Hypothalamic Amenorrhea

Disclaimer: All opinions on If Gravity Happens are my own personal opinions, views, and experiences. I am not a doctor, nutritionist, or anything like that; I am strictly talking from experience. Please contact a professional for any specific questions regarding your diet/exercise/medical issues.

After a year of falling in love with running, eating healthier, and losing weight – I was down 43 pounds and counting, running 25+ miles a week, doing high intensity workout videos, lifting weights, and had reached my goals. I was now ready for a new goal, a baby.

In December of 2011, my husband and I decided we were ready and excited to start a family. I got off birth control pills at the end of December and we started actively trying for a baby in January. Unfortunately our journey went from very hopeful to devastating. After 2 months of waiting to see if I would get my period and many negative pregnancy tests later, I was prescribed Provera (progesterone) to take for 5 days and that would induce a bleed…but I didn’t respond.

Next steps were to continue to wait…maybe it would come on it’s own…maybe it was just the years of artificial hormones I put into my body…maybe…maybes were all that I was given. I am such an impatient person that this waiting game was such a huge challenge for me. With some fertility issues running in my family, my biggest fear was starting to stare back at me, the fear of not being able to be a mom and give the gift of being a dad to my husband.

Along with waiting, my doctor felt that at 5’4” and 114 lbs (and falling…) that my weight was too low and I needed to gain some back. I had asked my doctor if running could be an issue and she reassured me that she has patients run up until the day they give birth.

So my focus was on gaining weight. This was incredibly hard. I also realized that I had developed an issue with food. I wanted to be so ‘healthy’ that everything I ate barely added up to the calories I was using to live each day not to mention with added exercise. I had put myself in ‘starvation’ mode, not meaning to, but I was SO good at losing weight…not realizing that I needed to stop losing and start maintaining. I didn’t know how to. I didn’t understand the difference between eating healthy and not eating enough. I realized I wasn’t consuming much of any ‘fat’ in my diet. So I bought some REAL peanut butter (yes, I was eating PB2…), ate some ice cream and began to let go of the guilt I felt after I ate something that was ‘forbidden’.

In 2 months I gained 10 pounds…but continued to run and exercise. In the meantime, being the Type A personality that I am, I did lots of research on what could be causing my issues. I was determined to figure out why my body was failing me. I came across a term called “hypothalamic amenorrhea”. Everything about it echoed me and my situation…

Wikipedia defines hypothalamic amenorrhea as, “the absence of a menstrual period in a woman of reproductive age. It’s often caused by hormonal disturbances from the hypothalamus and the pituitary gland. The absence of menses for 3 months in woman with previously normal menstruation.”

So what causes it? “Women who go through significant weight loss, dieting, or perform considerable amounts of exercise on a regular basis are at risk of developing hypothalamic (or ‘athletic’) amenorrhea” (Wikipedia).

I was thinking, well this could be me…I lost weight, I run a lot, hmm…could it be hypothalamic amenorrhea? I don’t work out or run THAT much, do I? Yes, I had lost 43 pounds in the past year and was running 25+ miles a week…but is that a lot? I wasn’t running any marathons or anything.

So I decided to ignore my irrational thoughts and face the music to “lighten” up on my running. I figured it was worth a shot and I felt better doing everything I possibly could. I went from running 25+ miles a week to 2-4 miles a few times a week, this was definitely a challenge as I was going through some very stressful times in my life and running was my stress reliever. But I continued to wean myself off of it while I waited for my appointment with a new doctor, a gynecologist/fertility specialist.

Before my appointment, I was prescribed the birth control pill to take for 2 weeks and then have a withdrawal bleed so that I could go in for blood work.

May 1st came around and my husband and I went to our new doctor to talk about my blood work and to talk about our next steps. My labs came in with all low levels. She briefly touched on hypothalamic amenorrhea…I knew it! But she said it was a vague diagnosis that she never likes to go into because there are so many causes and it’s so hard to say that’s what’s causing it.

