Are you missing periods? What is your period health like? How is your period health indicative of overall health? In this podcast episode, Dr. Cristina Castagnini speaks about the surprising connection between periods and health with Cynthia Donovan.


Cynthia is a Registered and Certified Dietitian Nutritionist (RDN and CDN), as well as a Certified Health Coach. Since founding the Eat to Regain Your Period Program in April 2020, she have worked with hundreds of women in helping them get their period back. Cynthia loves assisting women to restore fertility, providing guidance to gain food and exercise freedom, and educating her clients on why the pill isn’t a treatment for their missing period despite what their doctor says.

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  • Hypothalamic Amenorrhea
  • PCOS or HA?
  • Mental and physical signs of HA
  • What you can do for HA recovery

Hypothalamic Amenorrhea

Hypothalamic amenorrhea (HA) is a condition attributed to poor diet, so a lack of eating enough, stress, and usually too much exercise. (Cynthia Donovan)
Your periods can disappear if your body doesn’t have enough nutrients or minerals to create the endometrium lining in the womb. If you lose your periods or have no periods, it could be because you eat too little and exercise too much, and that is not healthy.
However, many medical professionals will say, “Oh, you’re a normal BMI, you’re ‘healthy’ … you can’t have HA”, [but] you can have HA at any body size. (Cynthia Donovan)


A woman with HA has follicles in her ovaries that look like cysts in ultrasounds when doctors test for PCOS. These follicles develop here because they cannot move anywhere else because there are little to no hormones – therefore, a lack of a period, due to poor eating and over-exercising.
Someone with PCOS can also have these multiple follicles, but what they will usually have accompanying them is the abnormal hair growth and/ or the elevated androgens, so elevated testosterone levels. (Cynthia Donovan)
Women with HA:
  • Have normal to low levels of FSH, LH, and estrogen
Women with PCOS:
  • Have normal to high levels of FSH, LH, and estrogen

Mental and physical signs of HA

Using exercise as stress relief or as your only form of stress relief is going to worsen your missing period. (Cynthia Donovan)
HA is often a symptom from eating-disordered behavior that has been left untreated for a long time. Therefore, many things that lead to HA are related to eating disorders, such as:
  • restrictive eating
  • over-exercising
  • using exercise as punishment
  • binging or purging
  • having strict rules around eating times
  • treating exercise and food control as coping mechanisms
  • avoiding social situations that involve food
Because of this, a method of slowly bringing the body back would be to recover from the disordered eating behaviors and make an effort to feed the body nourishing foods. Remember that a missing period is never normal.

What can you do for HA recovery?

If some of your HA symptoms relate to disordered eating behaviors, then consider looking into your mental and emotional health; are you using food restriction and exercise to cope with difficult emotions and stress? How can you make a genuinely healthy and compassionate change for the better, for yourself, your quality of life, and your overall well-being? Cynthia’s advice:
  • seek external help and guidance to care for your mental and emotional wellbeing
  • eat enough and focus on nourishing foods without restriction or punishment
  • eat consistently throughout the day
  • keep exercise to a healthy minimum and cut out anything very intense
For those of us that are out there that don’t have an appetite back yet, eating consistently and eating more of the carbs and fat sources will eventually turn your appetite back on and you will eventually be hungry again. (Cynthia Donovan)

Books mentioned in this episode:

BOOK | Dr. Nicola J Rinaldi Stephanie G Buckler EsqLisa Sanfilippo Waddell  – No Period, Now What?: A Guide to Regaining Your Cycles and Improving Your Fertility



I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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