How to eat to get your period back
It can be really confusing and scary if you’re expecting and hoping to get a regular period every month and you are not, and it can be devastating if you are trying to get pregnant. Western medicine is a bit behind at the intersection of eating disorders and women’s reproductive health. Ok, a bit behind is just me being nice. Our system is failing women because our preoccupation with thinness clouds our vision and can cause us to miss what’s going on with one’s health and hormones. This article is to help you understand the common nutritional reasons someone may lose their period (known as amenorrhea), and give you guidance on what to eat to get back to a healthy, normal period.
So if you’ve been to the doctor and all they offered you was birth control, read on my friend. You are not alone and there is another way.
The menstrual cycle
For women and people with uterus’, having a regular monthly menstrual cycle is a sign of health. The period is commonly referred to as the 5th vital sign, and for good reason. A missing period means abnormal estrogen function. Since estrogen impacts so many part of the body, it tells us a lot about someone’s overall health – not just their reproductive health.
If you are not having a period, it is important to seek out a doctor that specializes in hormone health. A reproductive endocrinologist would be a good bet, or a dietitian who specializes in women’s health and eating disorders. If an absent period (amenorrhea) goes on too long, it can lead to serious health consequences.
Why you may lose your period – knowing why You lost yours is key
Missing a single period cycle could be a sign of a significant life stress, perhaps travel or a big life change. If this happens to you and your period returns the following month, it’s wise to take a look at how much you’re trying to ‘grind’ your way through life and try and find more ease, rest, and balance. But if you miss your period for more than three months in a row, there is likely something deeper going on.
Zoom out and take a look at the bigger picture in order to figure out what you need to do to get your period back.
Why your period might disappear:
- pregnancy, breastfeeding
- birth control pills
- medications including chemotherapy
- celiac disease or type 1 diabetes
- lots of stress
- weight loss (even if you don’t become ‘thin’)
For this article, I am going to talk mostly about hypothalamic amenorrhea (HA) – often caused by the last four on that list. Even though weight loss is often touted as a healthy and desirable change to your body, it can actually wreak havoc on your hormones, for some more than others. While weight loss is not the only reason someone could develop HA, it is very common. If this is resonating with you, know that you can get your period back after weight loss by working on your relationship with food and body image. And you deserve nothing less.
Hypothalamic amenorrhea (HA)
Hypothalamic amenorrhea (HA) occurs when the hypothalamus, a small but mighty brain region, reduces or stops releasing gonadotropin-releasing hormone (GnRH). GnRH is key in initiating the menstrual cycle, and its absence leads to reduced estrogen levels, affecting the menstrual cycle. This can happen for many reasons including significant weight loss (but sometimes as little as ten pounds), excessive exercise, or high levels of physical or emotional stress. If you exist in this state for long enough, the body’s natural menstrual cycle is disrupted, leading to missed or irregular periods.
If HA is present for an extended time, your whole body can take a hit with high cholesterol, low bone density, fertility problems, and anxiety and depression. HA can happen to women at any body size. Because this is not widely know, HA is often missed in women in larger bodies, and why it may be incorrectly diagnosed in women who are thin.
Hypothalamic amenorrhea is when you previously had a period and then it disappears for 3 months or more. You can lose your period, or it can become irregular, if you lose weight even if you never become ‘thin’ or have a low BMI. If you haven’t heard my explanation of why the BMI is so problematic and unuseful, you can check that out here.
Click here to skip to the food and lifestyle tips below on how to eat and exercise to get your period back, whether you’ve experienced weight loss or not.
Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a complex metabolic and hormonal condition. Symptoms include abnormal hormone function, metabolism, hair growth, mood changes, several of which can affect menstruation. Cysts on the ovaries cause irregular or absent release of eggs on a monthly basis, leading to absent or irregular bleeding. The other main components of PCOS are insulin resistance and inflammation, which can exacerbate irregular periods and lead to the systemic effects of PCOS.
