth control does nothing to fix the root cause, it simply gives your body synthetic hormones to create a bleed.
If you’re struggling to get your period back after the pill, check out How to Stop Taking Birth Control (Without Side Effects).
How to Get Your Period Back Naturally
If I had to sum up how you can heal hypothalamic amenorrhea in one sentence it would be: eat more, exercise less.
Because it is caused by an energy imbalance, the only way to get your period back naturally is to correct that imbalance. The energy imbalance is a major source of stress, which is shutting down hormone production. Stress has a profound impact on your endocrine system, and unless you deal with the root cause of the stress and the imbalance, you won’t be able to reverse hypothalamic amenhorrea.
It’s also important to remember that eating too little puts your body in a state of nutrient deficiency. So, if you’ve been chronically cutting calories and working out a ton, your body isn’t going to have the raw materials needed to create and secrete hormones. There are other functions that take priority, like the stress response, which is why your body shuts down your menstrual cycle.
The fastest way to recover from hypothalamic amenorrhea is to stop intense exercise and eat above your calories needs.
Think of the energy imbalance like a big, deep hole. Not only do you need to stop digging it deeper, but you also have to fill it back in. That’s why eating not just enough calories for your daily needs—but a surplus of calories—is so important.
You can take a more moderate approach, too by reducing exercise and slowly increasing your calories, but it will definitely take longer to recover this way.
Gaining Weight
No matter which option you choose, you will most likely need to gain weight in order to heal your hypothalamic amenorrhea.
Gaining weight is completely OK. Doing so doesn’t mean you’ll be less healthy (in fact, it means exactly the opposite), less worthy of a person, or that you’ll be less happy.
If your period went missing while you were pursing a certain weight you thought you should be, it’s important to recognize that your health and happiness is not a destination. Weight loss doesn’t equate to improved health, and there isn’t a linear relationship between leanness and happiness.
Very few women can reverse hypothalamic amenorrhea without gaining some body fat. Yes, even women who are at what most people would consider a “healthy weight” may have to gain weight to get their period back.
For most women, you’ll need to get back to the weight you were at the last time you had a period, and you may have to even go above that.
There’s no set number or body fat percentage to strive for, but you’ll know you’ve gained enough weight when you get your period back. Essentially, you are trying to get to a place where your body knows there is enough energy available, hormones have the nutrients they need, and cortisol is within normal ranges.
What to Eat
When it comes to healing hypothalamic amenorrhea, food quantity is more important than anything else. You’ve got to have enough food to fill that hole back in.
I recommend 2,000 calories a day as a minimum for women who are already healthy. Supplying your body with quality nutrients is the entire basis of my book, Coconut and Kettlebells. If you lost your period, 2,300 – 2,500 calories per day is a good place to start.
You don’t have to track calories, and you should never stop eating if you’re still hungry. That being said, if you’ve been undereating for a long time, you might need to count calories temporarily just to be certain you’re eating enough.
After food quantity, the most important food for healing hypothalamic amenorrhea are carbohydrates. In fact, according to Dr. Lara Briden, even if you’re getting adequate calories, undereating carbohydrates can trigger it for some women.
Yes, some women can eat a low carb diet without losing their period. But just because it works for them, doesn’t mean it works for you. Here are some of my favorite nutrient-dense carbohydrate sources:
- Potatoes
- Sweet potatoes
- Jasmine or short grain brown rice
- Squash
- Quinoa
- Oats! Try oatmeal, oat flour pancakes or waffles, coconut milk overnight oats, etc.
- Vegetables
- Fruits, including bananas, berries, apples, and more!
- Sprouted or sourdough bread
Food Quality
Yes, food quality matters. But, you might benefit from adding more calorie-dense (and dare I say refined) foods into your diet.
Taking the stress out of eating and exercise is what this is really all about. You shouldn’t be stressing about making the “right” food choice all the time. Try and listen to your body, eat what you’re craving when you’re hungry, and stop when you’re full. Sometimes you might eat too much or too little, but that’s all part of the journey.
Exercise
The amount of exercise that can trigger hypothalamic amenorrhea is all relative. What’s too much for another person might be OK for you, and vice versa.
In general, if you’re wondering if what you’re doing is “too much,” it probably is. When in doubt, do less. This is especially true for longer-duration cardio, like running.
