FHA is when your period stops not because of pregnancy or a problem with your uterus or ovaries, but because your brain (specifically, the hypothalamus) senses that your body is under stress. It decides to pause your menstrual cycle. It's like hitting the “pause” button on reproduction.
The hypothalamus controls reproductive hormones by sending out pulses of GnRH, which stimulate monthly cycles. But if your body's under stress—whether from too little food, excessive exercise, emotional strain, or even genetics—it slows or stops those pulses. The result? Low estrogen, no ovulation, and no period .
Though originally linked with thin athletes, FHA can affect anyone facing:
Insufficient calories (even at a normal weight)
Intense physical activity
High stress (mental, emotional, or physical)
A genetic tendency toward sensitivity to stress
As many as 1 in 3 cases of secondary amenorrhea (when periods stop after starting) result from FHA.
Key symptom: No period for 3+ months (if it was once regular)
Other signs: Low energy, emotional highs and lows, hair thinning, vaginal dryness, low libido
Why this is important: Low estrogen doesn’t just affect cycles—it can harm your bones, heart, mood, fertility, and even brain in both the short and long term .
They follow a step-by-step path:
Rule out pregnancy
Complete history & labs – Checking hormones (FSH, LH, estrogen, thyroid, prolactin), stress levels, diet, exercise, and emotional health
Imaging & bone scan – If needed, to exclude other causes and assess bone strength
Exclude other conditions like PCOS, thyroid problems, pituitary issues — FHA is a diagnosis of exclusion
Eat enough nutrient-rich foods
Ease off intense workouts
Reduce stress (through rest, therapy, or self-care)
Take calcium and vitamin D supplements
If your period doesn’t return after 6 months, doctors might recommend low-dose estrogen treatment (usually patches plus progesterone) to safeguard bone health
Team up with a doctor, dietitian, and possibly mental health professional
If lifestyle changes aren’t enough, cognitive behavioral therapy (CBT) can help reduce stress and shift eating/exercise attitudes — often improving hormone balance
Periods may return gradually before becoming regular
Bone density may improve over time with consistent lifestyle and/or hormonal support
Start with lifestyle tweaks and tracking cycles
If menses still don’t return, treatments like pulsed GnRH or medications such as clomiphene can help stimulate ovulation — but usually only after improving your basic health state
FHA isn’t a failure; it’s one of your body’s messages that something’s off in your energy or stress balance. The good news? It’s usually reversible. Most people can get their periods, and overall health, back by eating well, resting, managing stress, and getting the right support.
If your period stops, it’s worth checking in with a healthcare provider. A period is an important sign of your body’s well-being.