By the end of the appointment I had been told to gain weight and stop running. Doctor’s orders. I needed this. I needed someone with professional knowledge to say, “you NEED to STOP running.” So that was it. April 26th was my last run. Yes, I sound like an alcoholic in recovery…because that’s what running was to me. It was an addiction and something I felt I needed. I also realized that my weight had gotten so low back in January that that was also an issue. My options were to stop running and gain weight or be put on a medicine which yes, would force me to ovulate, but it also has its risks. I am convinced I can do this naturally and on my own – but I’m NOT on my own!

So I said goodbye. Goodbye to my timelines, goodbye to my plans, I had to make changes, turn my world upside down, make sacrifices, and focus on what I want more than anything…a baby.

After my vague diagnosis with HA, I was determined to know everything about it and overcome it. I found so many healthy living blogs with women writing posts regarding their non-existent menstrual cycles. Women just like me! One in particular was Ashley. Her and I emailed back and forth and she pointed me in the direction of an incredible support forum of women dealing with the same.exact.thing.

The support I received and knowledge I gained from these women has been truly inspirational and uplifting. They have been there on my worse days and coached me along the way to healing my body naturally.

Some days gaining weight seemed pointless, there are so many other women out there skinnier than me, or runners who run and get pregnant, how much weight gain is enough? What about when the weather is so nice and I crave a run…how can I be strong enough to keep pushing on? These women helped reassure me of my goals, reassuring me that with weight gain and relaxation…my body will heal.

Other than my husband, my partner in crime through this journey, my family has also been there for me and helped coach me through cheering me on and keeping me positive. Without them I really, honestly, could not have gotten through all of this.

And after 5 months of struggle, 17 pounds gained, 1.5 months of no running or exercise except for walking (I even had given up my Jillian videos, elliptical, and weights…as that is all included when you have HA)……

On May 31st, my cycle returned. I was ecstatic and finally felt like all of the work and hardships over the past 5 months were worth something. Change was happening…and now I continue to hope that my body is working again. Our bodies are amazing things if we just trust them and take care of them.

This hasn’t been an easy journey, it has been one of the hardest things I’ve ever had to go through but through it all, it has made me stronger, my marriage stronger, my faith stronger, and my trust in my own body stronger. I will overcome this. We will have a baby. I am struggling for a reason, and that reason is to hopefully help someone out there overcome it as many bloggers and women of a special forum have helped and are helping me. People are out there dealing with this just like me and we all need to support one another because one day we will all be celebrating that plus sign together and the beginning of our lives as mothers.

Getting my cycle back was just a step in my long road to recovery.

So what is hypothalamic amenorrhea?

Disclaimer: All opinions on If Gravity Happens are my own personal opinions, views, and experiences. I am not a doctor, nutritionist, or anything like that; I am strictly talking from experience. Please contact a professional for any specific questions regarding your diet/exercise/medical issues.

Basically it’s when your body isn’t communicating with the reproductive system. Because I lost weight, got too low of weight and more importantly body fat, and was exercising the amount I was without refueling properly – my body was in stress-mode and fertility is the first thing that shuts down.

Good news is: it can be reversed! There are medicines out there that will help force ovulation, with HA I was not ovulating. There is also a chance to ovulate naturally with a change in lifestyle, like gaining weight and reducing exercise.

A good goal for me was to reach a fertile BMI (a BMI of around 22-23+), when we started trying for baby, I was around 19.5 for a BMI, I am currently right between 22 and 23 and got my first natural cycle this past month. I also think it’s important to gain weight and combine it with not exercising. Since my body is super sensitive to stress right now, the more relaxed I can keep myself, the better! Also, with HA, bones suffer because of the lack of estrogen my body produces. Walking and yoga are great forms of exercise for me now.

Basically the way I think about it is that it’s like I have an injury. Let’s say I broke my leg, well then I wouldn’t go for a run; I would let it heal. HA is an injury to me. I must allow it to heal. When your body starts to shut down like mine has; basic survival instinct kicks in. I have to make my body trust me again and to do that I need to trust it in return.