There will be time for more exercise when you’ve recovered from hypothalamic amenorrhea, but any intense exercise or cardio will add stress. While workouts are stress relieving, intense exercise literally breaks down muscle tissue requires energy.
The best exercise you can do while trying to get your period back naturally is the simple, gentle, and joyful stuff: walking outside, yoga, swimming, and hiking are all good options.
The only rule is it has to be fun and feel good. If you’re exhausted after a long day, and your body is begging you to lay down for a few minutes, that outside walk is going to do more harm than good.
Mental Health
To heal hypothalamic amenorrhea, you have to be willing to change what you think of as healthy and start taking action to encourage a healthy body image. That can be scary, especially if you’re a type-A kind of person who thrives on order and control. In fact, type-A personalities are the ones who are prone to experience it.
It can feel like throwing caution to the wind. When else has anyone ever said you should eat MORE and exercise LESS to become more healthy?
The truth is, a lot of what our culture calls “healthy” is really based on appearance. True health has nothing to do with what your body looks like, how many hours you exercise per week, or what you body fat percentage is.
How do so many of us end up spending weeks, months, and years chasing after a specific weight or size? The diet and fitness industry thrives on making you feel shame for how you look. In order for you to buy into the next diet, program, or product line, you must believe you need to be something else in order to be happy.
And so, the majority of the marketing you’ll see from diet and fitness brands is laced with shame. It’s designed to make you believe there is something wrong with you, and that it needs to be fixed (with their special product, of course).
Consider this: there isn’t actually anything wrong with your weight if you’re happy and healthy and can do the things you want to do. You don’t actually need to get rid of your cellulite. And having a “flat” belly doesn’t make you more worthy of a person.
How Long Does It Take?
The more “hardcore” you go in exercising less and eating more, the faster you can expect to get your period back.
In general, the amount of time it takes to heal hypothalamic amenorrhea usually correlates with how long your period has been missing (and how long you were undereating and over-exercising before that). But, in most cases, it can take anywhere from 3 to 6 months. If your period has been MIA for years, it probably is going to be on the longer end of that.
If you’ve been eating more and exercising less for more than 6 months and your period still hasn’t come back, the first thing to do is get real with yourself.
- Are you really eating enough, consistently?
- Have you cut back on exercise enough?
- What else in your life could be creating excess stress for your body?
You should also check in with your practitioner again. It may just take longer for you to recover your period. I have heard from women who have required 2+ years of consistently working toward recovery to regain their period—often by finally doing things they thought they’d never do.
What to Do When You Get Your Period Back
It finally happened: you got your period back!
It’s incredibly gratifying to recover, but as soon as you get it back, you’re going to be thinking about something else: what do I need to do to keep this from happening again?
If you immediately go back to your former exercise routine and restrict your caloric intake, you will lose your period again. This is because your body responds to stress in a very specific way—by stopping mensuration—and that response will not change.
Once your period returns, I recommend slowly increasing your exercise over time while maintaining your caloric intake. Just keep in mind, your old habits weren’t healthy and you don’t want to return to them. If anything happens to your cycle during this time—it becomes lighter, longer, or disappears again—reduce the intensity of your training and ramp it down until your period normalizes again.
Eventually, you should find a “sweet spot” where your body can exist and be in balance. When you reach this state, it’s important to continue to balance hormones naturally long-term. Always be aware of how stress can impact your period and your hormones.
Rethinking Health
Treating hypothalamic amenorrhea requires you to completely reevaluate everything you’ve been taught about health.
I know how scary and uncomfortable it is to have long-held beliefs questioned. But know this: when you heal your HA, you will develop a much more powerful, true knowledge of what health is for you.
It’s not easy, but it’s so worth it.
Want more resources and insight regarding recovering from hypothalamic amenorrhea? Check out the following podcast episodes:
#039: Amenorrhea and Getting Your Period Back
#094: PCOS and Hypothalamic Amenorrhea, Pooping Concerns, & The Copper IUD
Diet Versus Nutrition, Post Birth Control Amenorrhea, & Overworked and Overtired
Andrea says
Hello Noelle! Great blog with helpful information. I myself am currently experiencing HA or so I believe. For reference my last period was on September 2020. I think I’ve lost it due to the fact that I realized that I have been bloated for most of my life and decided to do something about it. I have always been “lean”. I’m 5’4 and used to weigh108lbs but ever since I had that realization I began to count my calores, intermittent fast and cut down significantly on processed food. I am now at around 98lbs! I realize I have to eat more in order to get my period back becase the absence of it is no joke as it is an indication that my body is not properly functioning but just the mere thought of seeing my weight go up by a few numbers seems scary. Also, P.S: is it just me or are lots of people during quarantine obsessing over food???
