This is the first installment of an exclusive new video series on women’s health and wellness available only to LPC members, and we’re kicking it off with a string of episodes that focus on menstruation, hormones and in particular how to fix hypothalamic amenorrhea (HA), especially for female athletes who often have a different mindset toward exercise and training. Joining Tawnee is her co-host, Sam Morse, a triathlete who’s currently in the process of healing her own hormones and HA, and is passionate about women’s health.

If you have a question for Tawnee and Sam send to questions@lifepostcollective.com. We’ll be recording 1-2x a month.

Content Outline:

  1. Defining HA.
    1. Click here for an article explanation by Tawnee.
  2. “If I’m pretty young, not looking to have kids for a while, and want to kick ass at sport, why should I want my period back? It just seems like an inconvenience.”
    1. Bone density (BD) – Study on runners over 40 with history of amenorrhea but regained cycles didn’t have as good as BD as lifelong normal menstruating women; still had BD similar to average 30 y/o. If you get your period back you can recover BD. Just take birth control (BC)? Not that easy: BC reduces bone breakdown but it also does NOT help bone reformation – you stay as you are, not necessarily good.
    2. Neurodegenerative disease risk – Parkinson’s, dementia, Alzheimer’s.
    3. Heart disease risk – low estrogen indicated in women with CVD. Estrogen helps with vasodilation and elasticity.
    4. Plus if you DO want kids, you’ll make things easier on your body if hormonal functioning is in place. It took Tawnee 2 years to get regular cycles (because not “all in” and still trained/raced). So when you finally do want kids you don’t want to have to wait years for it to work out. Granted some women are different and when they want kids they stop everything, get periods back and can get preggo relatively soon (<1 year).
  3. “Can I still train while working to get my period back? Can I get a reality check on what ‘intense training’ means?”
    1. Yes, but your definition of training may have to change. Some women indeed eat enough calories, but because training and possibly life stress are high they’re not getting their period back.
    2. Intensity and volume need to be checked. Can’t do too much, and this may be less than you ideally want to do!
    3. Concept of Metabolic reserve – don’t empty the bank account and try to keep going! Chris Kresser had a great podcast on this as it relates to adrenal fatigue and exercise. Listen to that show here.
  4. “Ok, so I know I need to be in appropriate energy balance (calories in vs. calories out) to get my period back. Does meal timing matter? Could I do a fasted or low-calorie workout session then eat a HUGE meal afterward to make up for it? Or will the hour or two in energy deficit hurt me, even if I ‘make it up’ later?”
    1. Ideally, no fasted workouts, but if you’re well fat-adapted you may be able to squeak some in. I did. (But my cortisol still remained high due to fasted workouts, and that’s why I say you’re better off avoiding AM fasted workouts; have least 100 calorie snack, doesn’t have to be a full meal always.)
    2. As for the energy deficit: You never want to get to a point where you feel like you’re starving and especially not going 4-5+ hours without food. Ideally, eat every 3 hours.
    3. Plus huge meals after can be a stress on digestive tract. Read Eating to Nourish Adrenals, many of the same concept apply here.
    4. Insights from Tawnee on the mistakes she made: For a long time, I don’t think I was chronically too low calorie and vividly remember eating a lot especially once I started dating John in ’11, but I was too low carb and often training fasted. I hated sports nutrition gels and crappy products so I’d go long times on not much fuel then eat a huge meal after of whole foods – this strategy didn’t allow me to regain menstruation. My fuel timing and macros were all off. And energy balance probably wasn’t perfect every day; I’m sure on some days I needed more cals in general too.
    5. On low-carb: The hypothalamus literally senses this macro missing and can become suppressed as a result. No restrictions of macros!
    6. That said, Tawnee differs from conventional advice here. I think diet-wise we can recovery without binging on junk food! A lot of experts recommend eating everything and anything, and while I agree no restrictions and if you want something, have it, at the same time I believe in maintaining a clean healthy diet even to regain your period.
  5. “What are some signs that I might be getting some hormonal activity back?”
    1. Blood test markers – Increase in LH; maybe not FSH or Estradiol. LH increases because hypothalamus is working again and sending signal to allow GnRH pulses.
    2. Weight gain – Tough to stomach but weight gain is a big one, although it may not need to be much. It depends how low you were and what you’re still doing. I got my period back without needing to gain much weight (maybe 5-6 lbs), for me it was more lifestyle, training stress and diet that needed work (I had regained most my necessary weight after ED).
    3. Feeling warmer.
    4. Better sleep.
    5. Better more consistent stools…. but also….
    6. Potential for some bloating or digestive issues – after an ED, significant weight loss, restrictive diet or chronic low-calorie dieting PLUS associated stressors, GI issues can surface (this is even shown in research). When reintroducing food, the body is getting use to ample food and variety and this can be a stress and why you may want to do smaller more frequent meals vs less frequent HUGE meals a day.
    7. Low abdominal cramping/sensations.
    8. Possible to have spotting but not a full period.
    9. Fuller breasts.
    10. Increased libido (and vaginal lubrication).
    11. Perhaps better skin, nails, hair depending how nutrient deficient you were (also the hormones help boost these things).
    12. Increased metabolism – it gets sluggish when you’re in starvation mode.
    13. Less food thoughts/obsessions – because you’re now giving yourself fuel!
    14. More energy or more tired – it depends. Tired will be because body’s repairing same way with adrenal fatigue recovery.
    15. Desire, passion and vitality return.
    16. You might feel RAVENOUS – this is because you’ve told the body that ample food is back in the picture so it’s asking to make up for lost time.
    17. Water weight – body doing it’s job to repair.