Myths About Hypothalamic Amenorrhea (Episode 353)

Full Transcript: Episode 353

LISA: Welcome to the Fertility Friday podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of the fifth vital sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles, regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with us today.

Today I’m jumping in with another episode about HA, hypothalamic amenorrhea. As you’ve noticed in the past couple of months if you’ve been tuning in, I’ve touched on this issue quite a few times. Ultimately, the reason I continue to talk about it is because it’s fascinating to me that in this day and age, when so many women are struggling with this issue, it can be so difficult for them to find the right support and really get to the root of the problem — when, as far as period issues go, HA is kind of one of the easiest to understand, not necessarily the easiest to deal with, but often the easiest to understand in terms of what happened when the period went away. So today I am joined by Dani Sheriff. Without further ado, let’s jump into today’s episode.

I’m excited to be here today with Dani Sheriff. She is an Australian-born, Austin-based digital illustrator, YouTuber, and podcaster. She’s the host of the Hypothalamic Amenorrhea Podcast and founder of the HA Society, a podcast and online community for women who care about getting their periods back. Her mission is to free up mental space for people who are caught up in the diet-hard mindset so that they can do their life’s greatest work. We met virtually, of course — I came on as a guest on your podcast, and you experienced HA firsthand and overcame it. I got the impression that’s what fuels your fire, and I thought I’d invite you on the show to share your story because it’s powerful. Whenever I do shows on HA, I get a lot of women messaging me — sometimes saying they found the podcast, learned about HA, and eventually got their period back, or it led them to other resources, or sometimes they come and work with me directly. Either way, this is something so many women struggle with. So welcome to the show, Dani.

DANI: Thank you. Yeah, I’m excited to share my story because that really is just, for some reason, the most effective way to spread the word — being like, this is what happened to me, what happened to you? On my show, I do the same thing. I mostly get women’s stories. It’s really powerful.

LISA: Yeah, over the years I’ve talked about this a lot on the podcast. Doing interviews with insightful, highly credentialed guests with years of experience is always important, but there’s something very powerful about giving women the space to share their real experiences. Where would you find a trove of actual women’s experiences with these things if we weren’t making these types of stories available?

DANI: Yeah, and I don’t know exactly what it is, but it’s so important to have that balance of practitioners and experts who are learned in the subject talking about the science, but it’s really hard to apply that knowledge without the comfort of knowing your story is common, what’s happening to you is real, and you’re not the only one. That’s a really important foundation before you can dive into the research.

LISA: Well, and technically, the research, if it’s valid, must be based on actual experience. We can talk about theories all day, but if you’re doing a bunch of things and your period isn’t coming back, we need to talk about what makes the period come back. So let’s jump in — would you share with us, when I do my fertility awareness reality series and pill reality series, one of the questions I always ask is how old you were when you got your first period, and then take us through your story, whether you used birth control, and your journey with HA.