Signs I realize I had when looking back now:

I saw some signs, especially when I look back…I was cold, NON-STOP. My hands and feet were freezing, this winter was the hardest ever for me to get through and believe it or not it was the most mild winter in YEARS in Iowa – with only 30’s and 40’s for lows instead of the typical negative temperatures.

Another sign I noticed was my nails stopped growing. They were extremely brittle and thin, but never really grew. They stayed very short on both my fingers and toes.

At my lowest weight a friend of mine mentioned my hair getting thin. I have always had thin hair and never thought much about it, but as this friend is a very close one and very honest – as well as a nurse – her pointing this out to me was a bit of an eye opener. Actually, I got very defensive…knowing that it probably was due to dipping into the ‘unhealthy’ borderline weight I was at then.

My skin was also an enemy. I’ve always had skin issues, mainly being too oily. Nope, not the issue then, my face was dry and flaky…another sign something was up.

And of course, the biggest sign of all – no menstrual cycle.

Once I started allowing myself to heal…all of these began to reverse.

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33 Responses to “Hypothalamic Amenorrhea”

  1. Rose June 15, 2012 at 2:47 am #

    Wonderful post. So honest and heartfelt. Congratulations on sharing your story–I know you will be a positive force in the world for bringing light to HA. Best of all, you DID it–you conquered!!

    • ifgravityhappens June 15, 2012 at 11:59 am #

      Thanks Rose for reading! 🙂 You have played into my success so Thank You!

  2. Lindsey June 15, 2012 at 9:02 pm #

    Thank you for sharing your story! It is inspiring and comforting to know others out there are going through the same thing. I have been on the same journey for the past 6 months. Last summer I was running 50-60km a week (trained for a full marathon last May), and had not had my cycle since going off BC in Oct -’10. Finally in the Fall I smartened up, starting eating more, but still ran, did high intensity exercise..and nothing changed. Then in March I started to run less, do light cardio and eat more, I have now gained 6lbs and working towards getting my period back. I am still thinking no cardio might be the answer. I was recently diagnosed with low progesterone and high testosterone.

    • ifgravityhappens June 20, 2012 at 6:04 pm #

      Lindsey – I am glad you have started to make some changes 🙂 I agree, until I totally cut out all of my cardio/exercise (except walks) that’s when I saw my cycle return for the first time. If you ever need to chat, feel free to email me 🙂 ifgravityhappens@gmail.com

  3. maureenbreakingfree February 22, 2013 at 4:36 pm #

    Thank you so much for this post!!!! I am a recovering binge/emotional eater ( I just recently started a blog documenting my recovery and journey to healthy and happy life). My life pretty much followed a similar pattern to yours. I lost a lot of weight, got obsessed with losing weight, cutting calories and over-exercising (cardio) to the extreme. I was miserable and due to my disordered thinking thought I still wasn’t skinny enough even though I had gotten very thin. After a few very stressful months and the death of someone very close to me, I spiraled into a depression and binge eating cycle. I had lost my period while over-excercising and calorie cutting and my doctors couldn’t figure out why because I too had gained weight like they told me. It was only when I acknowledged my issues, and began taking small steps to begun healthy again that I began to get my period regularly again. I’m still working on all the other issues so it’s inspiring and hopeful to see someone like you, healthy and happy, on the other side! I hope I can get there one day too!!

    • Mallory February 25, 2013 at 6:25 pm #

      It’s SO easy to take eating healthy and losing weight to the extreme and let it control you. I am so proud of you for taking small steps to get healthy again and find your balance! Congrats on the steps you’ve made and remember how strong that makes you as a person!!! You will get there and you are not alone my friend! 🙂 Email me if you ever need to chat or have any questions ifgravityhappens@gmail.com. Thanks for finding my blog!!!

