It was the summer before I turned 30 years young. I just finished my first round/cycle of fertility treatments and was on a break per doctors order until my ovaries were in good condition.
Over the summer, I went to multiple weddings, a trip to Vegas and took a ton of "me" time, time with my husband and time with family and friends. All while intuitively eating and not exercising intentionally- but joyfully. Boy did it feel good! For the first summer I could ever think of, I wasn't worrying about what I looked like in a bathing suit, how I was going to look in a dress for all my weddings, letting myself eat or drink whatever I wanted when I was out with my husband, in Vegas or at all of the weddings. I took beautiful morning walks, listening to the birds chirp and the dew hitting my face and felt okay with just walking (normally is wasn't exercise unless I was sweating to death), I went hiking, I went to movies, hung out with my non-workout friends (I still hung out with my workout friends and still do to this day) and the list can go on. The picture to the left is me and a few of my friends out having FUN :) I never isolated myself from going places but the worry of eating "bad" foods often played a big role when I did go out. I felt FREE and was having SO much FUN! My head was no longer clouded with food or exercise. I was finally able to focus on all the things I was missing out on before.
So you might be thinking..... She's making it seem so easy! Or man, I wish I could do that or feel that way. You SO can ! If you have already read through the previous posts (which I totally encourage you to do), you will see I struggled with my body image, negative thoughts about food, restrictive eating and exercising -since I was a young girl. Also, I'm not going to lie that these "bad" or "negative" thoughts never crossed my mind when I went "all in". They did and in fact its completely normal for these thoughts to come up. However, it is HOW you react to these thoughts. YOU have a choice. I would notice these thoughts and let them pass bringing myself back to the present moment focusing on what I was actually doing (for example- at a wedding with my husband and maybe I thought "Ugh I am feeling so fat after I just ate" noticing that thought then realizing "I am here at a wedding celebrating my friends and having a ball with my husband on the dance floor". Over time, these types of thoughts decreased and now as I write this I can say its extremely rare I ever have these types of thoughts. It took time, patience, self compassion and practice to feel this way.
So I titled this TTC journey continued because I knew that conceiving a child through fertility treatment alone wasn't going to get me to where I needed to be to conceive and taking on a new role as "Mom". After my first round of treatment, I did not feel mentally prepared to do it again until I was in a good place. Fertility treatment is not easy, its mentally and physically draining. Woman do and can conceive without practicing self compassion, self care, managing stress and going "all in" with fertility treatments. I just don't recommend it. I don't recommend it because nutritionally your body needs time to heal and be able to provide the best possible nutrition to your growing baby. Not just my personal recommendation but my professional recommendation. I also don't recommend because after you have the baby things are difficult- you want to be your best self for this little human.
As you may have read in my previous posts I already tried a couple things before my diagnosis of HA. Clomid, Clomid + Metformin and a diagnostic hysterscopy. Nothing budged for me with these interventions, which was fine because at the time I wasn't trying to achieve pregnancy. Now it was time, years past during the journey of finding my HA diagnosis. In Spring of 2015 we started our TTC (trying to conceive) journey.
At the same time of embarking on our TTC journey I had switched jobs and now my insurance covered fertility treatment!! Bonus !! My RE suggested jumping right to injectable medications, as clomid would not work for me. We started with Follistim injections followed by a trigger shot of HCG when it was time. We decided we would try timed intercourse this round and if that didn't work pursue IUI next. I can't remember how often I was giving myself injections or for the length of time during the cycle. I am sure it varies from woman to woman. However, I do remember how nervous we were when my husband had to stick a needle in the cheek of my butt. I still can picture this in my mind LOL! Multiple ultrasounds and blood work accompanied this "fun" process. Which I am totally joking when I say its fun. Just making light of the situation. My first round/cycle of treatment was unsuccessful and followed by Ovarian Hyperstimulation (OHSS) and hair loss. OHSS put me out of work for a solid week. My hair loss was a huge kick in the gut. For me, my hair was always the thing I loved most about myself but admittedly took for granted during the days of trying to obtain the perfect body. My RE encouraged me to take a few months off to get my ovaries in good condition before trying again. This left me so sad and discouraged. I knew deep down inside I would become a Mother one day but I struggled as I saw everyone getting pregnant so easily before my eyes.