DANI: Yeah, awesome. I got my period in the high school bathroom when I was 12, my first year of high school — pretty normal. I went on the pill somewhere in high school, on and off for maybe five or six years. By the time the whole situation with HA happened, I hadn’t been on the pill for about 10 years, so I don’t really identify as someone who had post-pill amenorrhea — I just got it later in life. I had a very normal childhood, wasn’t particularly athletic, loved computers, was a bit of a nerd. When I got older, around 18, I started to gain weight, had a traumatic experience in a department store dressing room, and decided I needed to start going to the gym and working out a lot. Up until then I was cycling totally normally, eating whatever I wanted, very hungry, very young. I feel like the day I discovered high intensity training was the day my period went missing. And I didn’t care, because I didn’t know — in fact, it was quite convenient. I went a long time not caring, and I think a lot of people experience that, and it’s even glorified, because if you’re not cycling, you must be working out hard enough, lean enough, athlete enough. Being an athlete became increasingly important to me, so I kept piling on more physical stress through dieting and exercising. Something that resonates with a lot of people when I tell my story is that I never developed a diagnosable eating disorder, and I never got particularly lean — I was a normal BMI, people thought I looked great — but I still looked in the mirror and saw opportunity for more weight loss. So the important thing I got on my high horse about was that this isn’t just an anorexic person’s problem — it happens to women who’ve lost five to ten pounds, or who are in a high-stress environment. I kept going down that path because I didn’t feel like I fit any kind of problematic mold. Then I went for my annual OB-GYN visit and mentioned I don’t cycle, which I’d told doctors before without concern — they’d just say it’s normal for healthy, fit people who exercise a lot. But this time, an unlikely doctor said, “That’s kind of a problem, we worry about women when they stop cycling.” I was 25 or 26 at that point. He prescribed a progesterone challenge — a seven or nine day pill that tests whether you have a uterine lining that could potentially bleed. If you bleed, you pass; if you don’t, you fail. I failed, which showed me how deep into it I was. That’s the day I started looking into it, and the process brought up so much anger, confusion, and frustration — why is no one talking about this, why am I not supposed to be dieting and working out every day trying to be the perfect career woman when that’s literally what society tells us to do? I was in denial for a while, then discovered communities and podcasts talking about not having to chase being teeny tiny, and I thought, these people don’t know what they’re talking about — that’s how deep in the belief I was. But I kept learning and started to see how disordered a lot of the messaging we get really is. I made it my mission to be open about what was happening to me, and the more women who came out of the woodwork about it in my life, the angrier I got, because it’s not just me — it’s so many of us. So, due to under-eating and over-exercising, probably combined with trying to work full-time and be everything, my hypothalamus told my reproductive system it wasn’t worth running right now. That’s my story.

LISA: Well, I really appreciate you taking us through that — there are so many nuggets in there. It’s interesting that when you started listening to other women’s stories saying you don’t have to chase the weight-loss thing, you were like, no, there isn’t more to life, I’d never heard that. This is also interesting because I recently released an episode with Laura Schoenfeld where she said something similar in different words — that there’s more to life than your body and how you look. It sounds almost obvious once you’re on the other side of it, but when you’re in it, you’re in a completely different mindset. One common thread across these interviews is that you mentioned going to a few doctors and always mentioning you weren’t cycling, but it was treated dismissively.

DANI: Yeah, I went to a few different doctors over my life, for general check-ins, and I would always mention it on the side.

LISA: Can I ask — why did you mention it?

DANI: Yeah, I don’t know exactly why. I think intuitively I knew that I didn’t know much about it and that I probably should be cycling.

LISA: I find that so interesting, because you also said you didn’t care, that it was convenient — but every time you went to the doctor, you mentioned it. This is what I always talk about with intuition, that voice inside guiding you, and if you don’t listen to it, things get worse. I haven’t interviewed enough women to make this a scientific study, but I feel like most of us, on some level, sense when something is wrong.

DANI: Totally. I knew, without any education on it, that because I wasn’t cycling, I couldn’t get pregnant. I don’t know how I knew that — it was just obvious that they’re related.

LISA: Well, you mentioned the progesterone challenge test. With HA, you’re not ovulating, so you’re not having a bleed or a true period, because a true period only comes after ovulation. From a hormonal standpoint, you’re not making sufficient estrogen to build up the uterine lining or trigger ovulation, and because you’re not ovulating, you’re also not making progesterone in significant quantities, since that only happens after ovulation. So you wouldn’t have much uterine lining thickness, because you’re not producing the hormones required to build it — it’s like trying to make coffee without coffee beans or water. So it’s interesting that this test is used, because if women are truly not ovulating and nothing is changing in their diet or lifestyle, they likely wouldn’t respond to it at all — there’s nothing to respond to.

DANI: Totally. Most of the women I see go through a point where they think, I’ll just try it, I’m desperate, I’ve been doing everything to get my period back for ages, maybe this progesterone will be the last thing that triggers it.

LISA: And progesterone isn’t going to make you ovulate. Even if it makes you bleed, that doesn’t mean your period is “back” — it’s more like triggering a luteal-phase-type bleed, but you can’t have a true luteal phase unless you ovulate. The real test would be whether you go on to ovulate and have a true menstrual period following the progesterone. I’m not claiming to have all the answers, but based on how the hormone cycle works, progesterone doesn’t trigger ovulation. There was something else you said that’s important — with PCOS, women tend to be cycling, just irregularly, often with very long cycles, which is a huge difference. One thing that’s come up on the podcast about PCOS is that doctors often have a specific idea of what a woman with PCOS looks like — usually overweight to some degree — so lean or slim women with PCOS-like long cycles are sometimes told it can’t be PCOS. What you said about HA is similarly important — you don’t have to be anorexic or emaciated to have it, which might be a confusing thought for people who assume there’s a specific BMI threshold involved. The way I look at it through the lens of the menstrual cycle is simply: is she ovulating and menstruating, or not?

