Weight loss affects the body in many ways, including your period. Your period may stop if you rapidly lose too much weight, maintain a low body weight, experience stress, or over-exercise. While it might sound enjoyable not to worry about a period, it’s a change in your health that should be addressed. The normal function of several body systems (hormonal, reproductive, etc.) is off, which could increase your risk of long-term health issues.
Understanding Amenorrhea
Amenorrhea (or functional hypothalamic amenorrhea) is the term used to describe the stopping of menstrual periods for more than six months due to hormonal changes. Your healthcare provider will rule out other reasons (pregnancy or other medical conditions) for losing your period before diagnosing you with amenorrhea. Amenorrhea can be caused by rapid weight loss, stress, or excessive exercise. Sometimes, the three causes overlap, but weight loss is a common symptom of all three.
Why Weight Loss Can Disrupt Your Period
Rapid and significant weight loss can disrupt communication between various systems in the body. In this situation, the normal function of the hypothalamus, pituitary gland, and ovaries is suppressed, leading to the cessation of menstrual periods. This can happen after a rapid weight loss of 10 to 15% of baseline body weight.
The Role of Nutrition and Energy Balance
Energy intake (or calories) and balance are closely linked to the reproductive system. Suppose you aren’t consuming enough food or burning too much energy with exercise. In that case, the body will suppress or stop “less critical” energy-using systems (like your period) and prioritize life-sustaining systems like blood circulation or breathing. Losing your period is a symptom of a big change in the body and should be investigated further for optimal health. Low energy intake over time can change the release of the gonadotropin-releasing hormone (GnRH) from the hypothalamus. GnRH suppresses activity within the hypothalamus, pituitary gland, and ovary (HPO) system, which doesn’t allow for normal follicular creation, ovulation, and estrogen production. Other reduced hormones include follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which can lead to anovulation (no release of egg from an ovary), infrequent or light periods, and, over time, amenorrhea. Low energy intake causes weight loss and decreased body fat. Adequate body fat is critical in sustaining typical reproduction systems, including a regular period. Some research indicates maintaining a lower body weight can be an underlying cause of amenorrhea without recent weight loss or intense exercise. This weight range is calculated based on height.
Regaining Your Period After Weight Loss
Lifestyle changes are the first step in getting your period back after weight loss. Since low energy intake leads to amenorrhea, increasing how much you eat and reducing how much energy you use from physical activity and exercise will help restore the energy balance within your body. A common recommendation is a one to two kilogram (or 2.2 to 4.4 pounds) weight gain or a 5% increase in body weight, resulting in getting a period back within 6 to 15 months using an intensive education and managed exercise program. Each person is unique and may need to gain more weight to regain their monthly cycle. When individuals with amenorrhea worked with a registered dietitian nutritionist (RDN) for at least six months, over half of the women resumed periods with an average recovery time of 19 months.
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The Importance of a Healthcare Team
Suppose you don’t recover a period within six to twelve months after making these changes. In that case, healthcare professionals may recommend hormone replacement therapy (HRT) and professional counseling to address the behavior that preceded the loss of your period. Research indicates small doses of HRT are sometimes needed to prevent long-term issues stemming from lost periods and hormonal changes in the body. Long-term amenorrhea can lead to other health issues, including:
- Infertility.
- Bone loss or lower bone density, which can lead to potential fractures.
- Heart disease.
- Reduced mental health.
Working with an RDN can help you understand how much energy (or calories) your body needs to run optimally, ways to boost nutrient intake, and strategies to make changes to restore your period gradually.
Can Losing Weight Cause a Lighter Period?
Losing weight can cause a lighter period. As mentioned earlier, gradual hormonal reductions are related to low energy intake, excessive exercise, or low body weight. The hormonal reductions lead to a lack of ovulation and infrequent or light periods. Progression to full amenorrhea or stopping of periods occurs as the hormone levels continue to decline and no longer stimulate the normal HPO system. Changes in periods, the amount of blood and frequency, are symptoms of changes in your body. Paying attention to these markers can help you monitor your health and seek proactive treatment.