Periods can certainly be awol or missing with PCOS. I’m not focusing on PCOS in this post, but I will say this. Women who are in smaller bodies can have PCOS and women in larger bodies can have HA. Blood work is essential in figuring out which of these you have, because the recommendations that are commonly given with PCOS (even if problematic, see this) can exacerbate HA. Make sure to ask your doctor to make sure they have the right diagnosis, no matter your body size.
If you do have PCOS and your period is missing, check out this article on some non-diet ways to figure out what to eat to get your period back.
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. These fibroids can cause a hormonal imbalance or physical obstruction in the uterus, causing irregular, missing, or heavy menstrual cycles. While the exact cause of fibroids is unknown, they are believed to be linked to factors like hormonal changes, genetics, and other growth factors. Heavy bleeding is more commonly associated with fibroids, but I have seen clients lose their periods and have fibroids.
Dieting, body size, and period loss
An alarming percentage (70%!) of women struggle with disordered eating and body dissatisfaction. As far as I see it, there are two ways to look at this:
- Most women need to change their bodies by restricting their diets and suffering the physical, emotional, and mental consequences of this.
- The culture of thinness and perfectionism is harming women by telling them they need to change their bodies and causing them physical, emotional, and mental health problems.
Which seems more likely to you?
In recent years, diet culture and wellness culture had popularized the idea of ‘healing your hormones’ by cutting out foods, taking fancy supplements, and going on restrictive and “clean” diet plans. Problem is, most of these recommendations are based in pseudo-science and frankly, can do harm by causing eating disorders.
Women are often vulnerable to these messages. The intense cultural conditioning that we need to be thin and perfect in order to be happy, plus fertile mothers in order to be “good women” can lead many to follow harmful advice and get sucked into disordered eating.
Our hormonal systems do not happen in a vacuum. They happen inside of our lives. What I mean is this: you cannot micromanage your diet and restrict your eating and not expect that to take a toll on your health. The more you adhere to diet culture, the more likely you are to experience the health problems that undereating and obsessing about your diet can cause.
Losing your period can result from nutritional reasons, or because of stress that diet culture can cause. So the solution is different for everyone. Someone people who have lost weight may need to gain weight in order to get their period back. It’s the hard truth. Take a look at what you’re eating and how you’re thinking about food and your body to figure out what you need to do – and eat – to get your period back.
Intuitive Eating Mini Course
A free 5-day mini audio course (and workbook!) delivered strategically to your inbox, one lesson at a time.
Figure out what is standing in the way of you eating with peace, confidence, and intention.
Quit dieting and find freedom.
Many doctors and other healthcare practitioners that work in the weight-centric realm may miss a diagnosis of hypothalamic amenorrhea in a larger bodied person or PCOS in a smaller bodied person because of weight bias. Even though research has shown for decades that weight-loss interventions do not work, old schools ways of thinking are deeply entrenched and uprooting long-held beliefs is difficult.
People in larger bodies are told to lose weight or eat less to get their period back, but this can exacerbate the problem. The outdated BMI scale is still used to prescribe weight loss and gatekeep for a whole manner of health issues, despite plenty of evidence that weight is not a good indicator of health.
This can be really damaging because often those with a PCOS diagnosis will be told to exercise more and eat less, which is the exact opposite of what someone with HA needs, even if they are ‘overweight’. Our culture is just so sure that weight loss ‘works’ despite so much evidence to the contrary, so many people go undiagnosed, incorrectly diagnosed, or improperly treated.
This hits women especially hard. If you want to read another great blog post on the topic of period loss and weight, check this out from Robin Nohling, RD, NP.
Wellness Culture and Pseudo-Science
If you live on planet Earth, you are aware that we are all obsessed with food. You cannot attend a dinner party or be in the presence of food without hearing 100 different stories about what diet someone is on, what food they “can’t eat”, or how they’re “being bad” for allowing themselves to eat pizza.