During my first round of fertility treatment I put a lot of weight on. I believe this was attributed to multiple factors such as "going all in", the fertility treatments themselves, OHSS and the hormones running through me that made me want to eat everything in sight ! I can't put all the money on my hormones making me eat, my body was in recovery mode and for the first time I was giving it anything it desired. Not gonna lie, I struggled with this A LOT. It was summer, I had multiple weddings (above picture is my hub and I at our first wedding of the season) and a trip to Vegas planned. Looking back, I can say I was extremely proud on how I handled this situation. Instead of turning to restricting food and exercising, I accepted my body for what it was. Yes, negative thoughts still popped up but I did my best to just acknowledge them and focus on positive things. For example- I am going to Vegas I am going to look SO FAT in a bathing suit. I replaced it with a positive thought such as, some people will never visit Vegas in their life and here I am on my second trip with people who love me for ME! Though I already made some positive changes such as eating intuitively, stopping exercise and working on body image. I really had to start digging deeper to help myself fully recover. For me I knew fertility treatments were not the sole answer to getting pregnant. After my first round/cycle I knew it was much more than medication but even more on continuing to fuel my body adequately, moving joyfully and cutting the damn stress. Which I had already started doing alot of self care things to cut stress but made an extra commitment to myself that from now until I achieved pregnancy/delivered the baby, I would become "present" in everyday life. This meant to start having fun, loose control more (and I mean this in a positive way- because I was extremely type A) and enjoy everything life had to offer me.
This quote hit home for me, like really hit home. I came across this quote scrolling on social media (before I removed it from my phone for a temporary time frame during my recovery).
What do you feel when you read this quote?
My initial feeling was an "ah-ha" moment and a sudden onset of tears. The "ah-ha" moment went on and said "Holy SH**, I have been enemies with my body for SO long and living distantly from it". From this point on I made a commitment to myself that I would stop trying to fix or change my body, live inside my body not separate from it, start taking care of my body, be friends with my body and lastly but most importantly love my body NO MATTER WHAT. For SO long I treated my body like it was an enemy, I was mean to it, never ever nice. I don't need to go into details on what I said about my body because I know you are or have done the same thing. Seriously though, how could I be SO mean?! My body did SO much for me! My body stuck with me when I was was depriving it energy it needed and put it through crazy exercising, especially when it was tired. During all that it also kept me well helping me fight off colds, it got my to work everyday, it provided me with a heart to love and take care of others, you get the picture- our bodies do a lot of stuff we take for granted. A simple quote may or may not change your views on your body. It may take you years to realize you need to be friends with your body. Quick side story- When I worked as a clinical RD, I had a 76 year old woman who had cancer, she was losing weight due to her illness. When I told her she needs to eat high calories/high fat foods so she could stop weight loss, she told be she didn't want to gain weight and get fat. SAY WHAT?! She was sick and potentially dying and she worried about her weight/how she looked. Do you want to be in your 70's worrying about what you LOOK LIKE?! Regardless of your health status or age, life is too short to be anything but happy with your body. Though my journey had just begun, I thank HA for teaching me how to love myself and take care of my body.
Through your journey with HA, it is SO important to learn how to love your body and accept how it is or how it might change. I was so afraid to stop exercising and starting eating more carbohydrates. Trust me, I didn't stop being afraid of my body changing overnight. It took sometime with a lot of ups and downs. How could I expect to change overnight something I learned from when I was a young girl. Okay so maybe I couldn't change overnight but I could certainly accept myself and finally become friends with my body. There are SO many emotions and feelings I went through when I decided to "go all in", I cannot begin to put them into words.
Of course my entire journey left me mentally and physically burnt out but when the RE said you will not have children naturally and will need fertility treatments, that was a hard kick in the stomach. Even with fertility treatments, if I didn't stop exercising and start eating more, fertility treatments may not work. I most desperately wanted children one day and that day came soon after my diagnosis of HA. We had no idea how long it would take to get pregnant. The RE said I could wait to see if I got a natural cycle back but he couldn't guarantee how long it would take. I was 29 years old by the time of the diagnosis of HA, so we decided it was time to start fertility treatments. I had no idea what this was going to entail but one thing I did know is that now I had my body on my side and lost my need to control/shame/hate my body. I believe this was truly an integral first step before beginning the hardship of fertility treatments.
