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!
Thank you for sharing this! I’m also going through a similar situation. 18 months since going off the pill and still no period. I was also diagnosed with HA. Any luck with getting your period yet?
I’m sorry to hear that you’re dealing with a similar issue. No luck for me yet!
Hi Brooke,
Similar situation here, except I don’t exercise at all – BMI 18 is surely low but I have no muscle mass.
Did/do you also exercise? How is your AMH/LH/FSH/Testo/Prolactin?
Ladies we should stick together, it might be quicker this way to find a solution
Brittany. Do you have an update on this issue. I have been suffering the same problem. I have taken amh exam and pretty scare to see if I an fertile, waiting results. I have read about pituitary gland and thinking about MRI after reading your case. What was your results on this test? Did your period came back already? Thank you for sharing.
I’m so sorry to hear that you’re dealing with similar issues. I did an update in November (https://www.eatingbirdfood.com/amenorrhea-update/), but I didn’t end up getting an MRI so I don’t have any results for that. Wishing you the best!
Thank you for sharing Brittany. I’m at stage 1 of all of this, 13 years on the pill and stopped and now no mrnstruation. Wavering between being really concerned, and looking for a gynecologist (I just moved). Pardon the cliche, but it’s so nice to know I’m not alone. Best of luck!
Hi Brittany, I feel your pain and frustration. I wish I could offer some encouragement but I’m in a similar situation and feel like I’m losing my willpower to fight. I was diagnosed with PCOS as a teenager and put on the pill. I stopped taking it in May, 2015 as I got married and I have not had a period since. I have been on the pill for 13 years. For me it is not just waiting for my period to return. I am experiencing a plethora of unbearable symptoms. I have severe hot flashes, insomnia and awful headaches. I had lost some weight in an attempt to control my PCOS but when I went to see the RE, they diagnosed me with Hypothalamic Amenorrhea. I was exercising 4-5 a week and was on a low carb low glycemic diet. I have very low estrogen and my eggs are not growing. The hot flashes and insomnia are killing me. I gained 18 pounds in a 3 month period and stopped exercising completely. I just take long walks. I have been doing acupuncture for 2 months now, tried the herbs as well but still no relief from the hot flashes and insomnia. I think I am getting crazy. I have seen so many doctors already. There is no cure for HA so they don’t have anything to prescribe. I had an MRI scan and it came back negative. I feel so miserable and exhausted. I just don’t know what to do.
You don’t even realize how alone and confused I was feeling on the couch a few minutes ago before I read this. I am going through the exact same thing and have been hoping and praying to hear someone else who was experiencing what I am going through. I was on the pill for 3 years after I had my son, they immediately put me on it when I was only 4 weeks post pardom. After 3 years we decided to try again for a 2nd child. I had a feeling I wasnt going to immediately get my period but I knew I was only 29 and I was healthy and fit. I worked out 5-6 times a week and ate low fat, low carb diet. When my period did not return after 4 months I went to my obgyn and she too put me on estrogen and progesterone. It did force me to have one period but nothing after that. I went back to my follow up and she too put me on the progesterone challenge. I did it for one month, didn’t get a period and I decided I was not going to continue putting artificial hormones in my body when I knew that’s what got me here in the first place. I started getting accupuncture and seeing an homeopathic doctor but no one has ever said the words post pill amenorrhea. I was diagnosed with a “blood flow deficiency ” and inflammation. It’s been 3 months of doing accupuncture and taking supplements and 9 months of no period. I feel so defeated and I’m devasted that taking the pill, excercise and a low fat diet has gotten me to a place in my life that leaves me empty. My husband and I desperately want another child and my son would be an amazing big brother. I feel like he’s just getting older and I’m just getting older and I have no clue when my body is going to go back to a regular cycle. I’ve cut back on working out, I’m eating more and ‘I’ve gained 7lbs but nothing yet. I go back and forth on days of feeling hopeful and other days when I’m scared I’m still only at the beginning of a long journey. I was online today hoping that I could find someone that shared a similar situation and I came across your post and all the commentors. You all don’t even understand what your words have meant to be today thank you so much.
