Digestive issues and Hypothalamic Amenorrhea
Digestive issues is very common in Hypothalamic Amenorrhea. In this post I explain why this is and what you can do about it. I think it is an important topic to cover because many who experience poor digestion or IBS further try to restrict foods, which will push them further away from recovery.
What causes the digestive issues in Hypothalamic Amenorrhea?
Low energy availability
The main underlying factor behind your issues with bloating, IBS or stomachache is the same one as is behind Hypothalamic Amenorrhea: low energy availability. Your gut is a muscle, and it needs enough energy to function optimally. When there is a chronic energy deficiency the body responds by shutting down nun-essential functions to become more “energy efficient”. Breathing and pumping blood is more important than digestion or reproduction.
Your gut is an important part of your endocrine system (which regulates hormone levels in the body). The gut microbiome has a direct effect on hormone levels, and if there are more “bad” bacteria than “good” in your microbiome, you’ll likely have higher levels of stress hormones like cortisol (that contribute to Hypothalamic Amenorrhea).
Food restriction and low energy availability can cause a gradual decline in effectiveness of the gastrointestinal muscles. This causes a delay in the gastric emptying (‘gastroparesis’). This will result in feelings of fullness after eating a small amount, constipation, bloating, flatulence and abdominal pain. The body will also slow down digestion in an attempt to absorb as much as possible of the nutrients consumed.
Fiber and , ‘sugar-free’
Many of those with a restrictive eating behavior consumes a lot of foods causing bloating, as excess fiber, ‘sugar-free’ products and chewing gum.
How can you improve your digestive issues?
Regain your period
The good news is, just as Hypothalamic Amenorrhea, your digestive issues is a reversible condition. Just as with your menstrual cycle, your body will ramp up digestion as soon as the relative energy availability is in balance again. It will not be the menstrual cycle itself that resolves the digestive issues, rather the menstrual cycle is a sign that your body is feeling safe again. That it has enough energy available to prioritize non-essential functions. So the best thing you can do for your digestion is to work on regaining your period.
Reduce the fibers and be careful with artificial sweeteners and chewing gum
Many of those who suffer from Hypothalamic Amenorrhea seems to think that the more fiber the better. I believe this is a leftover of diet society that preaches about bulky non-dense food. The same goes for artificial sweeteners and chewing gum, that often is consumed to distract away from hunger. This will contribute to bloating and discomfort. Instead, try to not overdo the fibers, and reduce your consumption of sweeteners. This will also help you reach your caloric goal and thereby your recovery.
Eat more energy dense food
If you eat more energy and nutrition dense food, your bowel will be less filled up you will feel less bloated. I am not saying you should eat fast-food every meal if you don’t feel like it. But there are some great nutrition dense foot items as fat fish, nuts, avocado, full fat dairy products, which will make you feel satisfied as well as contribute with great vitamins and/or essential fat acids without taking up too much space. In my post What Should I Eat During Hypothalamic Amenorrhea Recovery? You can read more about what kind of foods that are advisable during recovery (and beyond).
Add liquid calories
If you don’t feel hungry and/or struggle with bloating it could be reasonable to add in liquid calories to your daily intake. These calories are easy absorbable and will not contribute to discomfort or gut stress.
Wear comfortable clothes
Make sure you ware clothing in general, pants in particular, that makes you feel confident. When clothes are too tight, it can be a trigger. You may feel something is wrong with your body, when in reality it is the size, fitting or design that is the problem.
Remember, the end goal of Hypothalamic Amenorrhea recovery is for you to feel at peace with food, restoring a healthy menstrual cycle, fertility, bowel function and ultimately allowing your whole body to heal! Feel free to contact me if you are interested in working with me.