Stress and menstruation

Hypothalamic amenorrhea: when stress (and not only) affects the menstrual cycle 

With Dr. Alessia Giovannoni, nutritionist biologist, we face this delicate topic

TW: DCA

How many times during a stressful period, a variation of one's diet or of one's physical activity, are there "skipped" menstruation? And how many times have we underestimated it thinking was nothing to worry about? In the event that this condition should become chronic, it could be a hypothalamic amenorrhea (but always contact a professional, do not rely on Dr. Google!). In this regard, we talk about it here with Dr. Alessia Giovannoni, Florentine nutritionist biologist: a young professional who has a strong interest in female nutrition, studying for these people a diet to support their gynecological and non -gynecological problems. In addition, also thanks to his personal experience of Amenorrhea, today he is able to help many people in the same condition. 

Dr. Giovannoni, give us a definition of hypothalamic amenorrhea. 

Hypotalamic amenorrhea is a condition of chronic anovulation not due to specifically organic causes but often associated with a condition of psychophysical stress, excessive weight loss, excessive training. It is a condition that unfortunately many girls suffer and often from them is underestimated or not taken into consideration until it is not sufficiently serious.

She spoke of your personal experience with this type of amenorrhea on her social pages. Do you want to talk to us about it? 

Yes, certainly. In 2018 I put myself on my diet, the classic DIY diets that then lead you to lose so much weight in a short time (no carbohydrates, no dinners or meals outside) .. this led me to suffer from Ortoressia, a disorder of the food behavior that shapes you on each side and which unfortunately led me to lose the cycle. I decided to start sharing my story of "recovery" on Instagram until, once the cycle is back, I shared what I did to make it go back in a spontaneous way. 

What was the most difficult moment of its care path?

Certainly the weight gain: I was not psychologically ready to see my body change. However, I knew, in my heart, that the weight gain was an event to be welcomed and understanding, that it would have served me as a prerequisite for laying the foundations for the return of the menstrual cycle. Defeating the mental barriers that I had built over the years, such as eating carbohydrates at each meal, was another difficult piece of my path.

When did he understand that he would have of nutrition his passion?

My dream in the drawer was to pass the medicine test that, however, I did not pass even if he tried it only once. He has always fascinated me man, health and over time, realizing that I suffer from a disorder of eating behavior, I understood that I wanted to deepen the relationship between what people eat and what is the state of health . Helping people to find their psychophysical well -being, to see each other well in the mirror, to find that food serenity that seems lost forever, to make them aware of their food choices and their behaviors, are things that I wanted to become an integral part of the My life: from here I made my passion my job.

How do you think that your personal experience affects her work (both positive and negatively)?

Having suffered from Ortoressia and understanding on my skin how you feel to have a completely absent menstrual cycle for two years, for sure it helps me in many sides of my work: when I am faced with people who have suffered or suffer from DCA I know what terms to use and how to put me, using a non -prescriptive approach is the key. Like all pathological conditions, they have symptoms (influence has fever, bronchitis cough) the DCAs have their own symptoms and are found in the vast majority of people. Having experienced symptoms on my skin I can ask targeted questions that allow me to frame the subject and understand it 100%. This positively affects the work sphere, honestly there are no negative influences.

What symptoms do you think they are more underestimated by the people who suffer from it? And by professionals?

The girls who suffer from functional hypothalamic amenorrhea initially when the late cycle of a few days or worse of a few months, underestimate the condition, perhaps thinking that it is a completely normal thing (the reasoning they usually do is "I changed diet, I started to Train me every day .. maybe that's why it will take time and everything will come back as before) when in reality the cycle starts to delay because the girls take on a quantity of calories below their basal metabolism, or maybe because they begin to train Every day in the exhausting way going to stress their body. The professionals, finding themselves in front of a girl who has problems of amenorrhea or menstrual irregularity, should ask specific questions about the relationship with food, with their body image and with training, in

so as to immediately identify the nature of this physical condition. What are the main advice that you feel you give to those who suffer (or think you) suffer from hypothalamic amenorrhea? If you have delays with the cycle and if you have problems with your body image, with nutrition and if you have an obsession with training, do not be afraid to ask for help: start a nutritional path as soon as possible and psychotherapeutic. The nutritional one will help you fill any food deficiencies and will help you achieve certain objectives including weight gain, the achievement of a % of body fat to menstruate, on the other hand the psychotherapeutic path will give you a mental support of fundamental importance to face Recovery's path. What are the suggestions that would like to give to your colleagues to better accompany people with amenorrhea? What I feel like advising my colleagues is this: be scrupulous, investigate every side of the patient, ask questions, observe the patient well, listen to it and take note of his attitudes. Every single thing called is important. Ask questions about the events of life, ask if the patient has spent a stressful period, if something recently happened that marked her deep.

Antonella Patalano