When Periods Pause: Understanding Hypothalamic Amenorrhea with The Period Nutritionist Cynthia Donovan (Ep. 52)
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In this episode of The Med Edit Podcast, Dr. Jessica Gray and Dr. Cari Sorrell shine a light on a condition that affects countless women — but is often misunderstood, misdiagnosed, or dismissed entirely: Hypothalamic Amenorrhea (HA).
HA occurs when the brain senses that the body isn’t in a safe or nourished enough state to sustain a menstrual cycle. It accounts for nearly 30% of secondary amenorrhea in reproductive-age women, yet many don’t realize their missing period is a medical red flag, not an inconvenience.
To break it all down, we’re joined by Cynthia Donovan, a Registered Dietitian Nutritionist, Certified Health Coach, founder of Recipe for a Period, and host of The Period Recovery Podcast. Known online as The Period Nutritionist, Cynthia specializes in helping women restore their periods through nutrition, mindset, and sustainable lifestyle changes.
In This Episode, You’ll Learn:
1️⃣ What Hypothalamic Amenorrhea Is
How the hypothalamus controls reproduction
Why periods stop when the brain perceives stress or energy deficiency
Common misconceptions (no — this isn’t an “ovary problem”)
2️⃣ What Causes HA
Low energy availability (undereating, overtraining, or both)
Psychological stress, burnout, chronic pressure
Perfectionism and “wellness culture” influences
Why body size alone does not determine who gets HA
3️⃣ HA vs. PCOS — What’s the Difference?
Why missing periods should never be ignored
How to distinguish between two commonly confused conditions
Why identifying the root cause is essential for long-term health
4️⃣ Health Consequences of HA
Missing your period affects far more than fertility. Cynthia highlights risks like:
Bone loss and osteoporosis
Low hormone levels
Metabolic changes
Thyroid disruption
Mood and energy impacts
5️⃣ The Path to Recovery
Increasing energy intake
Reducing high-intensity exercise
Rest and nervous system regulation
Breaking perfectionistic or restrictive habits
How to “redefine health” outside of diet culture
6️⃣ What Period Recovery Looks Like
Cynthia shares:
Nutrition strategies for restoring a healthy cycle
Day-to-day adjustments clients make
What realistic timelines look like
How her programs support women through the process
7️⃣ Fact or Mis(information)
Rapid-fire myth-busting on:
“Losing your period is normal if you’re fit.”
“Only underweight women get HA.”
“Your period returns immediately once you eat more.”
“HA only impacts reproductive health.”
Resources Mentioned
- Endocrine Society Clinical Practice Guideline on HA
- Cleveland Clinic: Hypothalamic Amenorrhea Guide
- PMC Articles on HA & metabolic impacts
- @period.nutritionist on Instagram or through this link: https://www.instagram.com/period.nutritionist?igsh=MXJsNGlkZXh0OXJxaA%3D%3D&utm_source=qr
- The Period Recovery Podcast
Continuing Medical Education (CME)
Clinicians — claim your CME credit for listening!
https://cmetracker.net/TTUHSC/Publisher?page=pubOpen&nc=7120399723#/myPortal
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LinkedIn: Dr. Jessica Gray: https://www.linkedin.com/in/Jessica-gray-md/
LinkedIn: Dr. Cari Sorrell: https://www.linkedin.com/in/cari-sorrell-42545a7b/