DANI: Yeah, I wish the PCOS conversation was quieter in the HA community, because it’s diagnosed in women with HA far more than I’d like, which just sends them on the long, scenic route of figuring out what’s actually going on.

LISA: Can you go into that? Because PCOS and HA are like a dog and a pig — you wouldn’t look at a pig and call it a dog.

DANI: Right, so it’s diagnosed based on missing three periods — that’s what’s in the medical books.

LISA: But there are women with PCOS who go 90 days between cycles, so there’s some symptom overlap that causes confusion. And women with HA can have plenty of follicles on their ovaries, which on an ultrasound could look like polycystic ovaries.

DANI: Yeah, and doctors are just more familiar with PCOS, so it comes up more often.

LISA: Let’s break this down for listeners, based on the Rotterdam criteria: having polycystic ovaries on an ultrasound alone is not a diagnosis of PCOS, because a certain percentage of women naturally have polycystic-appearing ovaries. The diagnostic criteria are polycystic ovaries, elevated androgens (which cause symptoms like hirsutism or cystic acne), and irregular cycles — longer than 35 days or fewer than eight or nine cycles a year. You need two of the three for a diagnosis. HA is different — it’s caused by a combination of under-nutrition, over-exercise, and stress, and the hypothalamus essentially shuts down so you don’t ovulate at all. It can’t really look like PCOS, because you’re not cycling — but that’s because I’m looking at it through the lens of the cycle first.

DANI: Yeah, that’s a really good point. And potentially it’s doctors not fully recalling these small but important details.

LISA: But it’s a huge detail. Women with PCOS often don’t know when their period is coming, but it eventually does — that’s the key difference. If you’re charting, it’s easier to see, because PCOS is characterized by long pre-ovulatory phases with cervical mucus that can come and go for weeks. Women with HA don’t have mucus at all, because their bodies have suspended ovulation entirely. So depending on the lens — the menstrual cycle — there’s nothing similar between the two.

DANI: Totally. And when you’re in HA, you have no hormonal symptoms at all — your mood is steady, your skin might be dry and flaky but clear, you’re just not having those hormonal fluctuations. Whereas with PCOS, I’d imagine you experience more of a range of hormonal symptoms, and you are having periods. So to me, they’re just not the same.

LISA: So tell us more about what you came to understand about weight, because that’s especially challenging when a doctor assumes HA only happens to hyper-athletic, extremely slim, or classically anorexic-looking women. How can HA present in women who don’t look like that?

DANI: HA can present in anyone, looking any way. The most common commonality is a weight loss of anywhere from five to ten pounds at a minimum — if you were 75 kilos and lost five rapidly, that’s a stress on your body that could potentially cause it. A lot of people would think that’s not a big deal. Dr. Nicola Rinaldi, who’s been on your show, conducted a large survey and found that women in the survey had, on average, lost about ten pounds within about a one-year period. The theory is that everyone is different — some women can drop significant weight with seemingly no hormonal repercussions, and others, like me, will have their body say “nope” after losing just a couple of kilos. The message I want to get across is that you can’t compare yourself to someone else, because what your body needs and where it wants to sit is so individual. I got really upset learning that I wasn’t “allowed” to do what I thought was the most important thing at the time, which was to look a certain way.

LISA: I want to go deeper into that — do you think it’s about the amount of weight loss, or what’s driving the weight loss?

DANI: I think those are very different things. There’s a big difference between not eating sufficient calories to sustain yourself and then adding a lot of exercise on top of that, versus losing weight while still eating enough to sustain your daily needs. If a woman lost 20 pounds over two years without starving herself, that’s different. I think this is a product of that ’80s and ’90s mentality that turned humans into math equations — eat less, exercise more — and that myth continues today. For women’s bodies, the menstrual cycle is the great equalizer: either you’re ovulating and have a period, or you don’t.