Can Weight Gain Cause Period Loss?
On the other hand, weight gain can cause period loss, too. Women with polycystic ovary syndrome (PCOS) often struggle with losing weight and gain weight easily. Hormonal disruptions caused by PCOS result in a host of issues ranging from weight gain, blood sugar irregularities, infrequent or light periods, and amenorrhea. The hormonal changes common with PCOS affect the HPO system in a different way than amenorrhea - but can result in period loss. Working with your healthcare professional and an RDN to find the root cause of your period loss is essential for treating any health conditions you have and helping you to feel your best again.
Lifestyle Changes to Promote Menstrual Health
Below are evidence-based lifestyle changes that may promote menstrual health, including more regular periods.
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Adopting a Balanced Diet
It's incredible how starting a balanced diet can help promote menstrual and overall health. Fueling your body appropriately supports your body's everyday work to breathe, think, repair, and create new tissues, cells, and hormones. Start by adopting a healthy eating plan modeled after the Dietary Guidelines for Americans:
- Prioritize fruits, vegetables, whole grains, and low-fat milk or milk products like yogurt or cheese.
- Include protein options like seafood (salmon or tuna), lean meat or poultry, eggs, legumes and beans, soy products, nuts, and seeds.
- Consume foods with added sugar and processed foods (soda, desserts, sweetened beverages) in moderation.
- Listen to your hunger and fullness cues to fuel your body within its needs.
With increasing research supporting the idea that diet quality can impact your metabolism as much as calorie count, it's important to choose foods that contain B vitamins, omega-3, and calcium-rich whole foods. These ingredients can help regulate metabolism and improve period regularity.
Incorporating Strength Training
Strength training is also called resistance training or weight training. This type of training uses weights, body weights, or resistance to build muscle strength. Some examples include squats, push-ups, pull-ups, lunges, or using resistance bands.Strength training builds bone density and content in young and older men and women. Hormonal changes from amenorrhea can reduce bone density. Adding strength-building exercises helps build stronger bones and offset any bone density reductions from hormonal changes. Research shows improvements in bone density after six months of resistance training, regardless of age or gender. Bone density improved more so in younger people.
Prioritizing Self-Care
Self-care helps you function well and feel good. Self-care looks different to each person. For some, taking time to prepare nourishing meals is self-care. For others, walking with a friend through nature with coffee is helpful. Start with your basic needs: food, rest, hydration, clean clothes, and expand to other needs like belonging and friendship. Be intentional with your time to make room for self-care.
Monitoring Your Progress
Restoring your period is a multi-faceted process spanning across your whole lifestyle. These changes will take time to implement and regain balance in your body. Set daily, weekly, and monthly goals. Track goals and progress on paper or by phone. Little steps each day will help you restore your health and period. This week’s goal could be to prioritize breakfast five days this week and then come up with three or four breakfast ideas to make that week.
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Seeking Professional Help
Often, amenorrhea is related to behaviors that preceded the loss of your period, such as excessive exercising, stress, or untreated eating disorders. These behaviors were likely present for several months or years, which eventually led to amenorrhea. Professional counseling can address those behaviors for you to have holistic, long-term healing beyond just a return of your period. Other medical conditions, like PCOS, could be related to the loss of your period. Seeking care from healthcare professionals can guide you on the right path for treatment.
The Menstrual Cycle and Weight Loss: A Detailed Look
Body weight and composition are largely influenced by hormones. And because our hormones fluctuate throughout our menstrual cycle, so does our energy. On top of that, if you're a regular bleeder then you're probably familiar with the pre-bleed slump often coupled with changes to appetite and food choices. These fluctuating energy levels and food cravings can often feel like they're working against us when trying to lose weight. The premenstrual phase often leaves us vulnerable to overconsumption. Thanks to the hormonal imbalance during this phase, resulting in lower serotonin, we often feel even worse about this overeating if it does happen, too. This can be a tricky thing to navigate, but joining a community of women also on their own weight loss journey can be a great place to find support. Coupling this with proper medical advice, holistic treatment and support from GPs and lifestyle coaches can also be really beneficial.
