Episode 135: Nicola Rinaldi, PhD discusses the causes, treatment interventions and science of hypothalamic amenorrhea. Hypothalamic amenorrhea is a condition in which menstruation stops for several months (or more) due to a problem involving the hypothalamus. The hypothalamus is in the center of the brain and controls reproduction.
Nicola Rinaldi, PhD
Nicola has a PhD in computational biology Image courtesy of Michelle Baileyfrom MIT. After graduating she worked for a biotechnology company while pursuing her dreams of a family, which were thwarted by a diagnosis of hypothalamic amenorrhea (no period). Eighteen months of trying to conceive followed. She spent hours on research, using the knowledge gained to work on recovery.
Concurrently, she tried the medical route to pregnancy, with multiple doctor visits, injections, and ultrasounds resulting only in failure. Ultimately, she was able to achieve a natural pregnancy. Since that time, Nicola has shared her knowledge of the path to recovery, helping hundreds of others achieve their dreams of womanhood and pregnancy.
In this episode we discuss:
- Defining hypothalmic amenorrhea and understanding potential causes
- The recovery timeframe: what factors determine how long it takes to reverse HA?
- How that it takes more of an energy surplus / exercise decrease to get the hypothalamus to turn back on than it does to keep going once it has restarted
- Differences in treating HA and “lean PCOS”
- Importance of support networks in effective treatment
- Interplay of bodyfat levels, energy availability, stress and HA
Links & Resources:
- No Period. Now What? – Book
- Mallinson RJ, et al. “A Case Report of Recovery of Menstrual Function following a Nutritional Intervention in Two Exercising Women with Amenorrhea of Varying Duration.” Journal of the International Society of Sports Nutrition. 10(1) 2013: 34.
- Stubbs RJ, et al. “Rate and Extent of Compensatory Changes in Energy Intake and Expenditure in Response to Altered Exercise and Diet Composition in Humans.” AJP: Regulatory, Integrative and Comparative Physiology. 286(2) 2004: 350R-58.
- Williams NI, Berga SL, Cameron JL. “Synergism between Psychosocial and Metabolic Stressors: Impact on Reproductive Function in Cynomolgus Monkeys.”American Journal of Physiology: Endocrinology and Metabolism. 293(1) 2007: E270-276.
- Genetics and hypothalamic amenorrhea: Caronia LM, et al. “A Genetic Basis for Functional Hypothalamic Amenorrhea.” The New England Journal of Medicine. 364(3) 2011: 215-25.
- Glucose/insulin repressing the hypothalamus: Routh VH. “Glucose Sensing Neurons in the Ventromedial Hypothalamus.” Sensors.
- Zhang CM, et al. “Gonadotropin-Releasing Hormone Neurons Express KATP Channels That Are Regulated by Estrogen and Responsive to Glucose and Metabolic Inhibition.” Journal of Neuroscience. 27(38) 2007: 10153-0164.
- Post on length of time to recover
- Post on reactivating your hypothalamus
- HA versus PCOS info sheet and chapter (free download)