LISA: I get what you’re saying.

DANI: When I lost my period, I was eating very low-fat, high-volume, low-nutrient foods — a huge amount of cabbage. If I’d taken a slower approach focused on healthy fats, quality carbs, and protein, that would have been different. But I ate a lot of chicken breast and avoided avocado, olive oil, butter, eggs — anything “too high in calories.” I lost my period on 1,700 to 1,800 calories, which many women would consider fairly high, though I didn’t understand that at the time. So it was really about the quality of what I was eating.

LISA: And once you’re in that pattern, is it hard to reverse just by changing where those calories come from, while keeping the same total intake?

DANI: I’ve seen that it is hard to reverse that way, though I can’t tell you exactly why.

LISA: One of the things I always find interesting — and I’d love your perspective — is that from a research and menstrual-cycle standpoint, HA is actually one of the simplest things to understand: it’s characterized by under-nutrition, over-exercise, and stress. She’s not eating enough food — that’s what it is, in strictly scientific terms. What makes it complicated is the emotional aspect — there’s a reason she’s not eating. I’m not saying it’s simple to solve, just that it’s fairly easy to understand.

DANI: Yes, absolutely. Women who can continue to track and control their food intake often try everything else before increasing their caloric intake, even though they logically know what they need to do — eat more and rest, which usually comes with some weight gain. They’ll try bone broth, supplements, anything to avoid that step. And even once they start increasing nutrient-dense foods, if they’re still tracking everything in an app, it often doesn’t seem to work. But as soon as they stop tracking, it’s like the stress of obsessing over every bite was more powerful than we even realize.

LISA: Okay, so I feel like we’ve touched on this, but there’s kind of an elephant in the room — the bigger issue isn’t a lack of understanding, it’s the fear of gaining weight, which is tied to body image. Because if you gain weight, what happens?

DANI: You’re unloved. You’re not an acceptable member of society. People think you’re lazy, that you don’t try hard. Everyone has opinions about who you are. That’s the theme that comes up.

LISA: That’s powerful. So for a woman listening who’s afraid of that — did the world actually confirm those fears once you came out the other side? I remember in my interview with Laura Schoenfeld, we talked about how, say, being vegan can come with a whole community and identity, and if you change that identity — like starting to eat meat again — there’s a real fear people will disown you, and sometimes that does happen; people get hate mail, lose friends. So with HA, there’s a fear that if you gain weight, something bad will happen. Does it?

DANI: What we’re talking about is, no, it doesn’t happen the way you fear. You might get the occasional weird comment from a stranger online — “you’re going to get diabetes” or something — but that’s easy enough to write off as a random person being ill-informed. What’s harder is wanting to fit in, wanting to feel confident and beautiful at a pool party the way you assume everyone else does. Those hard days are real, and it’s okay to feel that. But if you ask, what’s so good about your life right now that you can’t imagine anything ever being better — when you’re tired, grumpy, sore from working out every day, and constantly thinking about food — the trade-off on the other side is real. You stop obsessing about food, you get so much mental space, creativity, time and energy for your relationships back. I’m now pregnant, which would never have happened otherwise. Life opens up so much, and honestly, your partner will probably be pretty happy you can start ordering pizza again too.

LISA: That’s really it, isn’t it — and you’re not sugarcoating that you might still feel uncomfortable gaining a bit of weight. One thing I’ve seen in working with women over the years — without ever having struggled with this myself the way you have — is body image distortion. Women who are very, very slim, with no period at all, will perceive themselves as overweight. Then when they recover their period and gain 10, 15, even 30 pounds, they still perceive themselves that way, even though to anyone outside that experience they’d look underweight. I don’t have a solution for that distorted perception — how do you even begin to address it?

