Although it doesn’t affect all sufferers, one of the most common side effects of Anorexia is amenorrhoea, or the loss of periods. When I initially missed my period for 3 consecutive months I was unsure as to why and it was only when I was later diagnosed with Anorexia that the connection was made.
I went 4 and 1/2 years without a period and it wasn’t until November 2019, when I was just 3-4 months in to recovery and my weight had reached the ‘overweight’ BMI category that it finally returned. And I actually couldn’t have been happier about it.
I wanted to share my experience with amenorrhoea and the things that helped me to get my period back. Whilst lifestyle and diet are important factors, there really is no shortcut and the only real answer is weight gain and more specifically, raising your body fat percentage.
Whilst previously I had been offered the contraceptive pill to help with my menstrual cycle it personally wasn’t an option that I wanted to take, as I knew that it still wouldn’t mean that my body was healthy. Luckily, I got my period back pretty early in to recovery and it happened completely naturally.
This post is in no away intended to replace the advice of a medical professional – I’m speaking simply from experience and what has been beneficial for me. If you are suffering from, in recovery, or think that you have a disordered relationship with food then please visit your GP. You can also find advice and resources on the following websites: Beat, Mind and the NHS.
Whilst it’s not anyone’s favourite time of the month, having a regular menstrual cycle is crucial for your long term physical health, as consequences of amenorrhoea include reduced fertility, high levels of blood cholesterol, osteoporosis and premature ageing.
There were 3 main factors which I believe helped me to get my period back so early in to recovery which were reducing exercise, increasing the amount of food that I ate along with the variety of foods, and most importantly – gaining weight.
For me, it wasn’t just a process that was about fertility. But in all honesty, there was a thought in my mind that I never wanted there to be a point in the future at which I had to look back, unable to conceive and feel as if it was all my fault – that in a desperate attempt to be skinny, I’d lost out on my opportunity to ever have children.
After gaining 30kg, I wasn’t surprised at all when my period returned. In fact, I’d been sat in college that morning with a lower back ache that I couldn’t help but compare to the same one that I used to experience with my period years ago, and I wondered why I’d felt so sad and quite frankly annoyed at the world, for no reason. But my period coming back later that day explained it all.
I was always worried that my period returning would make me feel a sense of warped guilt because of my eating disorder so I was surprised when that wasn’t the case. It’s definitely not something that I’d exactly missed, especially when it comes to the pain, but I was actually overjoyed that it was back. I had worked so hard to gain weight, challenge myself and heal my body, so having a sign that my body felt comfortable enough to start up my period again made me so happy.
There were a number of reasons, combined with amenorrhoea which caused me to make the decision to stop working out and reduce my exercise. I knew that over exercising would only over complicate the issue and pro-long the recovery process – both physically and mentally. I wanted to give my body the best opportunity possible to heal.
I didn’t want to put any extra unnecessary stress on my body and so I reduced my exercise to a short dog walk and yoga flow (which I later also stopped) every day. Previous to that, I was walking 12,000+ steps, a 30 minute yoga flow and a 1 hour long HIIT work out daily, so there’s no doubt that my obsessive and compulsive relationship with exercise was not only damaging my mental health, but my hormonal health also.
Research has shown that chronic, high intensity exercise can significantly disrupt the menstrual cycle, as is often shown in athletes. Excessive exercise, puts a stress on the body, disrupting hormonal health (exercise causes the release of stress hormones which interfere with the brain’s production of the reproductive hormones) and metabolic signalling and as result, the menstrual cycle. The body senses that there is not adequate nutritional intake to supplement the energy which is being expended by exercise, and so shuts down the systems which are not vital for life, hence why individuals with Anorexia experience amenorrhoea.
And yes I could have gone on the pill to fix the problem, however that would have been deceptive as it’s not a ‘real’ period. Taking this in to account, reducing the amount of exercise was always going to be a crucial part of helping my period to return.
