I only deserved to eat if I exercised enough
My recovery journey from amenorrhea
Hello lovelies,
In my last post, I left a glimpse of my journey into hypothalamic amenorrhea (HA).
Defined by missing period for more than 3 months, I set out on a journey to recover.
The ironic thing is HA is commonly found in type-A women who overexercise to reach a certain body goal, who restrict eating as a part of it (under-fuelling), or who developed an ED (eating disorder) as a result of unhealthy thinking mechanism that revolves around their relationship with foods.
I was like that. I ticked all the boxes. Probably orthorexia, but, in hindsight, it was always caused by restrictive eating.
Restrictive eating → not enough nutrition → my body craved something → I thought it was just the untamed appetite → restricted even more → sometimes bingeing → then guilty → overcompensated with restricting → the vicious cycle continued . . .
My Story
I don’t know where to begin.
I was overweight for a few years. I was of my ideal weight until 2013 when I started a taxing job. The perfect combo of stress, irregular sleep schedule, and lack of exercise made me overweight. Luckily, I was still young back then, so my resilience was not tested so much, unlike today.
My weight gradually went down after I started a more regular office job (which led to my career today in product management) in 2016. But I was still fat by Asian standards. I didn’t diet much, though.
Only after I went plant-based in 2020 (mid-pandemic) and had my health anxiety attack, which I confused for a heart attack, I lived under the impression that I might die any time of a heart attack, despite the lab and imaging tests proving my heart was healthy.
So I consulted with a dietitian about my plant-based regime and plan to lose weight. The doctor told me to cut my weight down to 56-57kg (I was 62kg when I consulted), and she developed a sensible plan. I managed to reach 57kg happily and kept at it in early 2022.
But starting in mid-2022, when I was in my MSc study, I started counting calories. I started wanting to live more vegan, more plant-based. I was amazed at the range of the vegan products offered by the supermarkets in the UK. For a moment, I was like an unbridled horse.
I tasted many things, from fake meats to vegan chocolates and drinks.
Little did I know, the ultra-processed foods I consumed ruined my taste buds. I started craving sweet foods. I started consuming more supermarket bread, although I watched tons of videos about the danger of sugar and UPF. I will list down the materials I read/watched so I hope that will help you, too, if you’re in this bingeing season and unsure how to stop.
As I shared in this post, I developed an unhealthy craving for sugary treats.
Fast forward to after the dissertation and on a holiday break in Indonesia and about to start my first job, I knew something’s gotta give. I needed to make the change, and it was by starting the ketogenic diet.
I was afraid of inhering the diabetes type 2 and other metabolic diseases that ran in my family. I learned that metabolic diseases could be prevented by a healthy lifestyle. So I cut down on sugar and ultra-processed foods.
Also, my LDL and total cholesterol were always high to begin with. So, I hoped that cutting down carbs and sugar would help with this, freeing me from the harbinger biomarkers that signal the risk of cardiovascular diseases.
In a good way, the keto diet reset my taste buds. My sweet craving was all gone, never coming back to this day. It’s been tested several times, I couldn’t finish the desserts/treats, and I knew when to stop.
It’s been replaced by the craving for whole foods, sometimes fatty ones such as cashews, tahini, and avocados. Even so, I know my limit as my almost bloated belly signals me to stop. In general, it’s good.
Also, keto made me stop counting calories. Since it’s whole foods plant-based, I don’t need to worry about cholesterol or fat levels.
But as with everything in life, I didn’t know my body's stress limit. I took it too far, so I ate less and less carbs, even feared them.
I developed an unhealthy obsession towards exercise and ‘clean’ eating (see the section with the trigger warning below).
– TW: ED / Orthorexia Thoughts or Habits That I Normalised –
I only deserved to eat if I exercised enough.
Back in my calorie-restrictive days (pre-keto): 1,500 kcal?? You should lower your daily to 1,300 kcal!
I’d gain weight if I skipped a day of cardio and weightlifting out of 6 or 7 days a week.
I only browsed for condo or apartment with a gym in it, because I had to go to the gym. Every. Single. Day.
I had to exercise in a fasted state. Every. Single. Morning. Session. I woke up at 6 or 7 am, exercised on an empty stomach, did my morning skincare routine and shower, and only then, by 9 am, I had breakfast.
I used to be afraid of bread/flour because they’d spike my blood sugar.
Cooldown after a cardio or weight training was only for dummies. My body definitely ran on high energy, I didn’t need a cooldown.
If I could do cardio 2x/ day, why not? (Morning: treadmill, evening post-office hour: dancing workout at home)
I must walk 10k steps a day. So, choose either dancing or walking (Jakarta pollution was no joke back then, so I had to be careful).
I would not eat the pizza that my friends ordered because it would spike my blood sugar. Or worse, I would be overeating.
I would do my blood glucose prick test as soon as I arrived home after eating that Korean food near the office.
