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!
I haven’t heard an update from you. Does that mean you’re pregnant???
Haha. No, we’re not currently trying to get pregnant, just trying to balance my hormones at the moment.
Hey Brittany! Sorry to hear about your diagnosis. Last year my period stopped for 8 months and ultimately is was all stress related. Who knew? I wanted to share with you that taking 2 Black Current Seed Oil supplements (a GLA fatty acid) has really helped regulate things, including PMS. Have you heard of this or have you been recommended to take a GLA supplement at all?
I am currently going through the same thing- haven’t had a consistent period since I went off the pill in late 2013! I am seed cycling and seeing a naturopath, since every MD has recommended I just go back on the pill- no thank you. I’m a bit discouraged at this point, since it’s been almost two years without a regular cycle (I’ve had 2 or 3 random periods, but nothing more than that), and I’ve been trying the same things: exercising a bit less, changing my diet a bit, etc, although old habits die hard. I’d love to know how it goes for you going forward!
Hi Emmy. Thanks so much for sharing! I say just keep at it and your body will figure things out. I’ll be sure to post an update here soon.
I am amenhorreic most of the time since I came off the pill a couple of years ago. I have a normal BMI, but I train for marathons – so I assumed it was because I run too much. But, I have discovered that if I consciously try to eat more/increase calories, I get my period back. In my case, it was due to low energy availability! You can still be a healthy weight and have amenorrhea
Thank you so much for posting this Brittany! My husband and I are not quite ready to have children but at the advice of my friends (who are recently pregnant or trying to get pregnant soon) I got off birth control bc they said even though I wasn’t trying to have kids soon I had been on birth control for so long (11 years) I would have no idea how my body would react without it. I’m so glad I listened to them because 5 months later I still am without a period. After 4 months I went to my gynecologist to have blood work done and everything came back normal expect my estrogen levels are low. She wants me to get back on birth control but since I am not in a rush to have children I really want to try and get my period back on my own. I too workout about 6 days a week but not anything super strenuous (running a bit, barre and stationary biking) and I don’t eat a super restrictive diet but do eat as healthy as possible. I’m at a healthy weight (20 BMI) but am wondering if I need to cut my workouts back and be more lax on eating. I’m going to try incorporate more yoga, walking and relaxed eating and see if that helps. Please keep us posted on your journey, it is so helpful!
Hi Brittany, thanks so much for sharing this. It really is important to shed light on woman’s issues! I’m in the middle of a book called Woman Code and it talks about balancing our hormones to optimize our health and our cycle. I’m not all the way through it yet, so I can’t say for sure where I stand on the tactics in the book, but it might be worth a look for you. The general idea is to use food to heal our bodies from fertility/mood/libido issues, choosing specific types of foods at different points in our cycle. Wishing you the best!
Thank you for sharing this Brittany. I had a very similar experience – after being on the pill for about 13 years, I went off of it and didn’t get my period for another 2.5 years. I took the same steps you did, minus the acupuncturist. I saw an endocrinologist who after looking at the results of my blood work diagnosed me with PCOS – despite that I had zero of the typical symptoms except not menstruating. (I think a more accurate diagnosis would have been hypothalamic amenorrhea.) I saw a naturopath and was told the my body was in perpetual fight or flight mode which meant I wasn’t digesting the food I was eating and thus not getting enough energy to perform basic functions, like menstruating. I started taking a food enzyme, to help me digest the food I was eating and focused on eating more protein, really just eating more in general. I didn’t stop working out but did reduce the amount of stress I was under. I ended up gaining about 20 pounds (of muscle and some fat) between the time I went off the pill in May 2013 and now. Like you, I wasn’t at an unhealthy weight for my height and my BMI was normal. [Some of the research I’ve done indicates that after being on the pill/ developing hypothalamic amenorrhea a woman may need to gain more weight than someone else of their build to jump start the hormones.] I did a lot of research about healing your hormones naturally and started to apply some of them, like eating liver, taking Fermented Cod Liver Oil and drinking bone broth. I started this journey to actively try to heal my hormones in December 2014. I started ovulating in April 2015 and got pregnant that very month. (Surprise!)
I just wanted to encourage you on your journey towards health – it takes time but it’s likely you can heal your body using a more natural approach. I just heard a very help podcast on the subject of getting your period back. Perhaps you’ll find it helpful as well. Paleo for Women Episode 23 (http://paleoforwomen.com/episode23/)
I can totally relate to this! I got off the pill in October 2014 and haven’t had a period since. This is probably due to too much exercising and not enough calories (I was restrictive for a brief time in the past). Since October though I’ve cut back on my exercising, still running but not as much as before, and I’m trying to increase the food I’m eating. The hardest thing for me is, although I have accepted that I need to gain some weight, I feel that it is all going to my stomach. This is making it harder for me to really want to eat more. Hoping I can overcome this soon. Thanks for sharing your story.
Hi Brittany! I’m currently in the same situation as you, except that I haven’t gotten a period, for more than 4 months, in about 5 years due to being on the pill for quite some time. I’ve tried everything as well, and just had a pelvic ultrasound and an MRI scan of my pituitary gland to rule out cysts. I would recommend it! It may seem unnecessary, but my ND told me that she’s seen many people my age trying all of these lifestyle changes, and not making progress because it’s a greater issue inhibiting hormones like a (benign) cyst. Mine came bak normal, so I’m working with her on homeopothy and herbs to try to stimulate my hormones naturally. Anyways, I just wanted to share my experience and let you know that I think it’s worth getting those tests done!
Hi there! Thank you for the advice! The only reason I’m reluctant to get the MRI is the cost, but I agree it’s probably worth it just to rule out a tumor or cyst.
So interesting reading this- I had the exact same situation. I’m also in Richmond and I’ll bet you we saw the same endocrinologist because he told me the EXACT same thing- MRI, eat more, work out less, less stress (even though I ate plenty, my bmi was normal, etc etc). Because my husband and I were trying to conceive I didn’t accept this “plan” which really wasn’t a plan at all and I got a second opinion. I’m SO glad I did because it changed everything and basically everything that first endo told me was wrong. Long story short, my period never came back, we ended up having to do ivf, and I’m now 9 months pregnant 🙂 I just wanted to let you know and feel free to email me if you want more info 🙂