As I’ve talked about extensively, I find all of this to be boring. But that’s not the main problem – it’s harmful. Trying to eat perfectly and blaming ourselves for not doing so is not actually improving our health or our diets. It’s just causing more stress and anxiety. All of the obsessing about eating perfectly has actually created a new eating disorder – orthorexia.
Orthorexia is an extreme version of what can happen if someone ends up stressing out way too much about what they eat. This is a overly simplified explanation, however. The truth is, women with HA are more likely to feel beholden to perfectionism, which is extremely stressful on the body. For the most part, and for the majority of people, the minute details of what you eat are not the key to getting your period back.
Missing period myths
Unfortunately, doctors often prescribe birth control pills to help someone bleed on a monthly basis or to regulate their hormones, but this is not helping your body restore it’s natural hormones, even if it does give you a monthly bleed. Sometimes synthetic hormones are given, which can be helpful, but not nearly as helpful as bringing your body back into homeostasis by learning to nourish yourself enough and consistently.
Another common myth with hypothalamic amenorrhea is that it only happens to women with anorexia. That is just simply not true. HA is more common in underweight individuals, but we see lots of people at all body sizes losing their periods because of energy deficits. When someone has experienced weight loss, no matter their resulting body size, some amount of weight gain is often needed to get their period back. Our bodies are not all meant to be thin, and this is excellent proof of that.
How to eat to get your period back
If you have lost your period, the following tips are here to help you feel confident in what to eat, how to exercise, and the other factors to recovery your period. Getting your period back by taking care of your nutrition takes an average of 6 months, and sometimes more. It takes patience and isn’t always easy, but you can definitely do it!
Getting your period back is essential for Whether you want to get pregnant or not, for your overall health. Here are some of the main nutrition and lifestyle tips for recovering your period, especially if you’ve been under eating or over exercising.
Adequate and consistent nutrition
In order to get your period back, it’s essential to eat enough to restore energy balance. This means getting your body out of an energy deficit at all times of the day. This usually means eating a full, balanced breakfast, lunch, and dinner each day. Those meals need to contain about 50% carbohydrates, 20% fat, and 30% protein. Most people who have lost their period due to HA also need snacks in between their meals.
Eat breakfast within an hour or two of waking up, and then eat every 2-5 hours after that, aiming to follow your hunger.
According to a leading HA researcher and the author of No Period, Now What?, a minimum of 2500 calories is essential to recovering your period. That may sound like a lot if you’re currently restricting your calories, but I promise you – it’s not. Your body needs every bit of it.
You will need even more calorie if you are exercising every day, are very underweight, or have recently lost a significant amount of weight. It could be more than you think you need, or than diet culture has led you to believe you need. Our culture’s obsession with thinness has given most of us an unrealistic idea of what a normal amount of food is. Not to mention what body size is appropriate for most people.
The truth is that body diversity is real, and it’s possible you will need to gain weight to get your period back and get back a healthy menstrual cycle. Remember, your cycle is a sign of overall health. You can trust it. But please also remember – THIN DOES NOT EQUAL HEALTHY.
If this is difficult for you to hear, send yourself some compassion. I suggest getting help with your relationship with food and your body from an eating disorder specialist who practices from a weight-neutral lens.
Be honest with how restrictive you are with food
Having a restrictive mindset around food can mean limiting certain food groups, not allowing yourself to eat past a certain number of calories or time of the day, or it feeling like you need to ‘make up’ for what you eat by exercising more. This is disordered eating and can affect your body – and your period – in two ways. It can cause you to have inadequate nutrition, and it can cause a lot of stress.
Do not eliminate or even limit any macronutrients. Cutting carbs or fat out of your diet is not good for your hormones. Your body is a fine-tuned machine, and it needs enough carbohydrates, fat, and protein every day. It is the fat in your diet that is converted to hormones and the fat in your body that produces estrogen. You cannot fool your metabolism by eating more celery. The food you take in makes up the ingredients your body uses to make your hormones – and your period – function.