Gelato from a friend: what if I overate? What if I couldn’t control my cravings? They must leave my fridge immediately (I ended up giving them away to relatives and office colleagues)
Oh, I gained weight today (from the scale reading). My waist circumference was 2cm bigger! I got fat!
(when watching my old pics of my holiday in Bali with Mum) Look at how fat my thighs were!
The next post is about my current healthier stance towards these thoughts.
My menstruation became irregular in the same month I started keto in October 2023.
It stopped altogether in December 2023, after a couple of weeks back in Scotland, back to the harsh winter, and started a new routine of working early in the morning.
If you’re regularly menstruating, and suddenly it stops: it’s a red flag. Menstruation is directly linked to how delicate a woman's body is: an orchestra of different hormones. Starting from GnRH (gonadotropin hormone) that produces FSH (follicle stimulating hormone) and LH (luteinising hormone), the orchestra goes down to your reproductive organs down there to stimulate the production and levels of oestrogen and progesterone.
Therefore, your reproductive function never starts from your ovaries alone. It starts in your brain, a part called the hypothalamus.
So, what causes my menstruation to stop?
There’s not a single cause as the condition was a perfect storm of:
Low carbs
Undereating (the amount of calories is less than needed)
Cold winter
New morning routines
In the articles I compiled below, the energy availability and the carb levels are the primary signals for the brain to start healthy sex hormone production.
Therefore, Dr Mindy Pelz, in her book Fast Like a Girl informs us that different days in our womanly cycle mandate different styles of fasting, sometimes to not fast at all.
Guess who did all intermittent fasting and low carbs all together at the same time back in a different timezone and starting the winter?
Yours truly.
High Cortisol Symptoms
My cortisol was high, manifested in bruises on my feet, rash on my fingers due to dry, flakey skin, and feeling cold all the time, which was totally not fun to live with here.
Feeling cold was actually my badge of honour: I was proud of myself for feeling cold even in my Jakarta apartment, which I set the AC at 25C because 20 was too cold for me.
The worst symptom which I realised so late: being wired. ALL. THE. TIME.
Mind, I don’t consume caffeine. My last coffee was in September 2023. I drank black tea every day until February 2024, but it was of way less caffeine, or so I thought. If not, well, then, that contributed to my healing now that I don’t drink blank tea every day.
The being-wired thing was real. I wasn’t in the tired-but-wired mode, probably because my sleep hygiene was, and is, regular, so that helps. But the wired part… I thought it was because of the B-complex vitamin I consumed. Apparently, it was cortisol.
I didn’t gain weight, either. People say a sign of high cortisol is weight gain accumulated in fat around the belly. I didn’t have that. It was probably because of my restrictive eating so my body didn’t have anything to accumulate anyway.
Dr Mindy Pelz says in one of her videos: cortisol up, progesterone low.
They’re antagonistic.
A woman’s body is indeed that sensitive to cortisol.
Lab Work That I Did
My NHS (UK healthcare service) doctor recommended me to have a blood work. I did it twice, once because my LH was low in early February. The doctor said to me that it was probably normal depending on the time of the month, so I had to do a second blood work, 2 weeks apart.
During the consultation call with my doctor, after the 1st result came out, I was told that I didn’t have PCOS. My hormone levels were normal to low (for LH was lower than the normal range), so it was different from PCOS which has higher levels.
I ended up having the 2nd blood work 2.5 weeks apart because of the appointment. The LH from this 2nd blood work was found back to normal. My doctor, upon the 2nd consultation, suggested that nothing could be done, and I should get checked in 6 weeks.
What changed between the 1st and 2nd blood work that returned my LH?
I ate more.
My HA Recovery Lifestyle
Do I still exercise? Yes. I don’t go “all-in”.
All-in is a protocol to recover from HA by Dr Nicola Rinaldi, in her book No Period Now What. She suggested that women should eat at least 2,500 kcal/day in the HA recovery. I’m not sure if my daily reaches 2,500, I just want to see if I can reverse the impact of stress by upping slightly more.
I increased my calorie intake slightly, but tbh I never really counted it because I don’t want to place more burden on meal tracking. I did that in my orthorexia life, I ate as low as 900kcal/day.
But I ensure I must eat at a minimum of 1,800 kcal / day, which can be achieved with ~100g of peanut butter, ~100g of nuts, and a different mix of tahini and avocado. The rest is from other whole foods, such as root veggies, green veggies, and fruits.
I joined therapy from NHS.
I spoke to my priest about an issue I’d neglected for a long time.
As for the exercise, I enjoy dancing workout and my daily walk. The days start earlier and end later on the cusp of DST, and the weather is cloudy and sometimes sunny, so having my daily walk is enjoyable. I do pilates or callisthenics, too, at home. But I believe I can compensate for the energy expenditure by eating more.
I don’t want to compromise on the exercise since my routine is way calmer and low impact now, as opposed to my October and November training regime, which, could you believe that, I still RAN on the treadmill the morning I had to fly back to Scotland.
Yes, I remember I went to my apartment gym to hit the treadmill as usual. I ran on the treadmill 6 days a week.
