diet and hypothalamic amenorrhea

How to eat to get your period back: The HA recovery diet

If you have read my posts in the period recovery series on Why has my period stopped and how do I get it back? and What is Hypothalamic Amenorrhea? you will know that chronic or restrictive dieting is one of the major reasons for missing periods.  So what is the perfect Hypothalamic Amenorrhea recovery diet? What should you eat to get your period back of it has gone awry? In those posts I stated that “good food and lots of it” is the way to go. In this article I want to give a few more tips on exactly how to eat to get your period back.

How much should I eat to recover my period?

It is recommended to eat 2500 calories or more to recover from Hypothalamic Amenorrhea. Yes, even for those who aren’t exercising (and I don’t recommend that you do exercise if you are trying to recover your period). Your body needs to be in an energy surplus right now which means taking in more energy than you are burning through being alive and any activities you do. If you have been dieting for a long time, your body will have a whole list of things it wants to repair, not just your hormones, and this energy will go towards building healthy bones, teeth, hair and nails just to name a few!

I will stress though that this is a minimum and if you are hungry for more than this then you should listen to your body and eat. When I first started recovery I spent a good few months eating at least 3000-4000 calories a day because that was what my body needed. Sometimes way more than that. Did I gain weight? Yes! But again, that was what what my body needed. Over time my appetite settled down but even now I never eat below 2000 calories and I have maintained a healthy period for over 3 years. I don’t recommend counting calories long term but it can be a good idea in the beginning to get an idea of how much you need to eat. Especially if you have been under-eating for a long time, you will need to recalibrate your idea of a normal meal.

What should I eat to fix my period? What is the perfect HA recovery diet?

Especially in the beginning, it doesn’t matter too much where these calories are coming from, it is the energy that is most important. As a nutritionist of course I am all about eating well and getting plenty of micro-nutrients into your diet but this is something that should be done over the long term and what you do for a few months of recovery is less important. You can choose to re-feed with only “healthy foods” or you can choose to add in more “fun foods”. My recommendation is to get plenty of nutritious food into your body but don’t obsess over having a perfectly healthy diet. Make sure you eat foods that taste good and bring you pleasure. I mean, if you are going to eat lots of food and gain weight you might as well let go and enjoy it! 

(edit – see my more recent post on the best foods to eat to raise your metabolism and heal your hormones!)

Will eating more fats bring my period back? What about carbs? What is the best macro ratio for HA recovery?

The first question women often ask is do I need to eat more fats to get my period back. The answer here is maybe! Check what you are eating right now. Are you following a low-fat diet? Our bodies need  fats to function optimally and produce hormones so eating more fats could be exactly what you need. On the other hand, if you are following a high-fat low-carb paleo or keto style diet, adding more carbs may be the answer. Eating carbs produces an insulin response which helps our bodies feel safe that there is plenty of food around and come out of energy-saving mode.

I fully agree that these diets can be beneficial for overcoming certain diseases and provide benefits for otherwise healthy people, but if you have lost your period you are not a healthy person right now and something needs to change. So no, there is no specific diet or macro-nutrient ratio to follow, just make sure you are getting plenty of carbs, proteins and fats and listen to your cravings.  Trust that your body knows exactly what it needs and don’t be afraid to go with the flow.

What about liquids? How much water should I drink?

On that note, I want to talk about water consumption. Many of us fell for the myth that you need to drink lots of water to be healthy. We also listened to the same people who told us to eat less salt to be healthy. For many of us with a perfectionist, all or nothing mindset we took this too far and drank several litres of water per day and ate hardly any salt. This is a recipe for disaster! We need salt to maintain a healthy water balance in our body and drinking too much water can flush out electrolytes leaving us feeling cold, dizzy and “washed out”.

If you have been doing this, I recommend experimenting with reducing the amount of water you are drinking and increasing your salt consumption. This is something I only learned way after my period recovery journey but it has been extremely beneficial for my overall health. I learned this from reading book Eat for Heat, a book written by Matt Stone, an expert on raising metabolism. He describes a symptom of restrictive dieting that I experienced myself – needing to pee all of the time as well as a low body temperature. Especially at the beginning of recovery, or if you are feeling very cold, replace all zero calorie drinks including water and diet soda with things like milk, juice, smoothies or even sports drinks containing electrolytes and glucose. Your body actually needs the salts and sugar to properly absorb the water which explains why plain water often feels like it “goes straight through you”. You can even add a pinch of salt to every glass if you are really struggling wit hydration. If you notice yourself peeing less frequently, feeling warmer, especially your fingers and toes, and sleeping better then you know you are on the right track to recovery.

Does it matter when I eat during recovery? Can I get my period back whilst intermittent fasting?

