Hypothalamic Amenorrhea and How To Exercise

I get asked this question A LOT. Especially since Sarah Wilson kindly posted my story on her blog. I think, inherently, we are all a little voyeuristic. A little pervy. Wanting to know the intricate details of other peoples’ lives. Or perhaps we just want a little guidance or confirmation that we are doing the right thing. Either way, I have decided to share how I approached exercise as I was healing from hypothalamic amenorrhea.

Peeping Toms in Tokyo, 1951. Image via pinterest by sahua d

First, know this: hypothalamic amenorrhea (also referred to as the Female Athlete Triad) is often a result of over-exercising and/or under-eating, which leads to an overall negative energy balance for an extended period of time. The body senses that you are, essentially, starving and says “Righteo, no energy for reproduction, then” and bids farewell to your monthly lady holiday.

So, taking this into account, you can see that exercise is perhaps contraindicated in the treatment of hypothalamic amenorrhea. Right? Right! 

Chronic exercise = no good. BUT movement = good!

Prior to actually deciding to do something about my infertile situation, this is what my exercise looked like: 

• Monday: Body Attack (1hr) followed by Body Pump (1hr). I might have walked ~1/2 -1hr too
• Tuesday: Maybe a walk, maybe a weights session (maybe both), maybe a cardio session
• Wednesday: Body Attack (1hr)
• Thursday: Body Step (1hr), ½-1hr walk
• Friday: Body Attack (1hr), weights (1hr)
• Saturday: Body Step (1hr) – every second Saturday
• Sunday: Body Step (1hr)

Holy crap. I am exhausted just looking at all of that! So much time wasted in the gym! Granted, it was my job, which made it more “legitimate”, I suppose, albeit no less damaging to my health and fertility.

I realised that this was unsustainable and would leave me in my infertile state if I were to continue. 

Yes, thank you for your wisdom, Albert. For a while, I was insane. I thought I could just throw herbs and vitamins at the situation and it would sort itself out. But, after spending thousands of dollars (literally), I realised this approach was no bueno. So here is what I did…

I progressed quite gradually, and it helped that it coincided with my dietetics placement, so I had an excuse to no longer teach a lot of my classes.

Stage 1

• Monday: Body Pump
• Tuesday: Walk
• Wednesday: Weights (functional training 1hr)
• Thursday: Yoga
• Friday: Weights (functional training 1hr)
• Saturday: Body Step (every 2^nd weekend)
• Sunday: Body Step

 A considerable change, but probably not enough. Cue stage 2.

Stage 2

• Monday: Body Pump
• Tuesday: Walk/yoga
• Wednesday: Weights (8 minutes – YES, you read right EIGHT minutes – 8 sets of 3 clean and presses; sets 1 min apart)
• Thursday: Walk/yoga
• Friday: Walk/yoga, maybe a Tabata session (4mins of cardio)
• Saturday: REST
• Sunday: REST

Although it was tough (mentally), I stuck to this routine for quite some time (until my period returned), gradually adding in more yoga (vinyasa/yin/hatha NOT bikram/ashtanga) and taking out the Body Pump. As I have previously mentioned, I found the yoga incredibly beneficial to the healing process as it allowed me to focus more on my body’s ability, rather than its aesthetics.

So, now that my cycle is getting back on track, how do I exercise? Well, it depends. I try and get outside as much as possible for a gentle walk/hike, as I now live in the nature-lover’s playground:

Image by Lake Wanaka Tourism

But if it is raining outside, and I feel really good, and my stress levels are low, my week might look like this:

• Monday: Weights (1hr - 10 min mobility warm up, 30 min weights, 20 min stretch/yoga)
• Tuesday: 1hr yoga
• Wednesday: Body Pump
• Thursday: Tabata
• Friday: 1hr yoga
• Saturday: Hopefully the rain has stopped by now and I can go for a hike!
• Sunday: Rest

Note: I do at least 30 minutes of yoga every day in the morning. It grounds me and sets me up for an awesome day.

Now please note, this was MY journey. This gives you a general idea of what worked for me. It may or may not work for you. Listen to your body. If you have exercise/stress/lack of food-induced amenorrhea, then you probably need to pull right back on the exercise to start with, then take baby steps along the way, depending on how everything is tracking along.

If this is all too overwhelming for you, I get it. My hubby (who is a PT and peak performance coach) helped keep me on track. Everyone needs someone. Feel free to shoot me through an email via my website if you would like to book a consultation for some more structured, personalised guidance that will help you get your sexy back.

Final note – as always, be kind to yourself. x

Period Party!

Image by Laura C George via pinterest

A few months ago, it was suggested that I undergo a procedure known as a “HyCoSy” to check for any structural problems with my lady garden, given I had not had a period in two years (which you can read more about HERE and HERE). They say that you may experience “mild discomfort” during the procedure and that you should consider taking pain-killers prior. Having had this done, sans pain-killers, all I can say is, don’t be a hero – take the drugs – the “discomfort” is more than “mild”. I’m not going to go into the gory details, but you can read more about HERE if you want. It was traumatic, to say the least. 

So anyway, post-procedure, I was lying on the bed/chair thingy, half-naked and wanting to throw up and/or pass out, and the doctor informed me that:

“You have PCOS (polycystic ovarian syndrome). You aren’t going to get your period back and you probably won’t conceive naturally, so we’ll start you on injections and then you’ll probably need IVF”.

