What Should I Eat During Hypothalamic Amenorrhea Recovery?
Although what you eat is secondary to that you eat enough in Hypothalamic Amenorrhea Recovery, there are some things with regards to macros to pay attention to. The short version is: make sure that you don't exclude any food groups, especially not fats or carbohydrates. Carbs are given a lot of space in this post because an adequate intake is of extra importance in an Hypothalamic Amenorrhea Recovery context.
Since you read this, you are probably suffering from Hypothalamic Amenorrhea. As you know by now, Hypothalamic Amenorrhea is the result of under-fueling your body to the extent that it lacks the energy needed to function and support your body’s natural processes (like menstruation). My guess is that you have avoided and feared foods or entire food groups. No wonder, given the diet culture we are surrounded and bombarded by from all angles. A big part of Hypothalamic Amenorrhea recovery is to erase and rewind everything diet culture has taught you. There is no good or bad food! Eating should not be complicated. Instead, try to follow the following principle (easy in theory, difficult in reality; I've been there): give yourself permission to eat any and all foods, as you please and feel like.
Don't be afraid of carbs, don't overdo the fiber
Carbs are the body’s preferred energy source, including your brain’s main source of energy. Consuming carbs contributes to the production of the brain chemical serotonin, an important mood-boosting neurotransmitter. Further, carbs are the most readily available energy to support your body and its daily activities and bodily functions, as menstruation.
What? Are carbs involved in menstruation? Yes! They stimulate our glucose sensing neurons in the ovaries. Eating enough overall and eating sufficient carbohydrates tells these neurons to communicate with signal substances involved in activating Gonadotropin-releasing hormone (GnRH). This is a hormone made by a part of the brain called the Hypothalamus (as in ha Hypothalamic Amenorrhea). It causes the pituitary gland in the brain to make and secrete the hormones Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). Both these hormones are in turn crucial for ovulation.
The work of the carbs does not end there. When you eat carbs, they are broken down into glucose. Glucose can either be immediately used or stored in the form of glycogen. A low storage of glycogen due to a low a low intake of carbs reduces the availability of easily accessible fuel to the body (remember, carbs are the body’s preferred energy source). This has been showed to cause disruptions in normal pulses of - you guessed it - luteinizing hormone (LH) and elevations in cortisol, both strongly associated with the development of Hypothalamic Amenorrhea. This goes both way. When we eat (sufficient amount of) carbs, insulin is released to break them further down into glucose. This signals energy availability to our Hypothalamus, and GnRH is fired more often.
To put it short, if you’re not eating enough carbs, you’re contributing to your body’s state of stress, messing up your hormone production (including your menstrual cycle) and basically telling your hypothalamus it needs to signal power saving mode to conserve energy due to the famine it’s currently in.
Try to include carbs every time you eat, regardless of main meal or snack. Ideally, around 50% of your daily intake should come carbs.
What are some good sources?
Don't make things complicated! Your body doesn’t care what kind of carbs you consume. Bread, potato, pasta, quinoa, chickpeas, fresh fruit, just listen to your cues and give your body what it wants.
Fiber is also a kind of carb, however your body can’t use or store it as energy. If consumed in too large amounts, it can contribute to bloating and gut distress. Further, a high fiber intake has been associated with low estrogen level throughout the menstrual cycle and higher risk of anovulatory cycles. Lastly, fiber may bind to estrogen, causing the estrogen to be excreted instead of absorbed recirculated, which in turn leads to lower estrogen levels (another characteristic of HA). So don't overdo it with the fiber.
Fat supplies building blocks for female hormones
Fat supply the necessary building blocks for hormones, including estrogen and progesterone. It also helps to create healthy brain and nerve tissue. These players are all involved in regulating the menstrual cycle, so it should come as no surprise that a low fat diet is problematic in the context of reproductive health. Particularly if you are suffering from Hypothalamic Amenorrhea, eating enough fat is crucial for your recovery.
About 30% of your daily intake should come from fat.
What are some good sources?
If you are fearful of fats, an easy way to get more of them into your diet is to simply switch from low-fat to full-fat when it comes to yogurt, milk, cheese etc. Other good sources of fat are butter, red meat, oily fish, oils, avocados, nuts and seeds.
Proteins are important but don't overdo them
Proteins are the building blocks for our bodies. They help to synthesize hormones, enzymes, neurotransmitters, antibodies, muscles, skin, hair, nails and more. As an example, the need for protein has been found to increase during the luteal phase of menstruation when the endometrial lining is build up to prepare for a possible pregnancy. However, in my experience, getting enough proteins in is not that much of a problem for someone suffering from HA. Rather, you need to be mindful that your proteins don't crowd out fats and carbohydrates from your diet.
About 20% of your daily intake should come from protein.
What are some good sources?
I think you have a good grip on that already; chicken, eggs, seafood, beans, .... But also don't forget full-fat dairy and red meat.