What I Would Tell You About Getting Your Period Back If I Wasn’t Afraid to Hurt Your Feelings (Real Talk about Amenorrhea From An Eating Disorders Psychologist)

Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy.

If your period has disappeared, your body is trying to tell you something. (I am guessing that you know this, reader. And yet, I want to make sure that I start this blog post out being as clear as possible, because there tends to be a lot of confusion around this topic.)

While there are many medical reasons a period can go missing, in the world of eating disorders and disordered eating, hypothalamic amenorrhea (HA) is one of the clearest signs that the body does not feel safe enough to support reproduction. A missing period is NOT the result of your body being “dramatic” or “lazy.” It is simply your body responding exactly the way a human body is designed to respond when it senses famine, stress, overexercise, or inadequate energy availability.

And if I wasn’t afraid to hurt your feelings, I would tell you this:

You will not get your period back by continuing to do the same things that caused you to lose it (if exercise or food are at all a part of the cause.)

A Missing Period Is a Big Deal

Somewhere along the way, our culture normalized missing periods.

Fitness culture even sometimes glorifies it. Athletes dismiss it. Doctors can overlook it-ESPECIALLY when someone who presents with a missing period is also an athlete.

But losing your period is not a “perk” of being fit, disciplined, healthy, or lean. It’s a biological alarm bell.

A missing period can be associated with:

• Restrictive eating

• Chronic dieting

• Orthorexia

• Overexercise

• Relative Energy Deficiency in Sport (RED-S)

• Eating disorders like anorexia nervosa or OSFED

• Significant stress on the body

• Inadequate fat and carbohydrate intake

And what I wish I could scream, from the rooftops is that even when someone is eating what others around them believe is “enough calories,” or appears medically “normal” on paper, the body may still be operating in an energy deficit.

And one more thing to scream from the rooftops here: you do not need to be underweight to lose your period.

Your Body Needs More Than You Think It Does

One of the most painful parts of period recovery is accepting that your body’s needs may be far higher than your eating disorder, fitness culture, or anxiety wants to believe.

At Wildflower, we hear from so many people who are hoping they can recover their cycle while maintaining their current body weight, continuing intense exercise, or otherwise staying in rigid control of eating and movement. And while this is so understandable, we think it’s much more respectful to be upfront with people from the start. So we will share that this usually will not work.

Your body needs consistent evidence that the famine is over.

That often means:

• Weight restoration

• Eating substantially more food

• Increasing carbohydrates

• Increasing dietary fat

• Eating more consistently

• Reducing or pausing exercise

• Resting more than feels emotionally comfortable

I want to repeat that none of this is because your body is failing you. On the contrary, it’s because your body is trying to protect you.

Yes, You May Need to Gain Weight

This is often the part people want therapists and dietitians to soften.

But the reality is that many people will need weight restoration to regain menstrual functioning.

Nope. Not everyone. But many.

And frustratingly, your body does not care what weight feels psychologically acceptable to you. It cares whether it has enough energy available to safely support hormonal functioning. Sometimes that means restoring weight a bit beyond the exact number where your period disappeared, and tolerating body changes that feel deeply uncomfortable.

Sometimes it means your body asking for more softness, more fat stores, more nourishment, and more rest than diet culture taught you was acceptable.

Though our culture and the eating disordered part of your mind will try to convince you otherwise, please know that none of this means you are “doing recovery wrong.”

Carbs and Fat Are Not Optional

Another important point about HA: if you are trying to get your period back while still fearing carbs or minimizing fat intake, your body may continue to perceive scarcity. Hormones require adequate energy and adequate fat intake. That’s it. That’s the post. There is truly no way around it, but that does NOT mean that I think this is ever easy to accept.

The brain especially pays attention to carbohydrate availability. Low-carb intake can signal to the body that resources are not reliably available, which can contribute to ongoing hormonal suppression.

This means period recovery often requires… well….more. More bread, pasta, desserts, oils, snacks. More overall energy intake. (And potentially less cruelty towards yourself.) The true keys to food when it comes to healing HA are abundance, consistency, and safety.