Noelle Tarr, NTP, CPT says
Andrea! YES!! When people feel out of control, they tend to try to exert control in other areas. Becoming obsessive with your body size, food, and exercise is a common coping mechanism. For you, I applaud you for your self-awareness! Yes, women need body fat for proper hormone function. Your body is likely experiencing chronic stress from the undereating, fasting, etc, which can lead to decreased hormone production and thyroid function, and your low body weight is likely resulting in low estrogen. I think you could also benefit from this article: The Adrenal Fatigue Myth: What’s Really Going On and How to Treat it. Also, I’ve talked SO MUCH about hypothalamic amenorrhea in my podcast, Well-Fed Women. Come on over and hang out with us! 🙂
Tasnia Hossen says
Hi I’m Tasnia and I’m 14 years old, turning 15 in April. I started my weight loss journey last years April (when lockdown had started) n lost 13kgs (29lbs) in about 11 months (as it is March 2021 today). In terms of exercising, I just walk 10,000 steps everyday, however I’ve done the Chloe Ting 2 weeks challenge in December 2020, and that was pretty much the only exercise I’ve done.
My eating diet started of pretty healthy. All I did was cutting off some sweets and fizzy drinks. However, I started to discover about counting calories and restricting. I slowly begin to decrease my calories intake and right now it’s 400-600 kcal per day. I also fast for 23 hours and eat those 400-600kcal in 1 hour since the beginning of 2021 because I realised that if I allow myself to eat, then I go over my calories (which is 600 kcal) and that makes me feel very guilty. No one in my family knows that struggle with this, I’m scared to talk to about it. My parents have started to notice how I’ve lost some weight, but I just said that I’m fine and there’s nothing wrong.
By the way, my height is 5’3 feet and I currently weight 43kgs (I used to be 56kgs last year when I started my weight loss journey). Now to the thing I’m concerned about: my period. I’ve missed two of my periods so far and in two weeks if I don’t get my period, then that would be my third missed period. I’ve kind of come to realise that what I’m doing is wrong, my diet is very wrong, but I can’t stop, it’s satisfying for me to see the number on the scale drop down. I don’t want to gain weight, it’s one my worst fears.
Noelle Tarr, NTP, CPT says
Hey Tasnia! It sounds like you’ve really starved your body of nutrients and food, and it’s responding by reducing sex hormone production. I’d recommend seeking help immediately with a professional (therapist or a nutritional therapy practitioner) who can help you back peddle and work on nourishing your body, balancing hormones, and supporting a healthy body image. If your period is missing long-term, it will lead to many other complications I don’t want you to have to deal with later on in life. Hope this helps! You are definitely not alone!
Sam says
Hi. Please help me. I haven’t gotten my period in three months and I’m really scared. I don’t know how to tell my mom. I have been exercising more and I have been eating less dessert I’m really sacred could you please help.
Noelle Tarr, NTP, CPT says
Please follow all of the advice above—eat more calories, reduce exercise, and tell you mom/show her this article. Hugs to you!
Carmen says
Hi Noelle 😊 I’m 21, haven’t had my period for 2 years now and finding this article very helpful, it resonates with me so much. I understand every one’s different, but do you think it’s possible to get it back and still exercise?
I used to workout 5-6 days a week, weightlifting and HIIT, and I guess I was not eating enough. I’ve upped my calories and gained some weight since last summer but still haven’t got it back, so now I’m reducing exercise, doing just 3 workouts a week and some yoga. I really enjoy working out, so I was wondering if you think it’s possible to get my period back if I still do workout?
Thank you so much angel
Noelle Tarr, NTP, CPT says
Hey Carmen! Congrats on putting in the hard work and making those changes! I know it’s not easy and takes a complete shift in mindset. I would say possibly, but it’s going to take longer to get your period back. Definitely keep it more gentle.
