Hypothamalic Amenorrhea (HA)

Why your period went missing—and how to get it back (naturally).

What is Hypothalamic Amenorrhea?

Hypothalamic Amenorrhea (HA) is a form of missing or absent periods caused by a disruption in communication between your brain and your reproductive system. More specifically, the hypothalamus—the part of the brain that regulates hormones—stops sending signals to the ovaries to stimulate ovulation.

The result? No ovulation, no period—and no chance of pregnancy.

HA is common in women who are under-eating, over-exercising, under stress (or all three). It’s your body’s way of saying, “I don’t feel safe enough to reproduce right now.” Functional fertility practitioners often refer to it as a “shutdown mode” due to energy conservation.

It’s a smart survival mechanism—but a frustrating fertility roadblock.

Symptoms of Hypothalamic Amenorrhea

HA can be subtle, especially if you’ve been praised for your “healthy lifestyle” or “discipline.” But the signs are often there:

❌ Missing Periods: You haven’t had a period in 3+ months (not due to pregnancy, PCOS, or menopause)
📉 Low or Unchanging Basal Body Temps: Suggests anovulation
🥣 Low Caloric Intake or History of Restrictive Eating: Including undereating carbs or fats
🏃‍♀️ Intense or High-Volume Exercise: Especially if not properly fueled
🧠 Chronic Stress, Anxiety, or Perfectionism: Emotional stress has a physiological impact
🧬 Low Estrogen Symptoms: Dry skin, low libido, vaginal dryness, poor sleep, brittle hair/nails
🪫 Low Energy, Feeling Cold Often, or Slow Recovery from Workouts

If you lost your period after dieting, changing your training, or going through a period of high stress, HA is a likely root cause.

Who Does HA Affect?

HA most commonly affects women in their teens, 20s, and 30s—but it can happen at any age if the brain-body connection is disrupted.

You may be more at risk if you:

🥗 Eat a low-calorie or low-carb diet
🏋️‍♀️ Exercise intensely (e.g., distance running, HIIT, or CrossFit)
🧘‍♀️ Have a Type A or perfectionist personality
💭 Have a history of disordered eating or body image struggles
😴 Don’t manage stress well or experience chronic emotional burnout

Many women with HA appear healthy—or even “optimal” on paper. But behind the scenes, their body is in survival mode.

How is Hypothalamic Amenorrhea Diagnosed?

HA is often diagnosed by ruling out other causes of missing periods (like PCOS, thyroid dysfunction, or POI) and looking at key hormone patterns.

Here’s what testing typically includes:

🧪 Low LH + FSH: Suppressed brain signals to the ovaries
🩸 Low Estradiol: A downstream effect of low stimulation
🧠 Normal or Low-Normal TSH, Cortisol, and Prolactin
📉 Low AMH: May appear low due to temporary suppression (not necessarily low reserve)
🔬 No Follicular Activity on Ultrasound: Ovaries may look “quiet” or small
📅 Absence of Ovulation or Periods for 3+ Months

Functional practitioners may also run DUTCH testing, HTMA, or metabolic panels to assess stress response, nutrient status, and adrenal function.

How Does HA Affect Your Fertility?

HA is a form of anovulation—meaning you’re not releasing an egg. And without ovulation, pregnancy is not possible.

Here’s how HA can affect fertility:

🧠 No Ovulation = No Egg to Fertilize
📉 Low Estrogen = Thin Uterine Lining: Which means implantation becomes unlikely, even with an embryo
🪫 Hormonal Flatline: Your body isn’t producing enough sex hormones to sustain a pregnancy
🧬 Nutrient Deficiencies: Common in HA and affect egg quality, cervical mucus, and hormone production
🧠 Stress Hormones Override Reproductive Hormones: Cortisol and other stress responses suppress reproductive function

The good news? HA is one of the most reversible causes of infertility when given the right support.

We Can Help!

Healing HA is possible—and no, it doesn’t always require “just gaining weight” or “doing nothing.” You need a strategic plan that addresses your metabolism, mindset, and mineral status.

✨ One client hadn’t had a period in 18 months after intense running and low-carb eating. With support, her cycle returned in just 8 weeks—and she got pregnant 2 months later.
✨ Another was misdiagnosed with PCOS. It was actually HA. After increasing food intake, supporting her adrenals, and reducing training, she ovulated naturally for the first time in 2 years.
✨ A third client came to us after three failed IVF rounds. Her root issue? HA from chronic stress and over-exercising. She conceived naturally after just three months of holistic support.

At The Greenhouse, we help you rebuild safety in the body—so your brain starts signaling your ovaries again.

👉 Apply for 1:1 HA and fertility support

Learn More

📰 3 Things that won’t confirm ovulation

📰 The truth about making more progesterone...

📰 Could your pain killers be the reason you're not ovulating?

📰 You can't get pregnant without ovulating.

📰 Progesterone - not Estrogen - is the real female hormone

📰 Do you know if your periods are true periods?

📰 Period Myths That Need to Stop

📰 Late Period? Or Late Ovulation!

📰 Do You Experience Painful Ovulation (Mittelschmerz)?

References

Gordon, C. M., & Nelson, L. M. (2003). Amenorrhea and bone health in adolescents and young women. Current Opinion in Obstetrics and Gynecology, 15(5), 377–384. https://doi.org/10.1097/00001703-200310000-00004
De Souza, M. J., Hontscharuk, R., Olmsted, M., Kerr, G., & Williams, N. I. (2007). Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite, 48(3), 359–367. https://doi.org/10.1016/j.appet.2006.10.006
Warren, M. P., & Chua, A. T. (2008). Exercise-induced amenorrhea and the female athlete triad: A review of the literature. Journal of Clinical Endocrinology & Metabolism, 93(6), 2016–2024. https://doi.org/10.1210/jc.2007-2416

**Not medical advice. Always consult your doctor before making changes to your health or fertility plan.