Missing Your Period? What Functional Hypothalamic Amenorrhea Means for Hormone Health
For women living with PMDD or other menstrual health challenges, changes to the cycle can feel especially unsettling. When your period disappears altogether, it’s not just confusing—it can feel like your body has gone silent on you.
The medical name for this is Functional Hypothalamic Amenorrhea (FHA). It happens when the brain senses that the body doesn’t have enough energy or safety to sustain reproduction, so it shuts ovulation down.
The consequences are very real. Women with FHA often experience fatigue, mood changes, low libido, hair thinning, and even bone loss. For many, fertility concerns are part of the picture too.
When a “Healthy” Diet Isn’t Enough
As a naturopath specialising in hormone health and PMDD, I often see women who eat what looks like a very balanced diet. On the surface, everything appears “healthy.” But when we look more closely, it becomes clear that the body isn’t actually getting enough fuel to thrive.
One woman I worked with hadn’t had a period in over two years. Blood testing confirmed her hormones had dropped to very low levels. When I looked at her food intake, the issue was obvious: her portions were far too small to sustain her body.
We increased her nutrition to a truly nourishing level, and I prescribed a personalised herbal formula to support her endocrine system. Within weeks, her cycle returned after years of absence. She later went on to conceive and give birth to a healthy baby girl—a transformation that wouldn’t have been possible without rebuilding her health foundations.
Why Women Can Be Vulnerable to FHA
FHA can affect women in any walk of life. Common contributing factors include:
Low energy intake. Not eating enough food to meet your body’s needs.
High activity levels. Exercise, when combined with under-eating or stress, increases risk.
Stress. Emotional stress impacts the hypothalamus—the part of the brain that regulates reproduction.
Lifestyle pressures. Perfectionism, busy schedules, or high performance expectations can push the body into energy debt without women realising it.
Clinical research shows that low energy availability—even without weight loss—is enough to disrupt menstrual cycles (Loucks & Thuma, 2003). Stress and over-exercise add to the effect (Misra & Klibanski, 2014; De Souza & Williams, 2004).
Restoring Menstrual Health Naturally
The foundation of FHA recovery is always about reassuring the body that it’s safe. This usually involves:
Eating enough calories consistently.
Including adequate protein, healthy fats, and nutrient-rich foods at every meal.
Covering essential nutrients such as iron, zinc, vitamin D, B12, and omega-3s.
Building in rest and recovery alongside movement.
Herbal medicine can provide additional support for hormone balance and resilience. Some of the most useful include:
Vitex agnus-castus (Chaste Tree Berry): Supports progesterone balance.
Withania somnifera (Ashwagandha): Helps calm the stress response.
Rehmannia glutinosa: Traditionally used to restore menstrual cycles.
In my clinical work, I find it’s the combination of nourishing food, herbal support, and lifestyle adjustments that creates the right environment for cycles to return.
Signs You Might Have FHA
Missing periods for three months or longer.
Persistent fatigue despite rest.
Slower recovery from exercise.
Loss of libido or vaginal dryness.
Stress fractures or unexplained bone aches.
Listening to the Body
Philosopher Lao Tzu wrote: “Nature does not hurry, yet everything is accomplished.”
FHA is the body’s way of saying: I need more nourishment, more rest, and more care. The good news is that periods often return surprisingly quickly once the body feels supported.
Your menstrual cycle is not just about reproduction—it’s a vital marker of overall wellbeing. If it’s missing, it’s time to listen closely.
About Camilla Brinkworth
At PMDD Naturopath, I bring together my training as a naturopath, nutritionist, and trauma-informed practitioner—alongside my own lived experience of PMDD—to help women restore hormone balance, emotional stability, and overall wellbeing. I support women through natural nutrition strategies, herbal medicine, and mind–body approaches like Family Constellations and Rapid Core Healing. Whether you’re navigating PMDD, Functional Hypothalamic Amenorrhea, or other menstrual health challenges, you don’t have to go through it alone.
References
Loucks, A. B., & Thuma, J. R. (2003). Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. Journal of Clinical Endocrinology & Metabolism, 88(1), 297–311.
Misra, M., & Klibanski, A. (2014). Endocrine consequences of anorexia nervosa. Lancet Diabetes & Endocrinology, 2(7), 581–592.
De Souza, M. J., & Williams, N. I. (2004). Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women. Human Reproduction Update, 10(5), 433–448.