'My Cholesterol is High and it Came out of No Where!"
When you think of Hypothalamic Amenorrhea (HA) - you may automatically picture someone who has historically eaten "clean", frequently excercises, and lives in a way that promotes quote on quote health.
Someone in HA may be living in a way that, to them, and on the outisde, looks like the picture of health. When you are in HA its easy to convince ourselves that this way of living truly is whats best for us.
So you can imagine the shock that comes when a woman finds out she is living this way - only to have abnormally high lipid levels.
HA is often only discussed in the context of missing periods, but its hormonal ripple effects go deeper—including impacts on cholesterol.
What does Estrogen have to do with Cholesterol?
At the center of HA is low energy availability. The extreme nutrient deficit suppresses the hypothalamus, reduces reproductive hormones, and ultimatley shuts down your period. One key consequence of HA is Low Estrogen. This matters because estrogen plays a protective role in metabolic and cardiovascular health.
Estrogen helps regulate how the body processes fats by increasing HDL (“good” cholesterol) and keeping LDL (reffered to as "bad" cholesterol, even though its not really bad, but I digress) in check.
When estrogen levels drop, this balance can shift—LDL may rise, HDL may fall, and total cholesterol can increase. In other words, the lipid profile can start to resemble what’s seen after menopause, except in younger, fertile aged, women.
Estrogen's Effects on the Liver
Low estrogen can also affect liver function. The liver is where cholesterol is produced and cleared. Low estrogen may reduce the body’s ability to remove LDL efficiently. This is another reason as to why cholesterol can rise despite dietary chanegs and choices.
Liver stress, combined with the metabolic stress of under-fueling, can further contribute to unfavorable cholesterol levels. AKA- now is not the time to cut out red meat and eggs just because they have cholesterol!
Women with HA are Offered Statins
When your provider sees the high cholesterol levels, they can be quick to reccommend dietary adjustments, a perscription for statins, and a refferal to a cardiologist.. yeah been there done that. It can be tempting and feel like the only option. We consider these options out of fear, because we weren't explained the full picture.
Thats why it is so important to speak with someone who understands the context of the WHOLE person and the relationship that low estrogen and cholesterol have.
But How can I improve my Lipid Levels?
The good news is - that this process is often reversible. The work you need to do to restore your period will automatically improve estrogen levels. The improvement of estogen levels will, in turn, impove your cholesterol levels!
SO long story short, persuing HA recovery can not only bring your period back, but improve your high cholesterol too!
Who would have thought :)
Rebecca Pinho
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