How To Get Your Period Back After Restriction

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Last updated on November 8th, 2024 at 10:00 pm

Have you lost weight or restricted eating and are wondering how to get your period back?

Loss of a menstrual cycle otherwise known as hypothalamic amenorrhea can come with many mixed emotions as well as many health risks.

You might lose your period for many reasons including:

  • sports
  • eating disorders
  • illness or injury

The reasons for the loss of your period can be intentional or unintentional, but regardless not having a period is not normal. It is also very dangerous.

This article will walk you through why you may have lost your period, what is happening in your body when you no longer have a period, and how to get your period back.

Can an Eating Disorder Make You Lose Your Period

Losing your period is one of the warning signs of an eating disorder.

Food restriction will often result in a woman’s period stopping or changing significantly. Let’s talk a bit about why this happens, and how to get your period back after restriction. 

Restriction looks like: 

Physical Risks Of Losing Your Period

If you’ve noticed changes in your flow you are likely restricting your food or overexercising in some way.  When your period completely stops it is called hypothalmic amenorrhea

Risks with period loss include: 

  • Decreased bone mineral density
  • Cardiac irregularities
  • Psychological Disturbances
  • Reproductive Concerns
  • Compromised immune system
  • Hair loss

Those with eating disorders who have lost their period have a 60% increased risk in bone fractures.

Let’s explore what period changes occur during the active restriction, the recovery process and beyond.  

hypothalamic amenorrhea infographic

Hypothalamic Amenorrhea Causes

When you significantly reduce our food intake, excessively exercise, or purge a cascade of events occurs in our bodies.  This really is loaded with a lot of scientific jargon, so i’ll try my best to outline the process in a way that won’t make your head hurt. 

Here is what’s going down when you notice you have lost our period with restriction:  

  1. The body is suppressing something called ganadotropin releasing hormone (GnRH). It’s not important that you know how to say it-or even that you know the acronym.  But it is an essential component in the body for the feedback mechanisms involved in making estradiol. 
  2. Low GnRH causes low follicle stimulating hormone (FSH)
  3. Low GnRH also causes low luteinizing hormone (LH)
  4. As a result of all of these hormones being low- the ovarian granulosa does not produce estradiol.
  5. Endometrial thickening does not occur. Meaning we do not experience menses. 

In other words, our body is telling us that we’re STARVING, and making babies is not important.  So we stop getting a period. 

Our bodies attempt to conserve energy wherever it can, including slowing heartbeat and breaking down lean body mass. 

How Quickly Will I Lose My Period With An ED

This answer will differ for everyone. 

However, it’s important to note that a body weight below the BMI standards is NOT what determines whether menses is lost. We can see loss of menses at any body weight when we are restricting.   

While hypothalamic amenorrhea technically lasts for 3 or more months of continual missed periods, lighter periods or skipped periods is also a concern. 

How To Get Your Period Back after ED

To get your period back after an ED, you need to be actively doing these things: 

  • Weight restoring to your body’s natural blueprint. This does NOT mean what’s on the BMI scale.  It may look like your pre-eating disorder weight.
  • Period recovery may require going beyond the weight you stopped having your period. This is called overshoot weight.
  • Stop exercise until you are fully weight restored and your healthcare team states it is safe to do so. 
  • Monitor your stress.  Stress increases cortisol in your body, which can impact having your period. 
  • Get adequate sleep.  Poor sleep can increase cortisol levels as well influencing how long it may take to get your period back.  

It is unlikely that you will resume regular periods if we are missing one or more of these factors. 

It’s also VERY important to remember that you CAN resume your periods BEFORE you are fully weight restored.  

Infographic on how to get your period back after ed with light blue and pink clouds

Hypothalamic Amenorrhea Recovery Meal Plan 

There will not be a one-size-fits-all all meal plan to get your period back.  Your meal plan should be tailored to meet your specific needs for weight restoration with a treatment team that includes an eating disorder dietitian.  

One of the most important things to consider in an amenorrhea recovery meal plan is that it is safe to increase food intake in an outpatient setting. 

For some people, their food intake is so low that refeeding should occur in an inpatient setting for safety.  This is to prevent refeeding syndrome– a potentially life-threatening condition that can occur when too much food is introduced too quickly following starvation.

However, if it is deemed safe by the treatment team to increase food intake at home, you should expect the following in a recovery meal plan which will promote weight restoration to get your period back. 

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Hypothalamic Amenorrhea Recovery Meal Plan Basic Structure:

  • Breakfast (includes grains, meat, dairy, fruits and/or veggies and fats)
  • Snack 
  • Lunch (includes grains, meat, dairy, fruits and/or veggies and fats)
  • Snack
  • Dinner (includes grains, meat, dairy, fruits and/or veggies and fats)

You should plan to have meals and snacks no more than 4-5 hours apart. Recommended portions of each of these choices will be decided by the healthcare team. 

It’s critical to know that starting too low or too high in your recovery meal plan could be life-threatening. You should carefully work with your healthcare team to establish the right meal plan for you.

If someone is following a vegan eating disorder recovery meal plan, special attention will need to be given to sources of iron and B12.