Claude says
Hi, I’m trying to get my period back and I’ve really reduced excercise and eating with no restrictions. I just feel like I’m gaining loads of weight (ik it’s healthy for me and I have to) but I haven’t got my period and it feels kinda pointless you know, I just don’t know what else I can do
Grace says
Hi Noelle,
I’m just wondering after getting back my period can I still lose weight at a slow/healthy rate. Because I previously lost weight very rapidly and lost my period. If I gain back the weight and get back my period will I be able to lose the weight again but this time losing the weight very slowly without losing my period again? Pls reply
Noelle Tarr, NTP, CPT says
Hi Grace! That all really depends on your unique stressors and physiology. Most people end up losing their period because their body is at a weight that is unnaturally low for them. So if you’re at a weight that is healthy for your body, you should be able to maintain your period.
Rosy says
Hello, are there specific healthy carbs to get the period going again??
Noelle Tarr, NTP, CPT says
Try starchy tubers like potatoes, rice, fruit, etc.
sara says
I dont want to gain weight. Isn’t there any other way? Can I just add carbs but staying in a healthy caloric deficit? & there are ppl who are under weight but still have their periods. I have been eating too much now. I dont wanna put on too much weight. Previously I had lower weight than this but had my periods. People suggest some seed cycle. Can I do that? I know a person who got their periods back just through that remedy & they still work a lot & eat less. But the only difference is that they eat whole foods. While I previously replaced whole food with veggies.
It just showed symptoms when I started to stress about my weight goals. Previously I was fasting, not counting calories & walking etc.But didnt lose my period.
P.S. I think cutting out carbs caused me to lose period. But I’ve never eaten sufficient protein.
Noelle Tarr, NTP, CPT says
Unfortunately Sara there’s not. It’s basic physiology, and starving your body of calories and nutrients is going to result in loss of period and imbalance hormones.
Lulu says
Are there any foods I can eat, that might speed the time it takes for my period to come back?
Noelle Tarr, NTP, CPT says
I would really focus on eating enough carbohydrates and calories overall.
Makayla says
I am a high school student and lost my period a year and a half ago due to eating between 1000-1500 calories a day as well as doing workout videos and walking. I began eating more, but also increased my exercise along with that until the point where I was taking 30,000 steps a day, and I thought I was eating “enough” but I wasn’t. Over the past 6 months, I have slowly reduced my exercise (now it is hardly anything) and have slowly gained a significant amount of weight because I have allowed myself to eat what I want. I feel like I am in a healthier position, but my period has not returned. I have had a bit of discharge show up, but nothing else too significant. Are there any other signs I can look for to know when my period will return?
Noelle Tarr, NTP, CPT says
You are doing all the right things, and the discharge is a great sign! It typically takes a little longer than you’d think for your period to come back. Your body has to play “catch up” of sorts to understand that it’s safe and has enough resources. I wouldn’t be surprised if it returns shortly!
Friely says
Hello Noelle!I have been undereating and overexcercising for two months!In the first month of overexcercising my period came…but it didn’t come this month and I’m concerned.I stopped dietieting and i have been trying to eat a lot of calories and i also have stopped exercising.(2000-2500 kcal a day).Do you think it will take me a long time to get my period back?I know there is no straight answer but I hope it comes back soon.Frankly,thank you so much for creating this article!It’s really helpful!
Noelle Tarr, NTP, CPT says
I’m so glad it’s helpful! Truthfully, since you noticed it so quickly and took swift action to reverse it, I think you’ll get your period back pretty quickly. Be patient… you’re doing an awesome job!
Friely says
Hello Noelle!Thanks to you ,today my period came back!I can’t believe it!Honestly,I cannot thank you enough!This article helped me immensely…it was eye-opening!Thank you so so much!Have a wonderful day!
Noelle Tarr, NTP, CPT says
So happy to hear that! Thank you for sharing!
Rebekah S. says
I just wanted to add a comment that some people need more food than others – according to online TDEE calculators I was eating over maintenance while I was counting daily and losing weight. I currently maintain on about 2500 calories while 5’7 137lb and less active than I was before (maybe 5 full hours of exercise a week right now?)
You’ll also note I’m not that thin, and my bodyfat’s probably around 25%. I think it must be a combination of life stress and losing 12 pounds throughout this year (2022). My last period was about 115 days ago and it ended after 2 days (they’re usually 5-9 days). HA is usually diagnosed as missing 3 full periods so recently passed that mark… my avg caloric intake never went below about 1950 calories.
Abuga Lydia says
I have enjoyed reading this health lessons