Amenorrhoea or Menopause? Why your periods might disappear.

Have your periods gone missing, but you're not sure if it’s early menopause… or something else entirely?

For many women in their 30s and 40s, the sudden disappearance of menstruation doesn’t always mean menopause has arrived. In fact, it could be Functional Hypothalamic Amenorrhoea (FHA), a reversible condition often triggered by lifestyle stressors like overexercising, under-eating, or chronic stress.

And behind both FHA and early menopause lies a silent, cellular player you may not have considered: your mitochondria.

Let’s unpack what’s really going on when periods stop—and how to support your body back into balance.

What Is Functional Hypothalamic Amenorrhoea (FHA)?

FHA is a form of secondary amenorrhoea, meaning periods stop after previously being regular. The cause? A breakdown in hormonal communication between your brain and ovaries, often triggered by stress; physical, emotional, or metabolic.

Rather than an irreversible loss of ovarian function (as in menopause), FHA is your body’s adaptive survival response to perceived danger.

When your brain senses:

• Low energy intake (dieting, fasting, skipping meals)

• High energy output (overtraining or physical exertion)

• Persistent stress (emotional burnout, unresolved trauma, environmental stressors)

…it dials down the reproductive system to conserve energy.

FHA vs Menopause: What's the Difference?

It’s important to note: blood test results alone can’t always give a clear diagnosis. Both conditions can show low estrogen, leading to hot flushes, poor sleep, and mood swings. That’s why a detailed case history and sometimes functional testing are key.

The Stress–Exercise–Nutrition Triad Behind FHA

🥗 1. Undereating or Dietary Restriction

• Calorie deficits, low-carb or keto extremes, and fasting can all suppress ovulation.

• Micronutrient deficiencies—particularly zinc, B vitamins, magnesium, and healthy fats—impair hormone synthesis.

• Your body interprets this as famine and downregulates non-essential functions like fertility.

🏃‍♀️ 2. Excessive Exercise

• High-intensity workouts (especially fasted cardio or multiple daily sessions) without sufficient recovery or fuel can trigger FHA.

• Energy availability is key, if you’re not eating enough to meet exercise demands, your reproductive system suffers.

• Many women unknowingly suppress ovulation in the name of fitness.

😰 3. Chronic Stress

• Psychological stress (work, relationships, trauma) and physiological stress (toxins, gut issues, sleep deprivation) elevate cortisol.

• Cortisol inhibits the GnRH (gonadotropin-releasing hormone) pulse, which is the first step in your monthly hormonal cascade.

• Over time, this can halt your cycle altogether.

The Mitochondrial Link: Your Cellular Energy Determines Hormonal Harmony

Did you know your ovaries are one of the most mitochondria-dense tissues in your body?

Mitochondria:

• Power the production of estrogen, progesterone, and other hormones

• Fuel oocyte (egg) quality and ovulation

• Detoxify oxidative stress that naturally rises with hormone fluctuations

• Respond rapidly to nutrient depletion, environmental stress, and toxins

Whether you’re dealing with FHA or early menopause, if your mitochondria are struggling, hormone production will falter.

Midlife mitochondrial decline is natural—but it can be accelerated by:

• Poor diet

• Overtraining

• Toxin exposure

• Sleep deprivation

• Chronic inflammation

• Hormonal birth control history

• EMF exposure (your electrome!)

By restoring mitochondrial vitality, many women regain energy, hormonal balance, better moods, and yes—even ovulation.

Mitochondria: The Hormone Powerhouses

Did you know your sex hormones can’t be made without mitochondria?

Here’s why:

1. Cholesterol is the starting block for all steroid hormones (progesterone, oestrogen, testosterone, cortisol).

2. To be transformed, cholesterol must be transported into the mitochondria by a special helper protein called StAR(Steroidogenic Acute Regulatory protein).

3. Inside the inner mitochondrial membrane, an enzyme called CYP11A1 (P450scc) performs the first, crucial step: it converts cholesterol → pregnenolone.

4. Pregnenolone then leaves the mitochondria to be further processed into progesterone, oestrogen, and other hormones in the smooth endoplasmic reticulum.

👉 If mitochondria are stressed, under-fuelled, or damaged, this whole pathway slows down—leading to reduced hormone production.

This is why supporting mitochondrial health is essential for ovarian vitality, fertility, and a smoother menopause transition.

Testing: What Can Help You Differentiate FHA from Menopause?

Hormonal Blood Tests

• Estradiol (low in both)

• FSH and LH (low/normal in FHA; high in menopause)

• AMH (can be helpful to assess ovarian reserve)

• TSH and prolactin (to rule out thyroid or pituitary causes)

DUTCH Test

• Shows cortisol rhythm, DHEA, and hormonal precursors

• May help identify adrenal suppression or stress-driven patterns

OligoScan / Mineral Testing

• Mineral imbalances (low magnesium, zinc, sodium/potassium ratio) can impact ovulation

• Toxic metals like mercury and aluminium can impair mitochondrial and ovarian function

InBody Scan / Body Composition Test

• Body composition may show low fat stores or under-muscularity

   

How to Support Recovery (or Thrive Through Menopause)

Whether you're navigating FHA or menopause, the core pillars of recovery overlap:

1. Eat Enough—and Consistently

• Reintroduce regular meals, especially whole-food carbs, proteins, and healthy fats

• Focus on nutrient-dense foods: eggs, oily fish, leafy greens, avocado, root veg, nuts/seeds

• Ditch restrictive eating for a cell-fuel-first mindset

2. Train Smart, Not Just Hard

• Prioritise strength training, pilates, yoga, or restorative movement

• Rest days are essential—especially if you’re not sleeping well or feeling depleted

3. Stress Less, Sleep More

• Prioritise circadian rhythm support, magnesium, calming adaptogens (Withania, Lemon Balm, Rhodiola)

• Practice deep relaxation techniques: breathwork, PEMF therapy, sound therapy, digital detox

4. Mitochondrial Support

• Nutrients: CoQ10, B-complex, magnesium, acetyl-L-carnitine, taurine, alpha-lipoic acid

• Hydration: Structured water, electrolytes (e.g. sodium-potassium balance)

• Devices: Red light therapy, PEMF, Hypervibe, HBOT, HOCATT

• Herbs: Rehmannia, Shatavari, Peonia, Tribulus (esp. for FHA)

Final Words: Missing Periods Are a Signal—Not a Sentence

Your body isn’t broken. Whether it’s FHA or menopause, the loss of your cycle is a call for deeper attention. It’s a sign that something isn’t in balance—whether metabolically, emotionally, or energetically.

With the right support, many women restore their periods, improve egg quality, or transition more gracefully into menopause with strength and vitality intact.

You are not alone. And you don’t have to guess.

Not Sure Which Path You're On? Let's Find Out, Together.

Book a Menopause Strategy Session with me and get personalised guidance to uncover what's really driving your hormonal imbalance. We'll look at your history, symptoms, lifestyle, and (if needed) testing to design a path that works with your body—not against it.

👉 Book your session here