To learn more about safely increasing food following restriction check out this eating disorder recovery meal plan.

period recovery meal plan infographic

Period Recovery Meal Plan Considerations:

Hypothalamic amenorrhea recovery meal plans will be different for everyone based on:

  • Age
  • Gender
  • Exercise level
  • History of weight loss
  • Length of time without a period

While in weight restoration, you could experience mental and physical discomfort. Unfortunately, the discomfort often due to gastroparesis in ED recovery is likely a necessary path to getting your period back and a normal part of the process.

Foods To Eat To Get Your Period Back

Foods with more energy per volume(high calorie foods) can make it easier for you to meet the high metabolic demands necessary to get your period back.

There is no one single food or group or food group that will cause you to get your period back. There are foods that might make it easier when included properly in your recovery meal plan.

Some good foods to include to help get your period back are:

  • Nuts and nut butter
  • Avocado
  • Ice cream
  • Added oils and fats
  • Butter
  • Full-fat yogurt
  • Protein shakes
  • Seeds
  • Red meats

These foods can be helpful if you are experiencing early satiety often associated with weight restoration because you won’t need to eat as much to achieve your nutrition needs for the day.

How Long Does It Take To Get Your Period Back After ED

It can take up to six months after fully weight restoring and eating to meet your nutrition needs to resume regular periods. It’s also VERY important to remember that you CAN resume your periods BEFORE you are fully weight restored. 

Factors such as experiencing hypermetabolism in anorexia recovery may impact how quickly your period returns as energy demands are very high.

The weight at which you get your period back is not a marker of where your body is being adequately nourished.  The time it takes to get your period back after an eating disorder will also depend on total calorie intake, exercise levels, stress and sleep.

infographic of period recovery foods

Should I Take Birth Control To Get My Period Back

No!

In fact, using birth control to get a period back can be very dangerous. 

While most birth control pills will result in blood flow during the “placebo” days, the hormones in birth control pills simply mask the absence of those hormones required to produce a period in our body. 

This is dangerous for a few reasons including: 

  • Your body requires energy to produce this placebo period.  This is often energy that cannot be spared, thus furthering the problems already common with low energy intake. 
  • The person with an eating disorder may think that they are weight restored because they are having a period. It tricks the eating disorder into thinking the body is “healthy.”
  • You and your healthcare team may miss the severity of your eating disorder. The underlying cause is not being treated (which is starvation) and your eating disorder could get worse!

The best thing you can do when attempting to resume your period is to restore weight properly with the help of a trained healthcare team.  

Hypothalamic Amenorrhea Recovery Signs 

Here are a few physical signs that you are about to get your period back:

  • Increase in body temperature. Those actively restricting in some often feel very cold and actually have a very low physical body temperature.  Take your temperature!  A normal body temperature can indicate your period is on its way. 
  • You’re getting hungry!  Regular hunger and satiety are good indicators the body is being fed and it can resume having a period.  HOWEVER, it’s important to know that not everyone who starts having regular periods again will have hunger and fullness cues.  Or these cues will likely still be heavily skewed by the eating disorder. 
  • You may notice an improvement in sleep.  Often when we aren’t having periods we’ll notice sleep disturbances. 
  • If you are having night sweats (common with restrictive eating) these may decrease. 
Infographic describing the signs your body may show when you are about to get your period back.

Having A Period After ED

Mixed Emotions Of Getting Your Period Back

There are often two competing voices when it comes to the way we feel about symptoms of recovery from an eating disorder.

One is the healthy self. When you get your period back after restricting, your healthy self will likely feel:

  • Accomplished! You’re on your way to recovery!
  • Safe- your body is no longer compromised
  • Healthy

On the other hand, your ED voice (eating disorder voice) is also probably having a lot of emotions about getting your period back. It may be saying:

  • It was sure nice to not worry about having a period
  • Now no one will know how sick you are
  • I don’t want to be “healthy,” I’ve worked so hard to keep my body the way I want it.

No matter what you are feeling when you get your period back, you are not alone! This is likely a time of mixed emotions.

Coping Tools for Getting Your Period Back

Some things that can help with the high emotions of getting your period back include:

It can also be helpful to look at some of the facts and myths that are common when it comes to eating disorders. Many of our negative thoughts around food and our bodies comes from not having all of the information we need to cover from an eating disorder.

You can recover your period and recover from your eating disorder with proper guidance and support!

 
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How Long Does It Take To Get Your Period Back?

It will take 6 months or longer to regain your period. Gaining your period usually requires weight restoration to your usual body weight or above your usual body weight.

What Are Some Hypothalamic Amenorrhea Recovery Signs

Increase in body temperature, hunger, decrease in night sweats if present, sleep improvement, spotting

What Does A Hypothalamic Amenorrhea Meal Plan Look Like

A hypothalamic amenorrhea meal plan will consist of three meals and three snacks per day. Meals and snacks should be no more than 4 hours apart. Hypothalamic amenorrhea meal plans will be different for everyone based on age, gender, activity levels and how much weight restoration is needed.

Shena Jaramillo. Registered Dietitian
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