You didn’t read it wrong.
Also, when I was in Jakarta, I ensured the apartments I rented in to have a gym in the compound. I didn’t want to stay in an apartment which didn’t have a gym in it.
Don’t get dismissive at me by saying: she knew that she had it coming.
I didn’t know that it could stop my menstrual cycle. How was I supposed to know? I still ate foods, clean eating no less.
Perhaps, my judgement was clouded by my flat abs. Oh, vanity.
My average starting weight on this journey was 54 kg and body fat was 19.7%. My current weight is 57 kg and my body fat is 21%.
So, I hope I’ll recover🙂.
Not soon, but in due time. (Remember, the constant rush to have everything on your desk by yesterday is what contributes to the stress)
To every thing, there is a season.
Closing Thought
The irony is not lost on me here:
By meticulously planning my exercise and food regime to avoid metabolic diseases, I unknowingly signed up for another metabolic disease for women: the hormonal imbalance, manifested in amenorrhea.
By placing too much importance on my waist circumference and body fat, I ended up having to increase my weight, and consequently, my waist circumference and body fat.
Resources
(tbh there are many videos on YouTube about women sharing their experience with HA, I can’t possibly list down everything I watched, but I shared here what resonated with me)
I broke the list down into several categories.
Scientific or Explanatory Media
Low leptin impact on women with normal body weight
https://academic.oup.com/jcem/article/83/7/2309/2865258?login=false
PCOS or HA
https://www.thehasociety.com/articles/how-to-know-if-you-have-pcos-or-hypothalamic-amenorrhea
Lost period due to diet
https://www.larabriden.com/have-you-lost-your-period-to-a-low-carb-diet/
Signs period is coming back
https://www.wholeheartedlytash.co.uk/post/signs-your-period-is-coming-back
… and many more, just look it up online
Stories from Women
Reddit /Amenorrhearecovery
Stephanie Buttermore, a bit heart-wrenching given how much hate she received online when gaining weight. A piece of proof that society is wired to place unrealistic expectations on women’s health. Even though Stephanie was clearly struggling with her hormones and health-wise she had to gain weight, nasty comments ran rampant.
Naturally Karli, I followed her for recovering in whole foods plant-based eating. She still exercised gently when recovering.
Dani Sheriff, she’s the founder of the HA society above. I learned a lot about this topic from her videos and articles.
Sanne Vloet, a supermodel, I can relate because she had suspected her amenorrhea was more due to psychological stress
Chlo Hodgkinson
Why Prolonged Keto Or Under-fuelling Isn’t Recommended for Lean Women to Begin With
Carb cycle during keto is a must
https://www.mindbodygreen.com/articles/why-women-should-carb-cycle-on-keto-diet
How much carbs should you eat to recover (50% from carbs)
https://lauraschoenfeldrd.com/carbs-heal-hormones/
When the “cortisol high” or the wired feeling has passed, you’re exhausted
https://www.ha-recovery.com/post/why-do-i-feel-so-exhausted-in-hypothalamic-amenorrhea-recovery
Cortisol impact on menstrual cycle
https://elara.care/hormones/how-cortisol-affects-womens-health-and-the-menstrual-cycle/
Ketogenic and your cycle
https://www.everydayhealth.com/ketogenic-diet/diet/your-period-how-keto-may-affect-your-cycle/
… and many more, just look it up online
This Week
(Friday to Thursday, since newsletter is out every Friday)
After Office Activities
Published my 5th instalment of Superteam UK Solana Pay writing research
Served in the choir and sang the Gospel Acclamation part (my 1st time singing the Gospel Acclamation)
Baked a chocolate banana cake for my flatmate’s birthday
Baked a spelt wholemeal bread from scratch. I used to bake homemade artisan bread until I developed fear for flour/bread. This was a huge leap for me.
About the DAO
Filled in the form for a business competition
If you’re a solopreneur and want to join the community of builders, head to our community channel of Berdaya DAO here:
Well-being
Seeing some recovery signs. I’m now 57kg.
Bought some secondhand clothes from the charity shops. I felt more feminine and relaxed. Didn’t make any sense, but perhaps that’s how I could relax more.
Took a lazy day on Monday (was a national holiday so no office work) and a nap on Tuesday afternoon. Resting is still a strange concept for me, a person who does not know “enough”.
wrote about this “Enoughness” in his article, which feels like a brick slap to my face.Other articles on Substack, for example,
with her slow living newsletter also served as a wake-up call for me.Dressed up. I don’t know why but I felt compelled to start dressing up these days.
Made different foods, such as this butchered version of spanakorizo (rice with spinach, a Greek dish) which my Greek landlord felt offended with.
Until next time,
Good for you for taking care of yourself and being so courageous! Wishing you blessings and wonderful health ahead!
Sekar this is a truly generous and brave post and I am so proud of you! I am so glad Slow & Gentle Living has helped you too, there is so much more to come. Thank you for sharing this- I really think you will help so many people with your honesty. All the love.