"Is it okay to not have a period for several months?"
No, it is not okay.
"Is it okay if I don’t want children?"
No, Whether you want children or not it is not okay to not have a period, period.
While getting a monthly period is often annoying and painful, in reality, it’s a blessing in disguise. Your menstrual cycle is your 5th vital sign — a barometer for health. When there is an imbalance in the body, if one is under too much stress, and energy deficiency, or lacking in vital nutrients, the menstrual cycle will change alerting us that something needs to be done to bring the body back into balance.
One of the biggest ALERT signs to look out for is when your period goes MIA.
The technical term is Hypothalamic Amenorrhea, lack of periods for 3+ months. While at first this can seem like a miracle, a relief that you no longer have to deal with tampons, ruining your white pants and cramps, the truth is losing your period is a warning sign that should not be put on snooze.
There are two types of Amenorrhea- Primary & Secondary. Primary Amenorrhea is the failure of menses to occur by age 16 years. Secondary Amenorrhea is the cessation of regular menses in someone who previously had a cycle. Secondary Amenorrhea, which this article will address, is very common in those who suffer from an eating disorder, especially Anorexia Nervosa, along with athletes ( or recreational exercisers).
For the purpose of this article, we’re going to look at some of the reasons why one might experience secondary amenorrhea. Before we dive into this topic it’s imperative to know that:
1-Having a period doesn’t necessarily mean you are healthy. I have had many clients who are deep into malnutrition who still get their period.
2-Getting your period back in recovery does not mean that you have fully recovered.
3- Having a “pill period” does not mean you are healthy and menstruating. This is a false bleed and it can mask the condition of amenorrhea. Many girls go on the pill WITH a monthly period but then fall into energy deficit and lose that period DESPITE the fact that they are still bleeding each month. In order to receive all the health benefits of a monthly menstrual cycle, you need to be able to bleed without the help of the pill.
You see, when on the pill your body is being forced to shed the lining of the uterus, it's not doing it because it thinks it needs to or because one has the correct amount of natural hormones present in order to make that happen. So really, it is not a period at all.
WHY YOU LOST YOUR PERIOD (top 3 reasons)
When the body undergoes famine-like conditions (i.e., cutting out certain macros, restrictive intake, low caloric meals), menstruation stops due to inadequate fuel to support the menstrual process.
All functions and systems in your body require energy, when energy is low, just like when your bank account is low, you need to reallocate resources to be able to pay for the most important essential things-- like beating your heart. The reproductive system is at bottom of the priority list as you can live without it but cannot live without your lungs breathing heart pumping, or nerves firing.
You do not have to be underweight for your body to be affected by undereating. Your body fat percentage and BMI may be in the normal range but if caloric intake is too low the hypothalamus will sense that there is not enough energy coming for how much is being spent and will cease sending out the proper hormones to induce ovulation. This is known as energy availability and is the balance between energy expenditure, energy intake and body mass.
If you don’t eat enough, your hypothalamus thinks you’re in a famine and makes the very smart and adaptive decision to not try to make a baby. Pregnancy requires a lot of energy and therefore calories. If the body is not getting enough to even maintain function for one, it will shut down reproduction to ensure that you do not get pregnant.
Undereating also results in a lower amount of nutrients available for the body which can result in malnutrition. These nutrients are vital for maintaining the proper functioning of the body. By eating less you naturally are eating fewer nutrients for your body to use.
One notable nutrient that is often low on low-calorie diets is fats which are the precursor to making sex hormones. When fats, in particular, cholesterol and saturated fats are low, the body will lack the essential building blocks to create these hormones for reproduction.
It is very important that you increase both the amount and variety of food to ensure a wide spectrum of nutrients given to the body to replenish its stores. Restrictive diets like veganism, keto, and paleo might not be the best option for you at this time. Your body needs plenty of carbs, protein, and fats during the healing process. In particular carbs are of importance. You can be eating enough foods calorically but if you are skimming out on carbs your hypothalamus can stop sending hormones to the pituitary gland.
More more more is the humdrum of society in regards to exercise. Higher intensity, more training days, hotter yoga, longer spin classes, many of us are simply doing too much, pushing our body too far, with little to no recovery time. For many women with amenorrhea exercise is the #1 reason why their period is gone and for many women, its the hardest behavior to change because Exercise is so intertwined with weight and body composition. While eating more may come naturally to many(cause let's be honest we all like food), exercising less can be extremely difficult. Many really question if it is indeed their exercise schedule that's preventing their body from having a period and the unfortunate answer for many is yes.
Why is exercising too much a bad thing?
It goes back to energy availability, many women are simply not eating enough to sustain the high level of movement they do. This results in an energy deficit wherein the body will shut down the menstrual cycle due to a lack of resources available
Another reason is due to stress hormones, in particular, cortisol, that rise when you are working out. Every time you work out the stress response is activated putting your body in the sympathetic (fight or flight) nervous system response instead of the parasympathetic response (res + digest) which is necessary for healing. Unfortunately, these stress hormones interfere with the body's ability to create reproductive hormones like estrogen and progesterone resulting in a decline of the essential hormones for ovulation and menstruation.
While you always hear of the benefits of exercise on the body, over-exerting yourself could actually undo the results you are trying to achieve and worse, could damage your bones, heart/arteries, and lead to gut and sleep disturbances. One of the biggest touted benefits of exercise is for maintaining healthy bone density. While this is true for someone who is healthy and in and energy balance, exercising while in an energy deficit (obvious if you are not menstruating) exercise can increase osteoclastic and reduce osteoblastic activity in the bones. Aka- weight training will experience amenorrhea can LOWER your bone density.
Mental and physical stress can have an impact on your hormones. The sympathetic systems sends information to the hypothalamus. If the sympathetic system is chronically activated it will send the hypothalamus a signal of “not safe” wherein the hypothalamus will cease producing hormones that have a cascading effect on your ovaries.
Most commonly stress comes from living up to the goals we have set for ourselves, dieting, having to maintain the “perfect body”, and having to maintain an intense exercise regime.Incorporating yoga and nature time to help reduce stress or any other modality that helps you is imperative during this time. You can increase your calories and reduce your exercise but the mental stress you have may block your body from healing.
Did you recently lose a couple pounds and notice you lost your period too? Your weight loss may be minimal and you may still have a very "healthy/normal" weight, but this can still trigger amenorrhea. Weight loss usually requires and energy deficit and as mentioned above energy deficit leads to a shut down of the hypothalamus and thus the reproductive system.
Amenorrhea usually is a combination of all the above-- weight loss, restrictive eating/ underrating, stress, and over exercise. To get your period back it takes addressing all of these things that could be potentially surpassing your hypothalamus.
To learn how I got my period back after 11 years of amenorrhea read my latest blog post here!
Love Love, Chlo
*Please consult your doctor to receive an official diagnosis of amenorrhea. This article is not to be a replacement of going to a doctor. All information is to be educational purposes only.
Rinaldi, N. No Period Now What. Factors in a Missing Period Part 1. http://www.noperiodnowwhat.com/hypothalamic-amenorrhea-info/factors-in-hypothalamic-amenorrhea.
Lindberg, J. S. (1984). Exercise-Induced Amenorrhea and Bone Density. Annals of Internal Medicine, 101(5), 647. doi: 10.7326/0003-4819-101-5-647
Loucks, A. B., & Thuma, J. R. (2003, January). Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women.