Functional Hypothalamic Amenorrhea (FHA)

Amenorrhea = no menstrual period

Oligomenorrhea = infrequent or scanty menstrual periods, specifically fewer than 6-8 periods a year. 

When a woman burns more calories than she takes in by eating, her body will sense a "caloric deficit" and try to conserve its fuel for the more important vital organs, such as the heart, lungs, and kidneys. Your body simply not put energy to maintaining your reproductive system. 

This condition is very common in athletes and in women who exercise or diet excessively. FHA is also very common in women who suffer from anxiety, since a constant state of anxiety expends a lot of energy. Another common personality trait is women who are perfectionists and/or who are higher achievers. 

Excessive exercise (women athletes), eating disorders (anorexia nervosa, bulimia nervosa), disordered eating (excessive dieting) and emotional stress are the most common causes of Functional Hypothalamic Amenorrhea (FHA) or Functional Hypothalamic oligomenorrhea. 

** NOTE: FHA and PCOS often co-exist. Please see the PCOS webpage 

• INCREASE caloric intake (attempt to eat 2500 calories daily)
• DECREASE caloric expenditure (decrease your exercise) 
• INCREASE in cholesterol (if your levels are low), since cholesterol is used to synthesize reproductive hormones. 
• Adequate calcium intake for bone health, 600 mg 2x daily, try to obtain at least 600 mg from natural food sources. 
• Adequate Vitamin D3 intake, our goal will be b/t 50-75 
• Note: If Vit D is low, your body will not be able to absorb the calcium you ingest, in order to be taken up by your bones to keep them healthy. 

Most often an initial appt with a NaPro provider will be one FULL HOUR in length. Generally speaking, NaPro appts will follow a typical protocol. However, every individual is different and your situation may warrant a more expeditious process. Please know, the Creighton Model Charting is very important. Your CrMS chart will help direct your NaPro provider as to what diagnostic tests and imaging tests should be done and what treatment plan would be most appropriate for you, personally. For more detailed information about what a typical NaPro diagnostic evaluatin will look like, please click the button below. 

I will be asking you to tell me very specifically how much you are bleeding. An example of a "detailed flow" is: M, M, H, L, L, VL/B

TAMPON or PADS: 

• Very Heavy (VH): changing a full pad/tampon every 1-2 hours
• Heavy (H): changing a full pad/tampon every 3-4 hours 
• Moderate (M): changing a full pad/tampon every 5-7 hours
• Light (L): changing a full pad/tampon every  8-12 hours
• Very Light (VL): changing pad/tampon less than every 12 hours

MENSTRUAL CUP MEASUREMENTS

• Very Heavy (VH): 60 cc in a 24 hours
• Heavy (H): 40 cc in 24 hours
• Moderate (M): 20 cc in 24 hours
• Light (L): 10 cc in 24 hours
• Very Light (VL):  5 cc in 24 hours

**The Diva Cup comes in 20, 30 and 32 ml cups 32 being the largest but other cups may vary. 1 ml = roughly 1 cc 

Other important information about your flow: 

• Tail End Brown Bleeding (TEBB): brown bleeding at tail end of period. 
• Premenstrual bleeding: pink spotting or brown spotting at the prior to a full period starting. 
• Intermenstrual bleeding: bleeding between periods.