      • maureenbreakingfree February 25, 2013 at 7:09 pm #

        thank you so much for reaching out! I definitely will 🙂

  4. Ashlie April 27, 2013 at 1:26 am #

    Wow thank you so much for this post… My husband and I are trying to have a baby but I am too suffering from hypothalmic amenorrhea. Running and working out have become my stress reliever, and just being diagnosed with type 1 diabetes, eating healthy has turned into one of my top priorities. I to have broken up with Jillian, and have embraced walking and yoga. Hope all is going well with you & your recovery!!

    • Mallory May 22, 2013 at 6:07 am #

      Ashlie, thank you for finding my blog! Ugh, I hate hearing when people are dealing with HA or infertility in general. It’s definitely a huge mountain to climb but I know in my heart it’s possible, especially those with HA. I’m so glad you are making the necessary moves to kick HA in the booty! Please feel free to email me at ifgravityhappens@gmail.com and we can chat 🙂

  5. Karen May 14, 2013 at 9:13 am #

    Hi Mallory, Thank you for this post. This is exactly what I am going through right now, with no period for 5 months. I was an intensed long distance runner, I have stopped 2 years ago and began doing intense weight training with a personal trainer. Lost 20lbs, low on body fat, and was on birth control pills to ‘regulate’ my period. I stopped taking it and my period hasn’t been back since. Doctor said my LH level (which is HA) is too low meaning my brain is not giving my reprdoctive system the signal to ovulate. Just by reading your post, I see that I must gain some weight back and stop my intense exercise. What exercise will you recommend? I am a healthy freak and really watch what I eat and hence probably not intaking enough as I burn a lot during my workout on a day to day basis.

    • Mallory May 22, 2013 at 6:05 am #

      Karen, So glad you found my blog! I am so sorry you are having to go through all of this. Feel free to email me at ifgravityhappens@gmail.com and we can chat 🙂

  6. anis May 24, 2013 at 2:35 am #

    Hi.. Your blog is so informational to people like me. Thank you. I am a 21 years old girl from Malaysia. I think I experienced amenorrhoea as my period did not came for 4 months. I know it was due to the weight loss as I restricted my calories intake and did cardio. I am definitely losing weight and I am loving it but the feeling of not having period some way made me feel incomplete. I think I am not fall into anorexia yet as my height is 5’1” and my weight currently is 108lb. Then last month I went to appointment with doctor and she gave me contraceptive pill. After consuming it for 7 days, my period came after 4 days the pills finished. Now I am worry about the next period either it will come normally or not because the only reason my period came is because it was induced by the pills. I am trying to add calories in my diet but as a student, trust me I don’t think I ever need that added calorie at all as most of the time I am just sitting down and studying. Currently, I am taking about 700-800 calories but honestly I am not an active person. I do not requires extra calories and fat but why I still having amenorrhoea at first place? Now I am waiting for my next period anxiously whether it will come or not.

  7. Stacie June 25, 2013 at 5:26 pm #

    Thanks so much for this post! I haven’t had a period in almost 2 years now (I’m 21) and have only really just realised that I should probably cease the exercise. I also took healthy eating to the extreme and exercised a wee bit too much. I’ve cut back on my exercise and have gained 11kg this year (I think about 22lbs?) which I’m not TOO happy about but health is more important right? Did you manage to start up exercise again once your cycles returned?

  8. o2befitmom July 18, 2013 at 4:07 am #

    I have been talking with Jessie (loves to run) and she told me about you. I can tell you that i went through it all and now have a ONE YEAR old daughter. I started off on medicine but hated the effects and cut it out to work with my doctor on naturally ovulating…and what do you know..3 months of work with my diet and exercise and I was pregnant. HARDEST time in my life but SOO worth it.
    If you ever need to talk let me know

    http://www.tuffmother.com

    • Mallory July 29, 2013 at 9:09 pm #

      I’m so glad u found my blog through Jessie and commented! She mentioned you as well 🙂 congrats on ur recovery and your little girl! 🙂

  9. jamie February 20, 2014 at 10:25 pm #

    Hi Mallory, Thank you so much for sharing your story. I was diagnosed with HA a year ago and have gone two years without a period. wow. makes my heart break to type that. I have been trying to share my story for a while on my blog but have a hard time being so open – thank you for inspiring me to share my story. So much love and light and hope you are healthy and whole 🙂 xxoo