You May Need to Stop Exercising (At Least Temporarily)

I know. I know. This is another truth many people desperately want to negotiate around.

But, if your body is already in an energy deficit, intense exercise can continue communicating danger to the nervous system and endocrine system. Even “healthy” exercise can become unhealthy when the body does not have enough energy available to sustain it.

So, as you likely know, this includes running and HITT workouts. But it’s important for you to also know that it might include long walks, hot yoga, pilates, and strength training. For many people recovering from hypothalamic amenorrhea, even exercise that you might consider as gentle could be taking from the reserves your body needs to feel safe again. So a significant exercise reduction or complete pause is often necessary.

This pause absolutely does not have to be forever. And have we worked with people who have recovered their periods even while engaging in modified movement? Absolutely. But, I want you to know that it does tend to be lengthier and a little harder.

It Usually Takes Longer Than You Expect

People often assume:

“I’ll eat more for a few weeks, gain a little weight, and my menstrual cycle will come back.”

Unfortunately, recovery is rarely that linear. For many people, it can take months and months for hormones to normalize after the body finally reaches adequate nourishment and safety. And sometimes your period will return, but only come inconsistently for a few months. This delay in reaching menstrual regularity again can feel psychologically brutal

Why? Because eating disorder thoughts often start bargaining:

• “See? It’s not working.”

• “You’ve gained weight for nothing.”

• “You should go back to how you were eating.”

• “Maybe your body just doesn’t need a period.”

Remember, healing often requires staying the course long after the eating disorder thinks you should quit. Your body may need prolonged consistency before it trusts that nourishment is truly reliable. It needs to believe the emergency has ended.

If You Lost Your Period, Something Is Wrong

I’ll say this again. Gently, but clearly:

If your period disappeared due to restrictive eating, compulsive exercise, or weight suppression, your body is trying to tell you that a change is necessary.

Even if your labs look okay.

Even if social media praises your discipline.

Even if people tell you that you “look healthy.”

Even if your eating disorder tells you that you are “fine.”

Amenorrhea is not something to ignore or normalize. It is one of the clearest biological signs that the body is under strain.

Getting Your Period Back Often Requires Letting Go of the Fantasy

Maybe you’ve had it. The fantasy. (It feels so human to think this way if you are struggling with an eating disorder, by the way.) It sounds something like this:

“I want my hormones back… but without my body changing”

“I want recovery… but only if I can stay in control.”

“I want health… but without rest.”

But true recovery often asks for something much harder: surrendering the illusion that you can out-negotiate biology. Your body will need you to release the idea that you can get your period back through rigid control, punishment, or restriction. Instead, enough food, rest, safety, trust, and consistency will be demanded of you.

Healing often begins the moment you stop trying to recover while still negotiating with the part of your brain that is keeping you sick and stuck.

Looking for Eating Disorder Therapy in Philadelphia or the Main Line?

At Wildflower Therapy, we specialize in working with children, teens, adults struggling with body image and eating disorders (as well as parents and caregivers navigating children or teens who are struggling with eating disorders, body image concerns, highly selective eating, and the emotional toll of caring for a struggling child).

Our therapists also support children, teens, adults, and families who are navigating things like ADHD, anxiety, depression, OCD, and maternal mental health/infertility.

We provide therapy in-person in Philadelphia or Devon (and virtually for anyone in Pennsylvania, New Jersey, Delaware, Florida, South Carolina, Vermont, Virginia, Ohio, and Massechusetts.) We work with children, adolescents, and adults. We are neurodivergent-affirming, queer-celebratory, and feminist-relational in our work.

You do NOT have to do this alone. Many of us have been in your shoes. We know how hopeless it can feel. And we want to shine the flashlight in-and show you the way out.

Reach Out Today!

If you’re looking for therapy for your child or yourself in one of the states mentioned above, or are seeking virtual parent coaching or consultation anywhere in the world, we invite you to reach out for your free consultation call.