You want to let go of the food rules you are following, loosen the reins on when and what you eat. Give yourself unconditional permission to eat what you want when you’re hungry. Again, if this feels like crazy talk to you, read up on intuitive eating.
If you’re been dealing with an eating disorder or disordered eating, it’s normal for this process to feel difficult. That is how eating disorders work. They trick your brain into thinking that controlling your food, micromanaging the details of your diet, or just stressing about food is keeping you safe.
Focus on good quality sleep
Not getting enough sleep can directly impact your hormones. Aim for 7-9 hours of sleep per night. I literally talk about sleep hygeine with every one of my clients. If falling asleep or staying asleep is difficult for you, check your anxiety, your caffeine, and your late night habits to see if there are tweaks you can make to allow for better quality sleep.
Limit intense exercise to restore your period
Exercise is a key element in period and hormone health because it greatly affects energy balance. As Dr. Nikola Sykes gathered in her research, some women who are doing what we may think of as a healthy amount of exercise were still falling into the HA zone and losing their periods.
Working toward goals and increased strength, speed, or distance is exciting and there is nothing wrong with that. If you have lost your period and you are exercising regularly, it’s critical that you explore toning down. You need to find ways to make gentle movement feel good to you. Gentle walking, yoga, or stretching are some wonderful options.
This doesn’t have to be forever. Once your period has recovered and been normal for three cycles, you can gradually return to more exercise. Make sure you go slow and keep up your nutrition. Just because your period came back one month, does not mean you can go back to your over-exercise and light eating.
Get your period back by reducing stress response
Stress can play a big role in keeping a period absent because of the way that stress affects our hormones. The hypothalamic-pituitary-adrenal axis, or HPA-axis, is our brilliant body’s way of managing and handling stress. When we are experiencing lots of stress, may that be a job loss or loss of a loved one, upcoming graduation or wedding, or every day things like stressing about what to eat, your HPA-axis can be affected by increasing cortisol production.
There are countless ways that our modern lives create stress for us on a daily basis. Make sure you aren’t downplaying the stress you’re experiencing is normal. Just because something is common, does not make it healthy or ‘normal’.
Take a look at how much you worry about things like work, your family life, your food and exercise routine. People pleasing and perfectionism are common with women as we’re held to impossibly high standards. We’re expected to to ‘do it all’, while looking perfectly and acting perfectly. You may not even notice this in your life. That is how it works.
If this resonates with you, I recommend taking a look at the beliefs you have about how you ‘should’ be. One wonderful book I read recently on the topic, On Our Best Behavior by Elise Loehnen is fantastic.
Explore Emotional Eating (too much or too little)
We may think about emotional eating as just ‘overeating’, but it can often be undereating as well. Anxiety and stress can reduce your appetite, making eating feel difficult.
But emotional eating is often misunderstood. Often, folks who feel like they are often eating emotionally are not actually eating enough throughout the day. If you’re skipping breakfast and ‘eating light’ for lunch and then find yourself binging in the evening, try eating more throughout the day first.
Try and get up to a consistent routine of breakfast, lunch, dinner, and a snack, and see if the emotional eating subsides. If you’re still often eating when you’re not hungry for emotional reasons, you’ll want to look at the underlying issue in order to soothe yourself. Sign up for my newsletter if emotional eating is something you struggle with. I talk about it a lot.
Foods to help recover your period health
The most important thing when trying to recover your period is eating ENOUGH. Eating calories, enough carbs, and enough fat. But in addition to that, here are some gentle ways to think about adding extra oomph to your hormone health:
Good quality fats
Fat has a direct line to your hormone metabolism, so don’t skimp on it. Try adding in some of these items to your meals to amp them up with those food fats.
