Months before Cynthia Donovan was ready to walk down the aisle, she decided she wanted to become the slimmest version of herself.

The New York dietitian, who already lived a healthy lifestyle, began eating more vegetables, lean meats such as fish and chicken and started working out seven days a week, sometimes for up to three hours a day.

Donovan also began to track her food intake and made sure she did not consume more than 1,500 calories every day – significantly less than the recommended 2,400 calories needed to maintain a healthy weight. 

She said: ‘I got engaged and thought, “I have to get into the best shape of my life”. So I kicked into overdrive.’ 

But while the dietitian managed to reach her goal weight well in time for her 2011 wedding, she realized the damage her strict diet had caused her years later. 

Due to the lack of healthy fat, low body weight and excessive exercise, Donovan was diagnosed with functional hypothalamic amenorrhea (FHA). 

FHA is described a condition that causes a woman’s menstrual periods to stop due to problems with the hypothalamus – a part of the brain that regulates hormone release. 

If left untreated, the condition which affects 1.62 million American women, can cause infertility and other long-term health problems, including bone density loss. 

Cynthia Donovan, a registered New York dietitian, had decided to lose as much weight as possible months before her wedding

The now 39-year-old told Newsweek: ‘I would exercise before work and then run after work. It was partly for stress relief, but I wasn’t fueling my body properly, and that created even more stress physically. 

‘I was eating healthier and calculating my calories based on height. That’s another misconception, that our bodies are just calculations.’ 

But while she being congratulated for her physique and discipline at her wedding, Donovan’s body had already begun to show signs of FHA. 

Initially, she thought that missing her period was a result of her discontinuing her birth control pill and as a result, decided to take it again before her wedding. 

‘My doctor told me it was normal post-pill amenorrhea [the absence of menstruation] and to wait three to five months. But with the wedding approaching, I went back on the pill,’ she said. 

However, what she did not realize was that her missing menstrual cycle was far more serious and was not going to return anytime soon – a signal she would struggle with infertility.

Over the next five years, Donovan and her husband continued to look for an answer as she underwent hormone therapies, supplements and acupuncture to bring back her menstrual cycle and reverse her infertility.

At one point, Donovan was misdiagnosed with Polycystic Ovary Syndrome – a hormonal disorder characterized by irregular periods and ovarian cysts. 

She told Newsweek: ‘I was told I had Polycystic Ovary Syndrome (PCOS), which is actually a common misdiagnosis when the real issue is hypothalamic amenorrhea.’

The brain’s hypothalamus is known as the command center for several bodily processes and is responsible for signaling the body to release crucial reproductive hormones such as estrogen in women. 

Despite being congratulated for her physique and discipline at her wedding, Donovan’s body had already began to show signs of FHA

Donovan and her husband continued to look for an answer as she underwent hormone therapies, supplements and acupuncture to cure her infertility 

However, triggers such as excessive exercise, poor nutrition and environmental stress can cause the hypothalamus to enter ‘survival mode’ and stop working properly. 

As a result, the organ puts certain bodily processes and functions on hold such as a regular menstrual cycle so it can focus on the more important ones such as breathing. 

This can contribute to a hormonal imbalance in the body. Combined with a lack of healthy fat, a person becomes increasingly susceptible to developing FHA. 

Apart from an irregular or completely missing menstrual cycle, symptoms of FHA also include low energy, vaginal dryness, low sex drive, depression, anxiety, hair loss and headaches. 

Eventually, the young New Yorker was diagnosed with FHA and was told that she would need to start eating more and reduce her exercising if she wished to reverse her infertility. 

By the time she turned 30, Donovan began undergoing IVF as she continued to seek answers about her condition – but failed to conceive a child after three cycles.

However, after completely scaling back her intense workouts and increasing her calorie intake, she finally became pregnant with her first son in 2016 via IVF. 

However after completely scaling back her intense workouts and increasing her calorie intake, she finally became pregnant with her first son in 2016 and second son in 2018 (both pictured)

As Donovan continued to breastfeed her newborn while eating more calories and exercising less, her menstrual cycle returned. 

Three months later, she became pregnant again with her second son without medical intervention and the child was born in 2018. 

Talking about her her weight loss journey for her wedding, she said: ‘Do you just want to see a nice body – or a woman who lived, laughed and loved up until her special day?

‘When I look at mine, I see a girl who was unhappy with her body, even though she worked her butt off. I was empty inside and on edge, because I wasn’t eating enough.’

After spending years recovering and reversing the damage in her body, Donovan said of her eating habits: ‘You can get in shape, but it doesn’t have to be extreme. It shouldn’t cost you your health. I want women to feel free – not stressed – around food.’