    • Mallory February 21, 2014 at 6:34 am #

      Hi Jamie! Thank you for finding my blog and your sweet comment. I’m so so sorry that you have been on such a long road for so long. It’s definitely a test of strength! I was also hesitant to really open up here, but my husband and I both have realized that opening up has helped US to heal, to face reality and charge at it with as much support and love behind us as possible. No one should feel this weight alone, no one. I’m here for ya Jamie! Heading to your blog NOW 🙂

  10. Kate March 11, 2014 at 7:04 pm #

    Hello there, first i wanna say thanks for sharing your inspiring story, it really made me realize that i’m not in a helpless situation after all and that i don’t have to feel like im so alone with all my problems.. I’m 19 years old and haven’t had my period for over a year now, pregnancy is not on top of my list at the moment but all the problems that come with HA are starting to be unbearable, especially the feeling of constant stress and guilt knowing that im the only one to blame for my situation(not to mention skin,metabolism and sorts of other problems). I’ve started eating better since i reached my weight goal ,with limitations to sweets and fats and smaller more frequents portions,but still no periods even though i cut on exercise and got to a healthy normal weight ( 55kgs to 163cm height).
    My question is , should i wait more and try to cut the stress ? How long did it take you to get your period after you balanced your exercise and diet?
    I really don’t want to gain more weight because i think its my optimal one, but as hard as it is for me to admit it, it might be the main issue along with huge amounts of stress..
    Thanks again and i look forward to your reply, lots of love and best wishes for you girl! :))

    • Mallory March 27, 2014 at 9:03 pm #

      Hi Kate! Thank you for finding my blog! I’m sorry you are dealing with HA 😦 It is not a fun thing to over come but please know that it is VERY possible!! Most girls that have HA on the Fertile Thoughts forum see results of natural cycles returning at a BMI of 22-23 so I’d aim for that and continue to rest/nourish and see how your body responds! Everyone is different but I truly think that if you hang in there, our bodies are smart things and want to work properly – trust and listen to what your body is telling you and it will trust you back 🙂 Best of luck girl!!!!

  11. Roo April 18, 2014 at 3:09 am #

    Hi Mallory, your blog is very inspiring! im 19, and have now not had my period for one year and a month… over the past year ive lost a 1 stone and 7 pounds and now have a bmi of 17.5, I am also a runner and have completed a marathon. I used to run a minimum of 8 miles per day but have now cut that down to around 4 miles per day due to extreme concern about the lack of period…. I continually deny that I am exercising too much and eating too little but I know deep down that I am…. Like you people always ask me about my running and always want help exercising and I do always help them and like to tell them about my long runs so it is hard to break this.
    I have just started on an extremely hard degree course and running, along with weight control help me deal with that.
    This is the first time I have fully opened up and admitted what is happening but recently my boyfriend (4 year relationship) mentioned families and how lovely it will be when we settle down and have a family. This obviously made me panic because I have not told anyone what is happening as I don’t particularly want to put any weight on. I have never had a BMI past 18.5 and the concept of that makes me panic.
    Im so pleased you are healthy now and wish you the greatest happiness with your future family!

  12. Youniq Pilates JC April 30, 2014 at 4:58 pm #

    Thank you for this post. It is valuable for all of us who are struggling with a same thing. Due to my work, it has been a battle to think of my health and after a year without a period, feeling weak, tired, cranky and just..depleted. It is not fun being overly thin. And it doesn’t look nice. It just..doesn’t. There is this point where one lives in the body that almost feels as a rusty machine. Your post is an inspiration to everyone that change is possible.