There is also is the question of when to eat? Again, there is no strict rule on this but consistency is key. You can eat 3 square meals or you can graze throughout the day. As long as you are getting in plenty of calories it doesn’t matter how you do it. What I will say is not to let yourself get too hungry as low blood sugar is perceived as a stress by the body. If you are getting cranky, anxious or panicky before your next meal you have probably left it too long and should think about adding an extra snack before you get to that point. Often 3 meals with 3 snacks is recommended as a good eating structure and if you have no clue then this can be a good place to start.

One thing I don’t recommend is intermittent fasting. Again, there is some research showing fasting to have lots of health benefits but it is really not a good idea in recovery. If you want to practice intermittent fasting I would suggest to do no more than 12 hours fasting e.g. 7am to 7pm eating window. This gives your digestive system a break to heal and repair but doesn’t leave you going for long periods during the day without food. Personally I got really hungry at night during my recovery and sometimes I would wake up during the night starving and need to eat. It really depends on where you are coming from, how long and how intensely you have been dieting. So, do what you need to and don’t set any rules as really anything goes!

Can I recover my period on a vegan or vegetarian diet? What about gluten-free?

Another question women ask is if it is possible to recover on specific diets such as vegan or vegetarian, gluten-free. The answer to this is yes it is possible! However, I would recommend to examine why you are following this diet and if it is a way for you to continue to restrict then maybe it is time to reconsider. I personally recovered my period on a vegan diet but later decided to incorporate animal products back into my diet when I realised that this was still a way for me to control my food intake and keep my eating disorder alive. If you are following a particular diet for ethical reasons or due to a health condition then this is fine, just make sure you are allowing yourself to eat plenty of food, not restricting any macro-nutrients and find suitable alternatives for foods that are off-limits so that you don’t feel deprived mentally.

What if my diet is limited by digestive issues? Can I still get my period back on a restricted diet?

If the reason you are avoiding certain foods is due to digestive issues, it is for you to decide whether you want to add them back into your recovery diet. If you have allergies or intolerances then by all means stay clear of foods you are sensitive to. However I will say that many people on restrictive diets find that they develop food sensitivities over time and end up eliminating more and more foods from their diet. This is a sign of your digestive system shutting down and is a signal to increase the quantity and variety of foods in your diet not to continue to restrict further. I know that for me personally after following a high fruit vegan diet for over a year, I initially struggled with stomach pain, bloating and gas when adding grains and legumes back into my diet.

Unfortunately it takes time for our stomach acid, digestive enzymes and gut microbiome to re-establish after a period of “starvation” and it can take a while to settle out. Again, this is where eating processed foods comes in handy as they are much easier on our digestive systems. Things like crackers or rice cakes with nut butter, jam, molasses or hummus spread on top were so helpful in the early days of my recovery. I also ate a lot of cookies (dark chocolate hobnobs mmmm!), cereals and sandwiches and found they digested really well. Later on I drifted back towards a more whole foods diet but still ate plenty of these foods on a daily basis. The best thing is to listen to your cravings and experiment freely.

Do I have to eat processed food to get my period back?

What I will say is that processed foods are your friend and there is no need to be afraid of them. Foods such as bread, crackers, pasta, nut butters, milk, cereals and jams are easy to digest in large quantities and will help you to get the calories you need into your body without over-stressing your digestive system. Basically you want to increase the energy density of the food you are eating i.e. more calories per volume. The reason that a whole foods diet is so successful for weight loss is because your body can feel full on fewer calories due to the higher amounts of fibre and water in foods such as fruits and vegetables. This is great for people who need to lose weight and overcome conditions such as diabetes and heart disease but you are not one of those people. You need to give your body the energy it needs to repair and feel safe again and in this case processed foods are extremely helpful.

Something that helped me with adding “fear foods” back into my diet was realising that a healthy system is a robust one that can digest and thrive on a wide range of foods, not one that can only function on a very specific, limited list of foods. The aim of the recovery process is to rebuild a healthy metabolism so that your body can function optimally again. A person with a healthy metabolism can consume a lot of food and has energy to live an active fulfilling life. Visualise what you want from your recovery journey and focus on that every day to help you get through difficult choices ♥️

Over to you…

I hope you found this helpful and feel confident in how to eat to get your period back. Like this post and follow my blog for more period recovery content like this.

  • Let me know in the comments, what is the most difficult part of the “recovery diet” for you? And what is your favourite food that you added back in since starting recovery?
  • If you are looking for support, guidance and accountability on your period recovery journey, please contact me for further information on the nutrition and health coaching packages I offer. Together we will set you up with a plan to get your hormones balanced and you feeing your best mentally and physically.

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