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Dealing with Post Pill Amenorrhea

By Brittany Mullins

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Published Jul 20, 2015, Updated May 24, 2021

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Hi and happy Monday to you! I hope you had a lovely weekend.

I didn’t know if I was going to do a full post about dealing with post-pill amenorrhea. Especially since I many of you come here for recipes, but this blog is really about health and for women our cycle is a great indicator of our health. Plus, I know from previous comments that there are others out there struggling with similar issues so I wanted to share. If you’re here for the recipes and workouts, simply skip this post. I’ll be back tomorrow with a recipe for ya!

So here’s the story — as I mentioned here and here, I’ve been dealing with post pill amenorrhea since going off birth control pills last September. If you’re unfamiliar, amenorrhea is the absence of menstruation. It can be brought on by a variety of things. Pregnancy, breastfeeding and menopause are all natural and normal reasons. However, it can also happen due to medications, contraceptives, lifestyle factors or other complications.

No period, no worries?

At first I wasn’t really concerned about experiencing amenorrhea after coming off birth control pills. I’d heard (and read online) that it can take a while for your body to adjust. After the holidays and three months without anything I started to get a little worried and decided to make an appointment with my gynecologist. I could tell she was kind of annoyed with me for just going off them without asking. Isaac and I weren’t trying to conceive — I just wanted to be more natural and stop putting the hormones in my body. Plus, I knew that in the next couple years we would likely want to start a family. She had me take a pregnancy test (negative) and then gave me a pack of birth control pills to take “just to see if I could jumpstart things.” I left the office with the pills, but knew I wasn’t going to take them. From everything I’ve read, I knew that the pill wasn’t going to solve my issues. If anything, it would just mask them.

At this point I had already started seeing an acupuncturist every two weeks. He did his needle work, prescribed me a few supplements and made me feel relieved by saying that he sees women all the time with the same issues after coming off hormonal birth control. I trusted his advice and just kept moving forward, hoping that working with him would help.

I also started looking for a new gynecologist and booked an appointment. She had blood work ordered. My hormone levels looked okay, but she recommended doing the progestin challenge. I was hesitant since it was introducing more hormones but my acupuncturist thought I should try it (as did my sister and mother-in-law) so I did. Nothing happened. This typically means you either have low serum estradiol (estrogen), a dysfunction with the hypothalamic-pituitary axis, or a problem with the uterine outflow tract.

Hypothalamic amenorrhea diagnosis

Since the progestin challenge didn’t work I was referred to an endocrinologist (fertility specialist) and after looking over my blood work he diagnosed me with hypothalamic amenorrhea. Both my luteinising hormone (LH) and my follicle stimulating hormone (FSH) levels are low. I am producing some estrogen but not enough. He recommended I get an MRI of my brain to check for a pituitary tumor and an ultrasound to check for cysts (because I could have PCOS as well!), but his biggest piece of advice was to eat more, exercise less and work on removing stress from my life. <— Easy peasy… hopefully you sense the sarcasm here.

Leaving the office I was scared. I was thinking about the possibility of not being able to have children, possibly having a brain tumor and also wondering about the exercise and dietary recommendations. Here’s a little snippet of my thoughts that day: I’ve heard of athletes losing their menstrual cycle, but I’m not THAT fit and I feel like I eat plenty. My body fat isn’t low, my BMI is normal (21) and I’m not training for a marathon or anything. Why me? I had my period in college when I was smaller than I am now!? How is that possible? <— I was on birth control in college so even if I wasn’t ovulating then, the birth control withdrawal bleed made me think and feel like I was.

After my appointment with the endocrinologist I met with my acupuncturist. My records had already been sent over to him so we talked everything through. He was grateful I got the blood work done because he now knows to work on the hypothalamic-pituitary axis. He still thinks that the pill has caused much of my issues. Being on it for 13 years is a long time!! Western doctors won’t typically admit this, but the pill has side effects. It suppress hormones (LH and FSH included) and it takes some women’s bodies longer than others to start functioning properly.

Eat more, exercise less?

I asked my acupuncturist about the eating more and exercising less recommendation and he said that he thinks 21 is a healthy BMI, but many doctors do like to see 22 so perhaps it could help.

I had a good cry and then I really thought about it. Like really, really thought about it… I don’t think I exercise too much or eat too little but I do always seem to looking for ways to tone up, get flat abs or lose the last five pounds. <— I feel like most women out there can relate to these feelings. Maybe I am being too restrictive with what I eat or exercising too much? Maybe working out six days a week is too much for MY body. Everyone is different and perhaps my current habits are putting too much stress on my body?

So that’s where I’m at right now. I don’t have any answers and I haven’t gotten my period yet.

It’s been about two weeks since my appointment with the endocrinologist. I haven’t gotten the MRI or the ultrasound, but I’ve been working to embrace his lifestyle suggestions. I’ve stopped tracking what I eat and I’m letting myself eat whatever I’m craving. I told Isaac last night I’m probably taking advantage of the whole “eat more” thing. As a food lover, that part is easy for me! We had a good laugh about it, but maybe it’s what I need. I’ve stopped running and cut back to exercising 3-4 days a week, only when I’m feeling up to it. I’m walking, taking barre classes and I’ve started back with yoga (which really helps with stress for me). I want to add in some strength training with weights as well, but I haven’t done so yet.

I’m doing a few other things to help as well. Going to bed earlier, taking specific supplements and I also just started seed cycling this week. I really want to balance my hormones naturally so I’m hoping all this works!

As a health coach, personal trainer and member of the health and wellness world I feel like this whole process is definitely going to be a challenge for me. Heck, it’s my job to work out, eat healthy and look fit! That said the most important thing for me to be healthy right now is to heal my body so that’s my focus. I might have to cut back on working out or gain a few pounds, but in the end I know it will be worth it.

Thanks for listening. I hope me sharing helps someone else and I’ll be sure to keep you all updated.

2020 UPDATE: Just wanted to share that I was able to heal hypothalamic amenorrhea, get my cycle back, became pregnant and had a beautiful baby girl. If you’re currently struggling with HA right now I’m sending hope, love and positive vibes your way!