DANI: It comes in all shapes and sizes — most of us have a bit of that, and some people have it to an extreme degree. We have women like that in our group, and they’re absolutely welcome; we want to hear what’s real for them. But for that more extreme case — someone who’s very small and fearful of a body size that isn’t even genetically realistic for them — I think they should always work with a professional trained specifically in eating disorders. I’m actually studying a course right now to learn how to better support those women, because it’s a much longer road for them than for someone like me who just took dieting a bit too far. For most of us, group coaching, reading the right content, and removing triggers can take you a long way — not necessarily to “loving yourself completely,” but to developing tools to get through a hard moment so it doesn’t derail your entire day or week. The more you practice that, the easier it gets, so you don’t spiral into “tomorrow I’m going on a diet” and then a binge cycle. There’s no shame in seeking that kind of support, whether or not you have a diagnosable eating disorder — we’re all more messed up by this stuff than we realize.

LISA: There was something I wanted to ask and now I’ve lost it — actually, while I think of it, can you tell us about the cabbage?

DANI: Oh yeah — cabbage is basically zero calories, so you can make a meal 80% cabbage instead of rice or pasta, drown it in spices, add some lean ground turkey, and you’ve got yourself a “zero calorie” dinner. If you eat enough of that, you’ll lose weight and your digestive system will be very upset about it. I went through a phase of knowing every low-calorie meal hack out there to feel full without actually being nourished.

LISA: That’s a whole other level. For someone nodding along, they already know exactly what you mean — but for someone who’s never faced this, it might sound bizarre. In my practice, one of the first shifts is getting people to stop thinking of their body like a car and food like gas — food is nourishment, not just fuel.

DANI: Right, you’re not a car, food isn’t motor oil, we’re not machines.

LISA: So, back to my original question — for women who are ready to get pregnant and need their period back for that goal, that’s still a fairly goal-oriented mindset rather than one rooted in self-nourishment. What tends to motivate women to actually want their period back?

DANI: A lot of them are ready to have a child and realize they can’t, which is simple and highly motivating. For others, it’s different — some are health-conscious people who thought they were doing everything right, and when that gets challenged, they think, “challenge accepted, I’ll show you I can do this without the pill.” And then there are women with more disordered eating patterns, not necessarily from an athletic background, who reach a point of “enough is enough” — those women are, to me, the most amazing, because they’re the most brave and courageous. Their motivation isn’t having a child or optimizing performance — they’ve just chased being thin for so long and they’re tired, they’re done.

LISA: That’s interesting — so for you, it sounds like you weren’t quite “done” with wanting to look a certain way, but you did want to be healthy. Whereas this other category of women just hits a breaking point with what you might call “thin girl stuff.”

DANI: Yeah, thin girl stuff — that’s exhausting for them and everyone around them, and they reach a point where they say, I need to do this. I think their awareness around HA also tends to come sooner, because they’re already talking to specialists about disordered eating. Whereas crossfitters, weightlifters, and endurance athletes come at it from a completely different path — often surrounded by a community built entirely around that identity, similar to the vegan community example.

LISA: We have a lot of crossfitters in the group I imagine.

DANI: Yes, I’ve attracted quite a few.

LISA: Sorry to interrupt — could you briefly describe what CrossFit is for anyone unfamiliar?

DANI: Sure — high intensity interval training, a lot of weight, mixing strength, endurance, and gymnastics into one workout. It becomes a whole identity — you’re not just someone who exercises, you’re “a crossfitter,” the same way someone might identify as “a runner.” The running world has known about this connection to lost periods for a while, but the CrossFit world is only just starting to catch on.

LISA: That’s so interesting.

DANI: I was in denial in the same way — I thought, I’m a weightlifter, not a runner, so this must not apply to me. That’s a really common one, and when I share my story I get a lot of weightlifters and crossfitters telling me, that was exactly me.

LISA: Because it’s your identity — the idea that losing your period couldn’t happen to you, because you’re an athlete, not “one of those people who over-exercise.” If your identity is wrapped up in being a crossfitter or weightlifter, combined with not understanding what a healthy cycle looks like or why it matters regardless of wanting children — we haven’t talked much about some of the more serious side effects of HA, but osteoporosis is one of them. There are women in their 20s with osteoporosis because of HA, which is serious, especially if you’re also a heavy exerciser, since brittle bones and high-impact training don’t mix well.