Hi Brittany
Thank you so much for posting this!
Your story is very similar to mine.
Just wondered if you have an update?
Xx
I’m planning to write an update next week!
I just came across this post and I am going rhrough the exact same thing. I have just been recommended to eat more and exercise less like you. I notice this post was writen in JUly and it is now mid october and I was wondering how you have progressed with these lifestyle recommendations? Im hoping to know how its been working for you so far. Thanks!!
Hi Tanya. I’m so sorry to hear you’re experiencing the same issues. I’ve been implementing the lifestyle changes but I still haven’t regained my cycle yet. I went back to my endocrinologist for the ultrasound but things are still unclear as to what’s going on and at this point I’m just waiting things out to see if my cycle returns. That said, I need to do a full post with all the updates. Thanks for the reminder. Best of luck to you — I hope the lifestyle changes work for you!
I just came across your blog looking for pumpkin recipes. Saw this article and was in disbelief as I kept reading. You have the exact issue I have. Like to a T. I was on birth control forever and when I got off of it to start a family, I never regained it back. My estradiol is super low due to the same issues. We ended up going the IvF route and I have a gorgeous boy as a result. 🙂 still trying to get my cycle back by working with an acupuncturist and homeopathic medicine. I just want you to know you aren’t alone. It is tough and frustrating! Good luck!
Just came across your post and it really resonates. After 15 years on the pill I came off it in May so that we could try for a baby, at first I wasn’t worried when my period didn’t arrive but as it approached the 3 month mark I got more worried and visited my GP. I was sent for hormone blood tests but basically told not to worry and to cut back on exercising (to be fair I was doing 8 – 13 hours a week of cycling, running & swimming which I know seems a lot to a normal person!). Blood tests came back ok, and actually FSH was 8.6 and LH 12 which to me doesn’t suggest a HA problem due to over exercise but I’m just an avid googler not a Doctor! I reduced my exercise to around 4 hours a week which made me pretty miserable as I basically gave up cycling with my club and cycling events. I also pestered my GP to refer me to the fertility clinic which I’ve since had a scan and further blood tests through. All tests so far are ok (other than showing that I’m not ovulating). I was most relieved to get a good AMH test result of 45 as this shows my egg reserve is good (so they are in there – they just need to get moving please!) I’m being told to reduce exercise further and put on weight. I’ve finally got to a stage where I’m ready to accept this (even in reducing my exercise I was still training for a half marathon which I have now completed) and I am trying to put on a few pounds but it’s making me pretty miserable, I’m not ‘skinny’ (my bmi is 20) but it’s made me realise how much I cared about having a super toned body. Exercise for me is my social life and my passion and I feel so lost without it but the more I read posts like these the more I realise that it could just be that my body has different limits to other people and it won’t ovulate at this weight and level of exercise.
I have an appointment tomorrow to be prescribed clomid but I’m in two minds whether to wait a bit longer and try and get my body to start ovulating again by itself. I have had one ‘period’ about 3.5 months after stopping the pill but I’m pretty sure I didn’t ovulate as I’ve been peeing on OPK’s religiously and never got a positive!
I will follow your progress and would be interested to hear from anyone else in a similar situation.
It’s so hard to talk to anyone, especially as all my friends have started announcing pregnancies, I am happy for them but I’m also more and more heartbroken every time!
Oh girlie! I hear you. I went off the pill twice (had to go back on a second time because the acne got horrendous, and period wasn’t coming back). The second time around it did end up coming back, no crazy acne, but it took awhile.
Honestly, I appreciate every single time I get my period now lol, after not having been able to have one of my own for 6 years (hence the pill).
Someone’s work to look into regarding hormones (interesting reads about progesterone and estrogen) is Dr. Raymond Peat. Have you heard of him?
I hope it all balances out for you! It will 🙂
Thanks for sharing, Katharina. I’m still working to balance everything out! I haven’t heard of Dr. Raymond Peat but I’m going to Google him right now. Thank you for the suggestion and the encouragement.
Miss you and hope you’re well.