I reached my breaking point. I could no longer continue to control or "fix" my health implications (AKA no period/PCOS/HA-whatever the hell I had) with outside sources. What I mean by this is, no more running medical tests, no more controlling food in regards to calories/carbohydrates, no more using exercise as medicine, no more body hating and I really needed to chill the F out and stop stressing over everything! I was doing the same thing OVER and OVER again and expecting different results. Isn't that one of the definitions of insanity? I really was starting to feel insane ! For the past few years, "curing" or "fixing" myself in regards to my health implications took over my life.
Little did I know at the time of my "fixing" phase that I completely 110% screwed up my metabolism. I kept trying to lose weight to have a "better" body and help PCOS, and NOTHING was happening. Mind you I was at a normal/over weight BMI. However, from years of "dieting" and food restriction/over exercising my body was whacked out and very confused. I will go into the science of this in a later post.
So, it was time for a change. It was also time to accept my diagnosis of Hypothalamic Amenorrhea. So that meant no more exercise and controlling food intake or lack of. As I mentioned before, giving up exercise is something I was struggling in my mind to do since I got the diagnosis. Everything I did revolved around it, my husband and most of my closest friends did Crossfit. If you are/were a cross fitter you totally get the closeness of the community within. Not to mention the "high" after doing an intense workout. I also struggled with what was I going to tell all my crossfit friends, would they understand? I did share I had some health stuff going on but thats it. I did not share what was really going on with me as I did not feel comfortable. I will share my story of not disclosing to people about HA in a later post.
After a couple months of fighting in my mind to give up exercise and "go all in", I did it. I cancelled my membership, stopped any extra exercise and really started to get into yoga. I first started yoga when I was a crossfit member but it always took a back seat because I needed to get my "real" work out in, feel good and burn calories of course. Prior to going "all in" I followed intuitive eating, I decided I was going to try my best to intuitively eat. I knew it was time to take care of myself, even though I thought I was before. I started scheduling more self care appointments, such as massages, pedicures, spa dates, going to yoga classes (non intense) and just plain RELAXING. I relaxed by watching mindless TV, taking naps, reading fun books, hanging out with friends I didn't see much due to exercise and spending more time with family. I also scheduled myself a get away at Kirpalu. Lastly, I started working with a shamanic energy medicine/soul coach, she really helped me turn around my ways of looking at things and helped me dig a little deeper to help heal my body. Deleting social media also played a big role for me. I mean who the hell cares what anyone else is doing?! I needed to focus on healing me. All of my close family and friends I didn't need social media to connect to. Not to mention that extreme role it plays in societies screwed up image of "health".
My suggested take away for you on this post is that I want you to know I was ready to make the change to "go all in". A year prior or two years prior I am not so sure I would have been. Though it wasn't easy to make the change and I don't think it will ever be easy for anyone to "go all in", you need to be ready. You also need support and the support that works for you. My husband and my soul coach were my backbone. You will also need "tools" to fill your time that you used to spend exercising. My tools were self care tools above. My self care tools were also very important in decreasing my stress levels. Stress is also something that needs addressing during the "go all in" change. For a while I questioned how I would fill my time if I wasn't exercising, so before you "go all in" consider these things. Ultimately, you HAVE to be ready, only you will know if your ready. My breaking point PLUS the RE telling me I will not be able to get pregnant naturally was finally the kick I needed to get my health in check. What worked for me to "go all in" may or may not work for you.
Stay tuned for more updates on my journey with HA.....
