When Should I Eat During Hypothalamic Amenorrhea Recovery?
Although timing your meals is secondary to that you eat enough calories, when you eat does indeed play a role in Hypothalamic Amenorrhea Recovery. In this post I explain the importance of eating regularly during Hypothalamic Amenorrhea Recovery (and beyond).
As explained in my post What is Hypothalamic Amenorrhea (HA), your body has entered a power saving mode because it has the feeling it is under a significant stress (caused by under-eating and over-exercising). This is a really clever reaction of your body. The hypothalamus is detecting that it currently is not safe for your body to have a baby. As soon as the body feels safe again, it will ramp up all the functions back to normal - including reproduction, a.k.a. your period.
Energy availability throughout the day makes the body feel safe
If you are going for long or short periods of time without food, maybe even fasting, you are adding to the stress your body is already sensing. This will cause a downward spiral, where the body is producing even more stress hormones like cortisol. It can be enough to wait too long with breakfast after waking up for your body to detect a famine state, a.k.a. danger. This micro energy deficit will interfere with your recovery.
One study on danish athletes came to the conclusion that energy balance across the day plays a role in the context of menstrual disturbances. The researchers found that athletes suffering from menstrual dysfunction spent more time in a catabolic (fasted), or micro deficit state, compared to participants without menstrual disturbances, although there were no differences in energy balance and availability seen over the day. Those atheltes who spent more time fasting showed a lower resting metabolic rate, lower estrogen and higher stress hormone levels (as cortisol). Gonadotropin-releasing hormone (GnRH) is a hormone produced by the hypothalamus in the brain. It is involved in reproductive function by regulating hormones like LH and FSH. GnRH is fired on an hourly basis to check the overall status in the body ("are we safe?"), and thus these micro deficits at specific time points throughout day could be enough for the hypothalamus to detect stress and low energy availability (which causes Hypothalamic Amenorrhea).
When we eat a sufficient amount throughout the day, this signals energy availability to our hypothalamus, which is what we want and need to recover from Hypothalamic Amenorrhea. Energy availability throughout the day, without micro deficits, is a pre-requirement for our body to feel safe again.
Eating regularly helps you hit your daily minimum
As explained in How Much Should I Eat During Hypothalamic Amenorrhea Recovery? we want to consistently eat AT LEAST 2500 kcal per day. Coming from a restrictive or disordered eating, it might be challenging getting these calories in. Even more so if you only allow yourself three or four meals per day. You need to eat regularly to allow yourself to meet your needs. Aim for:
Have breakfast within 30 minutes after waking up, before coffee or exercise.
Eat about every three hours throughout the day. This means
3 main meals (breakfast, lunch, dinner)
3-4 snacks between main meals (see my Snack Guide for inspiration)
If you have an early dinner, make sure you have a snack before going to sleep. By this you avoid that the time between last food in the evening and first in the morning gets too long
I know the thought of eating "so many" times per day can feel a bit overwhelming. You don't have to implement the necessary changes on your own. I am here to help, support and guide you. Just reach out to me if you want to work with me.