Spotting and Weight Loss
Spotting, or menstrual bleeding that occurs between your regular periods, can happen for a number of reasons. Stress, eating disorders, excessive exercise, and extreme weight loss can all cause menstrual irregularities. These irregularities can include spotting, cycle length changes, or a lack of periods altogether. Spotting isn’t uncommon, and it can range from a small amount of blood in vaginal discharge to a heavy, period-like flow. Aside from spotting due to weight loss, excessive exercise, and eating disorders, many young women have irregular periods, including breakthrough bleeding. It’s also common in menopause if you take hormone replacement therapy. You should always talk to your doctor about breakthrough bleeding between periods, as it can indicate more serious health issues as well.
Hormonal Changes and Spotting
Spotting can occur due to hormonal changes. These hormonal fluctuations can be due to your body’s response to stress, whether it’s from excessive exercise, a restrictive diet, or an eating disorder.
Prevention and Solutions for Spotting
Lifestyle adjustments may prevent menstrual irregularities related to weight loss. Eating a balanced diet, sticking to a moderate exercise plan, and losing weight gradually can all help prevent spotting between periods. Prioritizing sleep and finding ways to manage stress can also help. Medication is an option in some cases, typically those related to medical conditions. It’s best to lose no more than one to two pounds per week. A successful weight loss program is based on a healthy, reduced-calorie diet combined with moderate exercise.
When to Seek Medical Advice for Spotting
Spotting between periods may indicate medical problems such as endometriosis, a thyroid or pituitary gland disorder, polycystic ovary syndrome, or even cancer. Spotting can also be a side effect of contraceptives. It’s especially common in the first three months of starting hormonal birth control, whether it’s a pill, a patch, an intrauterine device, or another type. Contact your doctor if you have any unexplained bleeding between periods. If you have spotting or other vaginal bleeding that is not normal for you, start a menstrual diary or use an app made for tracking periods. Noting the dates and lengths of your periods and spotting (along with any other symptoms) can help your healthcare provider identify the exact cause of your between-period bleeding. Tell your doctor if you are prone to binge eating, severe calorie restriction, or if you exercise excessively.
Weight Loss and Menopause
It can be harder to lose weight after menopause. In fact, many women gain an average of 5 pounds after menopause. Lower estrogen levels may play a role in weight gain after menopause. But weight gain may be caused by your metabolism slowing down as you age, less-healthful eating habits, and being less active. Women usually need fewer calories than men, especially as they age. That's because women naturally have less muscle, more body fat, and are usually smaller than men. On average, adult women need between 1,600 and 2,400 calories a day. As you age, you need to take in fewer calories to maintain the same weight. You can also keep your weight healthy by increasing how much physical activity you get.
Important Considerations for Weight Loss
Women who lose too much weight or lose weight too quickly may stop having a period, or have irregular periods. Women who have obesity may also have irregular periods. A regular period is a sign of good health. Reaching a healthy weight can help women who have irregular periods to have cycles that are more regular. Men often lose weight more quickly than women. But, over time, weight loss usually evens out between women and men. Men may lose weight more quickly because men usually have more muscle, while women may have more fat. Because muscle burns more calories than fat, men may be able to burn more calories at rest than women. Because men are larger than women on average and have more muscle to support, men can usually eat more calories while still losing weight, compared to women. Portion control may be especially important for women.
The Impact of the Menstrual Cycle on Weight
The menstrual cycle itself doesn’t seem to affect weight gain or loss. But having a period may affect your weight in other ways. Many women get premenstrual syndrome (PMS). PMS can cause you to crave and eat more sweet or salty foods than normal. Those extra calories can lead to weight gain. And salt makes the body hold on to more water, which raises body weight (but not fat). Also, while your menstrual cycle may not affect weight gain or loss, losing or gaining weight can affect your menstrual cycle.