Here's a picture taken from that moment: 

Image via http://blogs.voanews.com

 Talk about bedside manner. What a douche!

As you can imagine, this wasn’t the easiest thing to hear. I got home and I lost my shit. Big time.

After a few days of feeling sorry for myself I thought I should take a look at the images of my baby-maker. What I discovered was that I did not have PCOS, but normal, healthy ovaries in the follicular phase, which was confirmed by my GP and naturopath. Woo hoo!

In other news, while I was in Broome, I got my period back! So it turns out that this trusted gynaecologist, in one of Sydney’s best ultrasound clinics, was wrong. And did I mention he was a douche?

It just goes to show that, when it comes to your body and your health, QUESTION EVERYTHING and don’t accept anything as gospel.

OK let’s back up – I got my period back – in outback Western Australia! I’m pretty sure my dietetics supervisor thought I was crazy when I exclaimed 

“You don’t understand how EXCITING this is!!!” 

And it was! I can’t explain the feeling, but it was like I felt like a woman again. I know all of you ladies out there with a regular period are scoffing at me right now, and all of you guys have either stopped reading or are thinking I’m a weirdo. By the way, kudos to you, boys, if you are still here!

It all suddenly made sense why I had completely devoured a whole block of Green & Black’s chocolate the night before. And why my skin was breaking out. And why I cried watching “How I met your mother”. Seriously?!

So what triggered the return of my lady-time that had been MIA for so long? Well, I think it was probably a combination of things, but I don’t think it was any coincidence that it came back while I was in Broome AKA “most relaxing, laid-back, picturesque getaway spot in Australia” (you can check out my pics from Broome, and a yummy recipe HERE). I embraced “Broome-time”, which involved……not much. Not much at all. And that’s the point. I said enough is enough, stopped trying to do everything all at once and calmed the f#@k down.

A typical day looked like this:

6am: Rise with the sun. Walk to Cable Beach. Do 15 minutes of yoga or a quick Tabata workout. Go for a swim in the ocean (this became a little less relaxing after a 4m salt-water croc was sighted on the beach). Meditate. Walk home

7:15am: Eat breakfast. Slowly.

8:10am: Go to work

4:30pm: Come home. Walk to beach. Swim. Watch sunset. Walk home.

6:30pm: Dinner.

7:30pm:Maybe a little work for Sarah Wilson’s I Quit Sugar. Maybe nothing.

8:30pm: Bed

9pm: Sleep

I spent lots of time by myself. And I spent plenty of time with some of the most beautiful, generous people I have ever met.

I’m sure to some, this looks pretty boring, but it was clearly what I needed.

Now I’m under no disillusion that this is achievable for everyone. I’m back in Sydney now and it all seems like a distant memory and, unfortunately, so is my period – MIA again, but I’m confident it will return when the time is right.

So if, like me, you don’t live in Broome and are having some lady-problems, here are a few things I would suggest:

1. Eat. And eat regularly. Every 3-4 hours have something small to eat.  And don’t cut out carbs. Why? If we leave it for too long, our blood sugar will drop. When this happens, cortisol, our stress hormone is released to bring blood sugar back up. This happens at the expense of our sex hormones (oestrogen, progesterone and testosterone). Eat!!
2. Practice yoga. I highly recommend the “YogaStudio” app for iphone or ipad. Not only do I feel this has helped my body, but it has worked wonders for my head. As I have mentioned, I have put on ~7kg this year, all in the pursuit of fertility. I have struggled with this, having previously been quite athletic-looking. Yoga has helped me focus more on my body’s ability rather than its aesthetics. I know how this sounds – like I am one of those crazy yoga hippies. Maybe I am. Whatever.
3. Walk around bare foot. Speaking of crazy hippies. It’s called “earthing”. It feels amazing. On that note – just get out and into nature more. Climb some trees, swim in the ocean, make sand angels, whatever floats your boat. Just don’t spend all of your time inside. It’s stifling, in more ways than one.
4. Go to bed early. Stop playing with your phone/computer/ipad at least an hour before you go to bed to help your body wind down.
5. Sleep in a pitch black room to allow adequate production of melatonin, our sleep hormone
6. Enjoy social time. Drink a little red wine. Play – lots!
7. Have sex. Often, if you can. Not only does this promote blood flow to our lady-bits, but also helps reduce stress. Winning!
8. Exercise, but not too much.
9. Cut out caffeine. Sorry, but this can really mess with your hormone regulation.
10. Speak to yourself as if you were speaking to your best friend. Would you tell your best friend “you’re fat”, “you’re ugly”, “you’re not worthy”? No? Then why tell yourself that? Your body has done more for you than ANYONE else will ever do.
    
11. Get help. I can’t thank the gorgeous naturopath Kate from Kore Wellbeing enough for all of her support.

My final word of advice would be this: don’t wait. Don’t wait until you decide you want to have babies to fix your period problems. If you do, it becomes all-consuming. And as much as you try to not let it, it can start to take over your life. It saddens me that so many girls accept menstrual irregularities as normal. It’s not! The time is right NOW to fix it. Not tomorrow. Not next year. NOW!

Oh, and just a little gratuitous shot to show that an extra 7kg isn't so scary:

Weird angle - my head looks very disproportionate, but you get the picture.