Now that my menstrual cycle is regular again, I have returned to exercise as I explained in this post, I’m ensuring that I don’t do it obsessively, compulsively or excessively, in order to maintain a regular cycle.
It goes without saying, that increasing the amount of food that you eat in recovery plays a key part in helping your period to return. When it’s put in to starvation mode and your body fat percentage falls, your body prioritises other important functions over your period. It concentrates on simply trying to keep you alive, rather than preparing for a new life.
For me, in conjunction with increasing the amount of food that I was eating, this also meant increasing the amount of healthy fats, protein, conquering my fear of carbs and relaxing my Veganism. My diet is still 80% Vegan, so I made sure to continue taking a multi-vitamin complex to supplement that, however I have been incorporating non-Vegan foods such as fish, eggs, chicken and yoghurt in to my diet more. Not only was this recommended to be my professionals, but I wanted to give my body the best chance of healing and my period returning as quickly as possible.
Research has also suggested that a high protein, low carbohydrate diet can disrupt the menstrual cycle, so having a balanced diet is key. For me personally, overcoming my fear of carbs was an important factor because they’re essential for activating the hormones in your hypothamaamus. Even if you’re eating enough calories but not enough carbs then it can affect your menstrual cycle, as you become energy deficient without necessarily being calorie deficient. But it’s safe to say that I’m now completely over my fear and 100% comfortable with them.
The increase in the amount and range of foods that I was eating helped to ensure that my body was being nourished properly, resulting in weight gain and the return of my period.
You can also read about my experience of gaining weight in recovery here.
This is probably the most important factor of them all because it’s impossible to get your period back without gaining weight and for most people, this is probably the scariest aspect. However period’s can be considered a barometer for health and their absence indicates that the body cannot maintain itself, and is failing to function normally.
I knew that I wouldn’t be able to recover with my weight still sitting at the low end of the healthy BMI range – my body had never sat there comfortably before and I was prepared for weight overshoot to be part of the recovery process. And no surprise, it took me entering the ‘overweight’ BMI category for my period to make a reappearance.
Body fat, more so than your weight itself is specifically important for menstruation as studies have shown that the body cannot menstruate at low levels of body fat. A body fat level of 11-12%, although it can vary, is said to be a marker for the onset of amenorrhoea in women, as the body senses that energy stores are insufficient to sustain a pregnancy, which has knock on effects on the bodies hormonal signals. And no, increasing your body fat doesn’t make you fat. It’s actually healthy to have an amount of body fat – leptin is stored in body fat and is a key hormone when it comes to the menstrual cycle. So no body fat = no periods.
As result of both my weight and body fat percentage increasing over a 3 month period, I have since had 5 consecutive periods. I will also point out that my weight has still continued to increase since then so just because your period has returned, that doesn’t necessarily mean that you should stop gaining weight – the healthiest thing that you can do for your body is let it reach it’s own set point.
Since gaining weight I have had 5 consecutive periods and yes, I’m happy about it because it means that my body is another step closer to being healthy and happy again.
A happy and healthy life is better than one ruled by an eating disorder.
I’m aware that I got my period back quite quickly, which in part is due to the rate at which I gained weight. There are of course several other factors, which contribute to maintaining a healthy menstrual cycle, but for me personally, I viewed these 3 as the most important. It is however a different journey for everyone and if you are suffering from amenorrhoea then as always, I recommend speaking to your GP or health care professional.
If you’re worried about the process, then please let me reassure you that you shouldn’t be scared or worried about getting your period back. It doesn’t mean that you’ve failed, it doesn’t mean that your fat. It means that your healthy. A healthy and happy life is better than one ruled by an eating disorder.
If you are suffering from, in recovery, or think that you have a disordered relationship with food then please visit your GP. You can also find advice and resources on the following websites: Beat, Mind and the NHS.
References and other useful articles on the topic
- 5 Things You Need To Know About Exercise Induced Amenorrhoea
- What Causes Infertility in Anorexia
- Athletic Amenorrhoea