Your period is missing! Where and why did it go? When will it come back? And why is this bothering you so much when you've wished countless times for your period to go away?
Anyone who has experienced a lost period — amenorrhea — knows about the anxiety caused by the sudden disappearance of our friend who usually visits every month. I mean, how dare she just dip out on you when she's accompanied you (without invitation!) to so many dances, dates, beach weekends, and final exams?
Amenorrhea isn't a disease, curse, or illness, but rather a symptom of something else going on within your body. Finding out exactly what is behind your amenorrhea can sometimes be tricky because it can be an indicator of many different issues.
The following are some of the main causes of amenorrhea so you can begin figuring it out:
1. Hormone imbalances
For the most part hormonal imbalances are behind the majority of amenorrhea cases. Typically, the hormonal imbalance associated with amenorrhea is low estrogen or a combination of low estrogen and low progesterone.
When a woman's estrogen and/or progesterone are too low, her body is unable to build up the uterine lining and subsequently shed that uterine lining each month (aka your period).
What exactly is causing this kind of hormonal imbalance can be one or a number of things:
- Hormonal Birth Control (especially the pill)
- Quitting Hormonal Birth Control (aka post-pill amenorrhea)
- Eating Disorders like anorexia or bulimia
- Exercising too much (CrossFit five times a week anyone?)
- Mental and emotional stress
- Low body weight
- Low thyroid function (hypothyroid)
- Early-onset menopause (before age 40) caused by premature ovarian failure
Additionally, a woman might have an issue where her body is producing too much testosterone, a male sex hormone. High testosterone can actually prevent or significantly delay ovulation each month, which causes periods to become irregular or disappear completely. This problem is commonly diagnosed as Polycystic Ovarian Syndrome (PCOS).
2. Structural and/or genetic issues.
These issues usually require more than just food and lifestyle changes. Primary amenorrhea, which means you've never had a period and you are 16 years or older, is the biggest indicator of the problems or conditions below. I recommend that you see a doctor to determine the cause as soon as possible.
- Asherman's Syndrome — uterine scarring or adhesions, which can prevent blood from exiting the uterus.
- Pituitary tumor — which causes high levels of the hormone prolactin. Prolactin suppresses ovulation and menstruation.
- Mayer-Rokitansky-Küster-Hauser syndrome — underdeveloped reproductive organs or a lack of them.
- Other genetic structural abnormalities
You know all those scary side effects that most medications list? Well, sometimes those lists include missing your monthly cycle. Here are some meds that commonly cause Amenorrhea:
- Hormonal Birth Control
- Blood pressure medicines
- Allergy Medications
4. Natural reasons
Our body progresses through natural phases and cycles where sometimes Amenorrhea is completely expected, so no need for alarm bells! These include:
- Perimenopause and menopause
Many women tell me that not having a period is a blessing or they don't want kids so why should they care about whether they have a period or not. My response is this: Regardless of whether you want children or not, it is imperative to understand that your menstrual health is reflective of your overall health. If your period is missing or irregular, something deeper is going on that you need to look at.
There are also many physical and emotional symptoms associated with amenorrhea that are no fun. These include:
- Acne — sometimes more than when you were a teenager
- Hair loss on your head or hair growth on your face
- A low or nonexistent sex drive
- Or worse: when you do have sex, it hurts like hell
- Low or no fertile cervical fluid — yes, sometimes your underwear can be too clean
- Your energy is so low you can't get out of bed easily or even get through the day without caffeine or sugar
- Depression or mood swings that disrupt your relationships and your life
If you have not had a period for more than three months and you are experiencing any of the symptoms above, I highly recommend seeing your doctor to determine the exact cause. Get to know your hormones, and you'll feel (and look!) healthier and happier.
You can sign up for my free 3-part video series, Bring Back Your Period & Regulate Your Cycle.