On the drive home from my first appointment with the reproductive endocrinologist (RE) I sulked. I was so happy that finally I had an answer to why I wasn't getting a period but I also questioned the diagnosis. Girls with HA have eating disorders, are very under weight, exercise/sports like crazy (this is what I learned in school). I didn't fit this, I ate enough (so I thought), I exercised no more than the average crossfit person (not gonna lie I was HARD into crossfit), I didn't have an eating disorder and my weight was normal (according to me I was overweight but thats another story). So I sat with this and really thought about it. At this point it was really hard for me to trust a doctor due to years of misdiagnoses or subconsciously was it because I really didn't want to stop exercising? So until my next appointment with the RE I continued to question HA vs. PCOS. I really was bent on having insulin resistance, I thought this was the reason why I wasn't losing weight. I exercised my butt off and wasn't eating a ton. The only thing I could attribute to this was insulin resistance. In a nut shell, insulin resistance inhibits the body to be able to lose weight effectively. My thought (because this was what I was taught in school) was less energy in and more energy out equals weight loss (which now I have learned is NOT true). So I begged my RE to run a glucose/insulin tolerance test. He wouldn't, he said there is no point because you are not insulin resistant. So then I called my OB-GYN to see if they would order it, nope. Then I called my primary care doctor and explained the situation and she would not order it. I cried until my eyes were ready to pop out of my head, I needed this test to once and for all confirm my questioning for my diagnosis. Or did I need it for confirmation of why I wasn't losing the weight or had the perfect body because I ate so well and exercised so much?
Mind you I have been investigating and trying to control my PCOS for years. Years of energy spent waking everyday and having this be my mission to "cure" what was causing no period. Years of pushing my self to the gym every day at 5am and then coming home after work and running. Years of eating "clean". Years of obsessing over my body and the abs I always dreamed of. I was exhausted! Mentally and physically. Ladies, this is when I hit my BREAKING POINT and knew it was time to change. I had to stop controlling outside factors and work healing, loving and accepting my body.
You may question, why this happened to a nutrition professional that is Registered Dietitian. Shouldn't I have known better? During my undergrad work we were taught strictly conventional approaches. Weight loss equals less food in and more exercise. We were taught healthy IS eating only "good" foods. We were also taught high weight status is directly related to co-morbidities such as heart disease, diabetes etc. It was not until I graduated and earned my credentials that I learned that everything that was taught in school wasn't everything. As an RD you can venture off into different avenues of nutrition. Practicing nutrition is one of the most diverse practices in the world. Specifically because one way of nutrition does not fit everyone.
Please check out my guest blog on Dr. Nicola Rinaldi's site. Here I explain my journey to becoming a Non-Diet Dietitian. Dr. Rinaldi is the Author of No Period, Now What. Anyone struggling with HA, I highly recommend this book.
For about 5 years I thought I had PCOS. Multiple doctor visits to my OB-GYN ( I even ended up switching OB-GYNs). Both of them confirmed by ultrasound that I had PCOS (note: I had no other symptoms other than an elevated testosterone level years back). So I continued to try to "cure" PCOS through a very strict diet and exercise regime. Throughout the years I was trying to cure PCOS I continued to seek help. No doctor could give me an answer to why I wasn't getting my period. So after a while I gave up. I guess I'll just try to get pregnant because no doctor could tell me why I wasn't getting a period. So begun my fertility journey. First I started with clomid and all the monitoring that came with it. It didn't do anything for me and it just didn't feel right (I still wasn't ready for a baby). Then I stopped trying to get pregnant for a bit and decided to just continue to cure my PCOS. Still no period. Okay, well maybe if I tried an actual fertility clinic they could help me figure out why I have no period. I assumed that they would want to figure out my problem before they determined the course of treatment. Makes sense right?
My first visit with the fertility clinic- which was an hour and a half away from my home and insurance didn't even cover treatment. We met with the doctor. He could not tell me why I wasn't getting my period. UGH, I give up. Just get me pregnant (though my mind still wasn't settled on this course of treatment). So first step was a hysteroscopy. Painful procedure and inconclusive because I am allergic to IV contrast. Next step, the fertility doctor wanted me to take clomid (again) and if that didn't work (again) go for an IUI w/injectable meds or IVF. So we had to take a step back and consider the costs involved. My gut told me this wasn't the way to go and I didn't want to spend thousands of dollars when I didn't feel it was necessary, I mean I still wasn't ready for pregnancy. I just wanted my damn period !!
So time continues to pass....
At my routine OB-GYN check up (with my doctor who I saw multiple times before), finally recommended me to a reproductive endocrinologist (RE) for my PCOS. My first initial thought was WHY THE HELL DIDNT YOU RECOMMEND THIS YEARS AGO?! At the time, I didn't even know what an RE was but I had a good feeling about this.