    • Vanessa May 25, 2014 at 7:46 pm #

      Does anyone experience extreme fogginess, exhaustion and loss of energy. I am currently recovering from H.A. and having a very challenging time. Any support from other H.A.’s would be very helpful,
      Thank you,
      Vanessa

  13. Nikki May 23, 2014 at 12:55 pm #

    I don’t suffer from hypothalamic amenorrhea anymore but I did in the past. It never really bothered me because it was nice to not have a period and I wasn’t trying to get pregnant. I got my period when I was 13 then around 16, it stopped for several years. I went on birth control pills to bring it back, which it did. But birth control pills don’t solve the problem, they mask it. I gained about 10 pounds. I may have been around 120lbs at the time which at 5’8″ isn’t anorexic by any means but for me, it was too low of a body fat percentage. After gaining the weight, I eventually decided to go off birth control pills in March of 2010. In December of that year, my period came back and has been regular ever since until this past fall I became pregnant. Despite my past history, my husband and I got pregnant the first time really trying. I am currently 34 weeks along and wanted to write to say, even if you have this condition for YEARS like I had, there is hope. Luckily I had patience because I wasn’t trying to get pregnant at the time but absolutely, you MUST get your body fat percentage up and cut back on the exercise if you want to get your period back. There are some woman that can run marathons every month and weigh less than you but never lose their period. Don’t compare yourself to others. In the long run, a few pounds more doesn’t mean anything in the journey for a healthy body and a healthy pregnancy.

  14. Lindsay July 22, 2014 at 1:28 pm #

    Hi thank you so much for your story! I am trying to recover from HA. I am older and wanted a baby so bad that I first did IVF and now have beautiful twin girls. I stopped breastfeeding about 6-8 weeks ago and still no period. I am trying to cut back on exercise and following a high fat diet. I think I am having symptoms of it coming back. Can you tell me if you had any symptoms before it returned and how soon after you had your symptoms did it come?

  15. jmeymarie September 8, 2014 at 9:49 pm #

    Thank you for writing such an honest post about your struggle with HA. I am starting my journey with something similar and all I have wanted to do is cry. Because my body doesn’t work like it should. Because I haven’t had a cycle on my own in a long time. Because i want nothing more than becoming a mama. Would you mind if I emailed you and learned a little more?

  16. Jessie D September 24, 2014 at 8:51 pm #

    Hi! I no your original post is now a couple of years ago but when I searched for hypothalamic-amenorrhea your post is what I got today!!!! What u write is me 100% to a tee almost to the height and weight!! And I also am a runner and excercise addict who has worked very hard to have my body the way I do now! But since going off the pill in March to start the process to get ready for a baby iv had no period! Until today I didn’t no the name of it I was just told the signal from my brain to my ovaries doesn’t work as I am now to lean eat!! I’m really struggling with slowing the excercise down and eating more! I do it and then get the guilts up and want to go for another run!!! So I’m thankful there are others out there like me and it was really nice to read ur story and relate so closely to it!!! Fingers crossed I focus on ur success and get through this! It’s going to be hard!!!!

  17. Ash October 9, 2014 at 3:04 am #

    Hi Mallory,
    I am so glad I came across our blog!! I am in the exact same situation as you.. Except I haven’t had my happy ending yet.
    I was on the pill for 12 years and came off last December. It has now been 10 months without a period (only a withdrawal bleed). I used to run half marathons and have been super active my whole life. I am now 26, married and ready and excited to start a family! But with no period, and not being sure if I am even ovulating – the chance of that is slim at the moment. I too struggled with maintaining my weight while loving to run and got down to 36kg 3 years ago. It took me a year and the help of my husband to, like you let go of that goal of running and enjoying being able to lose weight and be proud if my slim body. I am now back to 53kg – which puts me at a BMI of 19.5. I thought getting into the ‘healthy range’ would do the trick – I too am barely exercising (a run once a week and a few walks) but nothing compared to what I used to do years ago.
    I’m guessing that this is not enough and I too need to put on more weight!! Like other women I’m scared that doing this to my body and possibly not being ad ahoy with my body as I could putting on extra weight that it will be worth it if I can get my ovulation back on track and get pregnant!!
    Thank you for sharing – any advice would be sooo appreciated!

    Ash – Australia (Tasmania)

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