Dealing with Post Pill Amenorrhea
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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!
Thanks so much for sharing this, Brittany! I have a very similar condition as you (endometriosis and possibly lean PCOS but whatever it is is due to low estrogen and progesterone levels) and have been on the pill to treat it for 8 years now. It scares me a bit to go off the pill because they essentially had to force ovulation with progesterone pills before putting me on the pill, so the chances of natural ovulation are low when I go off. While I’m not ready for that yet, I really appreciate your honesty in your experience. It’s inspiring to so many other women out there who are going through the same things and you are dealing with it with such dignity, patience, and intelligence. Best of luck as you continue to work through this!
this is a super brave post, and i’ll be honest, i’ve never been a consistent reader because i felt like this blog was about how to just stay super skinny. (i apologize- i don’t mean to offend!). i am sorry things are rough healthwise. i am sure you are savvy enough in the kitchen to up the calories a bit and also keeping it healthy-adding a whole avocado a day, switching to full fat yogurts for a while, etc. good luck!
Hi Tassy! Thanks for the comment — I hope you’ll continue to read EBF. And oh my goodness, I’ve been eating avocado like crazy lately!! 🙂
What an open, honest and brave post, Brittany. I can tell by the number of comments from women who’ve gone or are going through similar situations that posts like this are so appreciated. I myself have experienced Amenorrhea twice (once in high school and once in college) and it is SO frustrating. The second time was after going off the pill and it probably took 2 full years for my period to come back. I was in the same boat as you, wondering if the amount I was exercising/eating was wrong even though I felt like I was FAR from going to the extreme in either category. Honestly, I feel like the small cut back on exercise (we’re talking 5-6 days of working cut to 3-4) and the small increase of eating was what did the trick. I’m crossing my fingers that it’s the same for you! Hang in there, girl!
Thank you so much for this post. It sounds like you are going through a challenging time but are now feeling positive and thoughtfully taking care of yourself. I especially appreciate your going public with this reflection. I personally have been struggling with finding my healthy balance as a mom and accepting that my postpartum body is and always will be different. Your approach to health and wellness is so refreshing and balanced and it really inspires me in a way that almost no other health/fitness blog does. Thank you.
As a person who has had an eating disorder which resulted in amenorrhea these words rang alarm bells in me “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. ” and “cut back to exercising 3-4 days a week, only when I’m feeling up to it” and “I’ve stopped tracking what I eat”
Six days a week is A LOT, you shouldn’t have to track your food intake if you’re not “dieting” and “only when I feel up to it” sound slick you’ve been pushing your body way too far. You shouldn’t be exhausted. When I was at my worst I would walk and excercise so much I was exhausted but would push myself. And I would have that detached feeling, it really sounds like you’ve been to harsh.
If you’re happy with your fitness, weight and how you feel you don’t need to push.
My periods came back all of a sudden when I entered a relationship and my hormones clicked in. I’m still quite irregular though. Best o flick and take it easy on your body and yourself.
Hang in there! I had been on the pill for 9 years when I stopped and it took 13 months before I got my period again. It’s been very irregular ever since. Sometimes every month but sometimes it can me months before I get another one. Pretty scary stuff since I don’t trust condom completely (everyone who has seen Friends has been traumatized :P) but it’s still better than the pill for me. I’m sure you’ll get yours back soon!
Thank you for the support!! I’ve heard from so many women that it’s taken 10 months or more to get their period again. It’s so crazy! Oh man, I just googled the scene from Friends and had a good laugh! 🙂
I had this for a year after coming off the pill, but I was also on the road to ‘recovery’ (ick) for my eating disorder, which, unbeknown to me at the time considering I was on the pill, would have stopped my periods.
I also discovered about 8 months after I eventually got my periods back that I had PCOS (yay!) which certainly explained a lot of things.
All I can say is firstly, I TOTALLY sympathise with how frustrating it must be right now. It’s weird not having your periods, especially after more than several months and you can sometimes get wound up thinking about when it’ll come and almost tricking your body into thinking you can feel it coming.
It will come. I promise. One day you’ll just know it’s decided to finally happen and it’ll be such a relief of your shoulders! I think your doctor is right in advising you to just ‘calm down’ a little, and listen to your body as much as you can.
Whatever you can do to just keep your hormones balanced is best too – hey Maca Powder!
All the best of luck with it, your body will work itself out, promise.
She’s So Lucy
Have you tried natural progesterone cream? I was prescribed synthetic progestin, which did not help, but natural progesterone cream did. I use Emerita. It restores balance without side effects. It’s worth a try! Best wishes to you. I know it’s frustrating, especially when you devote so much of your time/life to living a healthy life. You’ll get this figured out!!
Thank you so much for sharing this. I was off the pill for 4 months last year and my period never came, my doctor told me to go back on and I reluctantly did but have regretted the decision ever since. I’ve been scared to go off it ever since but it has been on my mind a lot lately. It’s comforting to know I’m not the only dealing with this. I hope it all works our for you, best of luck!!!
I’m sorry you’re going through this, but I think you should be more careful about promoting this kind of misinformation about the pill. Women have safely taken oral contraceptive pills (OCPs) since the 1960s and today the hormone levels in the pills are at the lowest they have ever been. I have an advanced degree and work in public health family planning and regularly have to shoot down these fears about hormonal contraceptives. Do OCPs have side effects – undoubtedly. So does caffeine and many other compounds we put in our bodies, but most women safely use the pill and other contraceptive methods for many years without problems. Based on what you’ve described, I think it’s very possible that you have had hormonal imbalances for years that the pill may have been correcting, but I think it’s irresponsible to say that it was CAUSING the amenorrhea you’re experiencing now. Furthermore, the person you cite as giving information about this causal factor (Nicole Jardim) is NOT any kind of health expert from what I could see from her website (she doesn’t have an MD, PHD, or MPH of any kind). She also seems to be selling her video series about the “TOP secrets doctors won’t tell you about your hormones.” As someone who works with experienced medical professionals in the OB-GYN field, I can assure you that doctors have no desire to withhold information from their patients about about health risks and benefits. I sincerely hope your health condition improves, but I would beg you to please not circulate this kind of pseudo-science.
Hi Heather. I’m not saying that the pill is causing my situation. At this point I don’t know exactly what is causing it. That said, hormonal OCPs have only been around since the 1960s so they are relatively new in the grand scheme of things and although there is no research to prove that OCPs cause hormonal imbalances or issues with regularity after extended use, there’s no research saying it doesn’t either!