Dealing with Post Pill Amenorrhea
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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!
Thank you for sharing this! I am going through the same thing, and didn’t even realize there was a term for this. Thank you for sharing your exploration, it is giving me ideas on what my next steps should be. Thank you!
I’m so glad you posted this! I’m sorry you’re going through all of this, but at least you have some answers and hopefully will be on your way to normalcy soon. I have been on the pill for over 10 years because I tested positive for PCOS and they say it helps limit the cysts, or at least the painful effects of them for me. Its crazy to think its been so long and I personally hate that I’ve been feeding my body these hormones for so long, and I know for sure that my body is reacting negatively, but its always been a fear of mine to come off of them (kind of like, I’d rather not face reality right now) but I know will need to soon.
Gosh, I know how you feel! I’ve heard from several women that doctors prescribe birth control to help with PCOS. I don’t know much about it so I can’t offer my personal experience or advice, but I hope you figure out a good solution that works for you.
I went off the pill in January of this year and, like so many others, did not get my period right away. I took the entire spring off from exercising (I just did an afternoon walk everyday), gave my body the rest it needed and ate all the foods. I put on about 8 pounds, which would have been mentally hard for me to do even a year ago. But now I know it was what my body needed and I accepted that going into this journey. I got my period in May and have 2 cycles since then. Keep relaxing and listening to your body.
Hi Anna. Thank you so much for sharing your experience. It’s really encouraging to hear how others have worked through amenorrhea. Here’s hoping I can do the same!
I went about 5 years without a period in my early 20s with no explanation. I did eat healthy and exercise daily though. My period retuned once I gained a few pounds and increased my fat intake. I wasn’t underweight but my body just needed more. My husband and I got pregnant in 2013 on our first try and we have a 13 month old. It’s very possible to conceive after years of no period.
Thank you so much for sharing, Nikki. Hearing from others who have faced a similar experience (and had children!) is really encouraging.
Thank you for sharing, Brittany. I went through a similar thing after going of the pill and didn’t get my cycle back for about a year. You are doing all the right things (eating and exercising a healthy amount, yoga, etc.), but my advice to you is this: another cause of stress is adding a whole bunch of knew things to your life. Maybe try changing one or two habits over 2-3 weeks, and then add the seed cycling, strength training, etc. Its all about baby steps and taking in too much at once can also throw off your cycle. Also, I’d love to know more about seed cycling! I’ve always wanted to try it, but don’t know much about it. Thanks!! Kathy
Great advice, Kathy! I’m trying not to overwhelm myself with different healing methods and advice. I know stress is a huge factor so I definitely want to keep myself as stress-free as possible! The seed cycling is really interesting. Here’s a great post I read about it.
Thank you for sharing. My husband and I have been trying to get pregnant for the past year, and although I was never on birth control I am also dealing with hypothalamic amenorrhea. It has been a very frustrating experience, and as a marathon runner it has been HARD to accept the lifestyle changes I need to make. Thank you for being so honest 🙂
I totally get where you’re coming from! It’s so hard especially when you have to “give-up” something you love. Everything I’ve read has mentioned that running is one of the most stressful exercises we can do and often raises our cortisol levels so it could definitely be helpful to cut back. Sending you a big virtual hug and positive pregnancy vibes. <3
Thank you!
Thank you for being brave and posting about a very difficult subject. I was in the same position three years ago. I am a marathon runner and cut back tremendously on exercising after my doctor’s advice. After several blood tests I finally had an ultrasound and was diagnosed with PCOS and referred to a fertility doctor. I do not fit the typical description of someone with PCOS at all. Hopefully, you find answers and peace with whatever answers are given. I know it is an emotional roller coaster ride. My thoughts are with you.
Thank you so much for sharing your experience, Erin. I’m going to be getting an ultrasound soon to check for PCOS as well.
Thank you for sharing your story. I have been going through the exact same thing. I came to the conclusion myself that I was putting too much stress on my body by working out too much so I am trying to break that habit. I have gone through a few rounds of medications to get my cycle going again. Keep us updated on what works for you because I think many people out there are having this issue and nobody can tell them why!
Hi Sonya! Thank you for sharing your experience. Sending you positive healing vibes as you work through what’s going with your body as well. And, I’ll definitely keep you updated!
Thank you for opening up! Posts like this are SO helpful and informative for others that are going through the same thing. I’ve been so skeptical of the pill and I don’t know how I feel about it. I hope you’re able to get things back to normal with eating more and exercising less. (The less stress thing is probably super hard!) Good luck, Brittany!!
Thanks so much, Liz. Had I known what I know now I probably would have avoided the pill, but all I can do now is work on healing my body. Hindsight is always 20/20.
I’ve been taking birth control for about 10 years now. I thought about going off of it because I don’t want to take the hormones anymore. Plus, I have extreme hot flashes and my moods were beginning to become more irritable. I went off the pill for a few weeks before going to a new doctor. I didn’t have a period after going off of them and I hadn’t had one in the prior 6 months. Long story short, I went to a new doctor. She gave me a sample of something else to try. It works better but after the first couple of weeks, I had a period that was basically nonstop for 2 weeks. NOT FUN! Now I’m back to not having a period at all. I still consider going off the pills as I don’t want to take the hormones. But I’m kind of scared to get an IUD (Paragard contains no hormones) due to the extreme pain I hear they cause. Gah!
Good luck! I hope everything gets back to normal for you soon.
Thank you so much for sharing your story with us, Brittany! And thank you for allowing me to ramble about my issue in response to your post. 🙂
Ugh! I’m so sorry your dealing with this, Julie! Having a non stop period for two weeks sounds awful!! :/ I hope you figure out what’s best for your body and everything gets regulated. Sending positive, healing vibes your way. xoxo