DANI: Totally, and there are links to heart health and brain health too — the brain research is still developing, but those links are there. It makes sense — it’s a chain reaction, with the reproductive system being one of the first things to shut down. And this is something else I really want people to know: HA isn’t a disorder or a condition to be “fixed” in the sense of something being broken. It’s actually a really smart thing your body is doing. If your body is shutting down reproduction, it knows what it’s doing — it’s protecting you. It’s when we see a prolonged absence of a period that it’s worth asking, why is my body sending this message, and how is it trying to protect me — rather than feeling betrayed by it.

LISA: Yeah, I think HA really requires a different paradigm — moving from thinking about food as gasoline or motor oil to thinking of it as a source of nutrition your body needs to live and be healthy. It’s a shift away from thinking about how your body looks and what that means about who you are, and toward thinking about exercise, rest, and self-care through a lens of overall health. Because I’m always looking through the lens of the menstrual cycle, I see your cycle as a sign your body is intelligent and working — when things happen, it’s not because your body is broken, it’s because it’s doing exactly what it’s designed to do.

DANI: Yeah, the reason you lost ovulation and menstruation is because your body is actually working — that’s exactly what you said about it sending a message.

LISA: I could talk to you all day, and I still have questions I didn’t get to, but I know we’ll both need to wrap up at some point. Thank you so much for coming on the show and sharing your experience — I’m excited to share this conversation because in one way, HA isn’t that complicated, and in another way, it’s very complicated, because it requires deconstructing so many ideas about how we’re supposed to present ourselves to the world.

DANI: Yeah, we always say on the show and in the group — killing HA is easy, it’s the mental part that’s really hard. The food isn’t going to eat itself; you have to come to terms with that. You can read about macronutrients and what your body needs to make hormones, and there are a few unicorns who just implement it immediately, but the rest of us need to keep having these conversations, because your brain will keep telling you, “this must be wrong, if I do this I’m going to gain 400 pounds.”

LISA: With everything we’ve talked about today, what would you want to leave listeners with?

DANI: I think it’s so important to know that what’s happening in other women’s bodies has nothing to do with what’s happening in yours — comparison can’t play a role here. You’re an individual, and you need to look at what you’re doing and work with a team that’s on your side to help you cycle properly. And if you are doing everything “right,” then keep learning about fertility awareness, keep going down the rabbit hole, and get as much knowledge about your cycle as you possibly can. You are not the same as the person next to you.

LISA: And it’s absolutely possible to get your period back — I wanted to add that, because that’s the good news here. It’s simple in basic terms, but also genuinely complicated, and we have to hold both of those truths — but the bottom line is, you can get it back if you follow the basic formula. Getting there is the challenge, but it will happen. So tell us about your podcast and your online community — where can listeners go to learn more about you?

DANI: Yeah, awesome — if you have HA or think you might be missing your period, come find the Hypothalamic Amenorrhea Podcast, or just Google it if you can’t find it right away. And I have the HA Society, a group for women with HA or who’ve recovered — we have community calls a few times a week where women going through it don’t have to feel alone, chatting, coaching, and supporting each other, because that community piece is invaluable for so many of us.

LISA: That’s awesome — we’ll put links to all of that in the show notes. Thank you so much for coming on the show today, this was great.

DANI: Thank you, thank you.

LISA: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/353, where I’ll also link previous HA episodes. This is a topic we’ve talked about many times on the podcast — there are so many resources available, and it is possible to bring your period back. Sometimes it takes time, and that time is often about shifting mindset as much as making dietary changes, but it can absolutely be done. I really appreciated some of the myths that got smashed in today’s episode — the myth that you need to be hyper-skinny to experience HA. Not every woman who experiences HA is stick-thin, and it’s important to recognize how sensitive our cycles can be to shifts in caloric intake, exercise, and stress. The menstrual cycle really is the great equalizer, and it helps us see that we’re not all the same — what one woman can get away with, another may not be able to at all, which is exactly why cycle charting is so valuable for figuring out what works for you. Regardless of whether or not you’re trying to have a baby, a normal, regular cycle is a sign of overall health, and losing it for months or years at a time is associated with a higher risk of osteoporosis, bone fracture, and other health challenges — so this is something worth talking about even if pregnancy isn’t on your radar right now. So with that said, I hope you have a wonderful week, and as always, until next time, be well and happy charting.