So my very first visit went as simple as this after I explained my history of my PCOS journey and my very "healthy" lifestyle. "Cynthia, you do not have PCOS you have Hypothalamic Amenorrhea (HA)". I already knew what HA was but I didn't fit that diagnoses. I wasn't anorexic, I didn't have an eating disorder, I was at a normal weight, I was HEALTHY, nope I couldn't have HA. He then proceeded to say stop all exercise. Whoa, wait a second. Stop exercise? So I FINALLY got an answer! But now I have to sacrifice what means the world to me?
Stay Tuned to the beginning of my HA journey and how I overcame it all, got my period back and most importantly starting loving and taking care of myself.
Please note, I am not bashing the doctors above. There is a knowledge deficit with practitioners in regards to PCOS vs. HA. Along with helping woman overcome HA I hope to spread awareness about HA to doctors across the world.
A little detour in my period journey for a minute to focus on the perfect body that I have been trying to achieve since I was like 15.
Growing up, I always remembered my Mom and her side of the family taking about weight. Specifically my Mom always counting calories, talking about how fat she was and making sure she was always exercising to burn off whatever "bad" food she ate. Her side of the family was always talking about (and still talk about) this persons fat, that persons skinny, "wow, look so and so is gaining weight". I'll never forget the day my grandmother asked me if I was pregnant (when I was actually trying to get pregnant). I asked "Why did you ask me if I was pregnant?". She responded "You look heavy". I was crushed to say the least.
My strive for the perfect body continued with me for most of my high school years and through college. Though it didn't really kick into high gear until it was time for my wedding. I HAD to be perfect for this day. I couldn't look fat in pictures, I had to fit into my size 4 wedding dress. So my healthy, clean eating whatever the hell you want to call it was in full effect along with a strict exercise regime. Wedding came, I LOOKED great I finally did it. I was happy in my own skin! Or so I thought......
The wedding went by and I could finally have some "bad" foods again and lay off the exercise a bit, PHEW! My mind needed a break from all the obsessing over the wedding, my diet and how I would look that day. With any "diet" and strict exercise regime once you go off you start to gain weight. Ugh, but I worked so hard I couldn't gain weight again, I was finally "happy". Then started the viscous guilt cycle and body comparison hell. I would look in the mirror and compare myself to my "wedding body" and just wished I could look that way again. We went on our honeymoon 6 months later to Aruba and I was super excited but a part of me wasn't because I was "FAT" again. The picture on the left is "fat" Cynthia and the picture on the right is the "super fat" Cynthia ( I was really just bloated from all-inclusive eating), so fat she couldn't take her bathing suit cover up off during some of her honeymoon pics because she didn't want to remember herself this "fat" in the picture. Seriously?! How could I be this mean to myself?!
Stay tuned for a future blog post on the "Perfect Body" and how I over came all of the above.
Weekly blog posts continue on my journey of regaining my period, having children and becoming the best version of myself !
Determined to "cure" PCOS my exercise regime consisted of Crossfit 6 days (sometimes 7) a week for atleast 2 hours a day and in addition a 3 mile run or other intentional exercise. My eating regime consisted of huge restrictions, nothing "bad" of course and boy if I ate something "bad" you better believe I was in the gym burning it off or beating myself up for eating it. The guilt if I didn't get to the gym or run was INTENSE. I followed a strict Paleo diet because it was supposed to be SO healthy, limited in carbs and everyone at my Crossfit gym was doing it. Not to mention I was a dietitian so I knew what I was doing and I also had to uphold my "healthy" and "fit" dietitian image. I mean who would want to work with a dietitian who wasn't fit or the image of health?
So on continued my intense, strict "healthy" eating regime and drive to cure my PCOS. This went on for about 3 years. During that time I still wasn't getting my period and doctors STILL weren't concerned! I worked with other professionals and doctors to improve my PCOS and even went on Metformin (a drug that helps with insulin resistance and actually has huge success with woman that have PCOS). Still no period. Hmm...okay ready to wave the white flag ! I finally sough fertility help but I still wasn't ready to have kids. I just wanted to know WHY I wasn't getting my period!! The fertility doc just wanted to get me pregnant.
So many woman with HA are diagnosed with PCOS. Check out the resource below for more information.
PCOS Vs. HA
Who Needs a Period? They are a pain in the a** anyway !