- nuts and nut butters
- full fat dairy such as milk and yogurt
- olive oil and other plant-based oils in cooking (aka don’t skimp on salad dressing or drizzling olive oil on top of your soup)
Make sure that your meals contain about 50% carbohydrates. They are good for your body and essential if trying to get your period back. Some nutritious options include:
- oats and oatmeal
- whole grain bread (or white bread if you don’t like whole grain – it’s fine!)
- potatoes and sweet potatoes
- rice, pasta, and other grains
- beans and lentils
Iron helps your metabolism function properly and oxygenates blood, which gives you energy. Add iron-rich foods like beans, green vegetables, and fish, poultry, and meat to your diet at least once a week.
Omega-3 Fatty Acids
These fatty acids found in fish and fish oil, as well as walnuts and flax seeds, support your body’s overall hormone system. These are especially helpful if you are missing your period due to PCOS, since they are an anti-inflammatory food and inflammation is one of the core components of PCOS.
As you have probably heard, folic acid is essential for conceiving and having a healthy baby. This is because our cells needs plenty of folic acid to replicate, which is happening quite a lot when you’re growing a baby. We get folic acid from green vegetables, but a lot of our foods are fortified with folic acid these days, which is also great for you and your body.
- leafy greens like kale, collard greens, chard, and spinach
- beef and chicken liver
- fortified grains and cereals (look for those that say fortified with folic acid on the label)
We get vitamin D from sunlight and our skin, but it is also available to some extent in foods. Spending 15 minutes outside each day is a smart idea, but it’s really smart to take a supplement as well.
supplement can be like a bonus for getting your period back
- 10g/day ground flax seed
- Acetyl-L Carnitine
Pregnancy after period recovery
It is absolutely possible to get pregnant after recovering from hypothalamic amenorrhea. And I hope you do.
It’s wise not to be too meticulous about not gaining too much weight during pregnancy, especially if you have a history of HA or an eating disorder. Because we live in a fat-phobic society that refuses to fund adequate research into weight stigma, we often hear recommendations to not gain ‘too much’ weight during pregnancy. But the research is poor on this and miscarriage rates are higher if you do not gain enough weight. And if you’ve had HA, you are increased risk of this.
It is very important that this not be your first concern. You need extra calories – lots of them! – when you’re pregnant. Do not listen to calorie counter apps that tell you how much to eat while pregnant. Follow hunger signals. Set up an appointment with me and we can make sure you’re eating enough.
Hooray! You got your period back. Great news. Now your job is to keep it. Keep up the increased food intake, calming exercise, good sleep, and stress management for a minimum of three months after your period returns. One cycle is not enough.
If pregnancy is your goal, it is especially important to keep it up. Everybody is unique and so is how long you’ll need to follow the exact plan you went on to recover.
When recovering from HA or from an eating disorder, our bodies need time to find homeostasis again. We need time for our nervous systems to realize that we will not be starving them again. Once your body stops stressing about food, and you feel good physically, that’s a good sign that you are recovered. That said, these strategies may need to be something you work on, even if subtly, for many years. Remember this: the problem didn’t occur overnight, so it won’t go away overnight either.
Recovering from hypothalamic amenorrhea is a journey of tuning into your body’s needs and creating a nurturing environment for it to thrive. It’s about balance, moderation, and self-care. Remember, every woman’s body is different, and what works for one may not work for another. Be patient with yourself and seek guidance from healthcare professionals when needed.
If you want help getting your period back and maintaining it so you can sustain a healthy pregnancy, I’d love to work with you. I specialize in women’s reproductive health and eating disorders. Book a discovery call to talk about working with me 1-1 to heal your period and take back your life.
I’d love to hear what you thought of this post below!
Emily Van Eck, MS, RDN specializes in intuitive eating, mindfulness-based eating practices, embodiment with food and movement, and healing from years of weight-bias and disordered eating. She helps womxn find balance, consistency, and peace with their eating habits so they can feel confident to get outta their heads and into their bodies. Emily is a registered dietitian and certified intuitive eating counselor with a master’s degree in nutrition science. Read more about her here.