Sarah is a young woman of nearly 20 who has worked hard to recover her health and life after overcoming a serious case of anorexia nervosa. She shared her worries about her period with me in this conversation.
Sarah: Marcia, I am very worried because I still haven’t gotten my period even though I’m about 130 pounds. I have plenty of fat in my diet, and it’s pretty well balanced in terms of all the food groups. Additionally, I haven’t been overexercising or rapidly changing my diet from day to day. If anything, I haven’t been getting as many fruits or vegetables as I usually get.
Marcia: Sarah, you have done a good job of getting your weight up to a level that should bring your period back and protect your bones. I think it makes sense for you to have a gynecological workup. If the doc finds no medical explanation, I would assume that for you (as for many people), your menstrual weight is at least 5 pounds heavier than the weight you have been maintaining. In this case I would advise that you relatively quickly gain the 5 pounds and maintain it for six months. Resumption of menses sometimes doesn’t happen until your body has had three to six months of stability (i.e. BMI of 20 or better, a balanced diet with generous fat intake, moderate exercise). If your period still does not start after providing these elements, go up another 5 pounds and maintain that weight. Keep me posted.