If you have not had your period for longer than 3 months it can mean your hormones are out of balance and need to be addressed and not ignored.
Prolonged cessation of the menstrual cycle - more than 3 months in women with previously normal menstruation and 9 months in women with irregular menstruation - is known as secondary amenorrhea (SA). SA can lead to osteoporosis, endometrial hyperplasia, heart disease, mood changes, can holt your plans of falling pregnant and for most women a feeling of disconnect between them selves and their bodies if left untreated.
However SA can be reversed, it is all about understanding and rectifying the root cause so our innate reproductive hormones can dance their pretty dance they love so much all month long.
So why may you not be getting your period?
We explain the main reasons why women stop having their menstrual cycle and tips on how you can support your body in getting it back.
1. Post Birth Control Amenorrhea
Birth control switches off ovulation and so switches off estrogen and progesterone, it flatlines your innate hormones which are replaced by synthetic hormone like-chemicals who's sole purpose is to stop you from being fertile.
Most women will cease birth control and resume a normal cycle however for 3-6% of us our cycle does not return within the first 4-6 months. Post birth control amenorrhea is caused by a blunting of our natural hormones for extended time and is more common in those who had menstrual irregularity before going on birth control or those who had late onset menarche.
It is characterised by raised prolactin and lowered estrogen, progesterone, LH and raised FSH and must not be confused for post birth control PCOS which presents differently and requires a different treatment approach. .
2. Stress Induced Amenorrhea (emotional too)
This is likely the most under-represented cause of ammenohrea because we find it hard to define stress. People may identify with under-eating carbs or over training however when you bring up stress and emotional drain, self-rated levels are always lower than what is actutally happening.
Stress and heavy emotional burden can stop a menstrual cycle even if all other factors have been addressed. Why? Stress elevates corticotropin-releasing hormone which holts reproductive function. It makes sense, why would our body prioritise reproduction in a time where our body is giving us signals of being unsafe?
3. Low carb diet
A recent trend towards low carb dieting has been a leading factor in the cessation of many womens menstrual cycles over the past decade. This fear or carbs is real and must be worked on and no wonder why it evolved, we are told carbs make us put on weight where infant this is incorrect - processed foods make us put on weight so dump the white carbs and get stuck into the wholegrain, legumes and vegetables, the way nature intended them.
In a carbohydrate restricted diet a max of 50gm of carbs (1 cup cooked rice) is recommended per day compared with the recommended 250gm of carbohydrates a day (5 cups cooked rice). That is a big difference.
Why are carbs important for our menstrual cycle? Carbs strengthen and nourish the hypothalamic-pituitaty-ovarian connection that is responsible for hormone pulsatility, without this vital function our hormones are unable to reach adequate levels to bring on ovulation. Think of carbs as the fuel that allow our brain to talk with our reproductive organs.
4. Over training
Exercise stimulates the hypothalamic-pituitary-adrenal axis leading to increased levels of prolactin, cortisol and other reproductive hormones in our body. Prolonged exposure to high intensity exercise coupled with a relative energy deficiency (under-eating) leads to a reduction in hormone pulsatility that allows for ovulation to occur (like what we talked about earlier). What is classified as over training? F45 5 days a week, 7 day a week marathon training, heavy weights training, training without a rest day.
5. Thyroid imbalance
An underactive thyroid gland (hypothyroidism) can cause amenorrhea, characterised by high TSH, insufficient T3, T4 and high prolactin levels. Why? Because our endocrine organs speak to each other and if one organ isn't happy it tells and affects the others.
If you enjoy deeper learning, this is how it can cause amenorrhea..
Low T4, thyroid hormone--> increases thyrotropin-releasing hormone (TRH), whichis a hormone produced in the hypothalamus that stimulates the release of thyroid-stimulating hormone (TSH)--> decrease dopamine, a neurotransmitter responsible for pleasure and motivation --> increases prolactin, responsible for breastfeeding --> decreases gonadotropin-releasing hormone (GnRH), a hormone responsible for the release of FSH and LH --> LH + FSH decrease --> amenorrhea
The toxic combination of over-training, under-eating and high stress is the usual picture we work with however checking your thyroid and understanding how birth control may have impacted you is equally important. If you identify with these reasons for not getting your cycle and are currently not menstruating we recommend the following tips.
Tips to help get your cycle back on track
Take 300gm of magnesium citrate daily
Swap from coffee to reishi lattes
Limit high intensity exercise or heavy weight lifting to once weekly
Get 8 hours of sleep each night
Eat 250gm carbs per day
Have weekly accupuncture sessions
Check your pathology markers with an integrated GP or naturopath - TSH, T3, T4, LH, FSH, Prolactin, DHEA-S, SHBG
We recommend working with a Naturopath or integrated gp to get a tailored plan to suit your individual needs. Our Naturopaths are available now to take your questions via our free base chats or to book in click here.
Jennifer Ward, Adv dip Nat, BCom Econ, Masters Repro Med (studying)
Jennifer is a qualified naturopath with a focus on fertility, pregnancy, hormonal imbalances.
Learn more about Jennifer here
Book a session with Jennifer here
To learn more about amenorrhea or for speaking enquires on this topic get in touch at firstname.lastname@example.org