This has been such a common topic lately I felt I would make a nice, big, general post. In fact, losing your period has been a LONG time discussed problem throughout the history of Calorie Count; if you were to do a search on "lost period" in the upper right hand search bar, you pull up about four pages of results!
So, to begin at the beginning. What is amenorrhoea? It equates to the absence of menstruation. It can come in one of two forms: primary amenorrhoea, and secondary amenorrhoea. What most people on Calorie Count experience is secondary amenorrhoea.
That doesn't explain so much, though, right? Well. Primary amenorrhoea is when you never have a menstrual cycle. Ever. This can be caused by genetic problems, a delay in puberty or something that stunts one's growth, and hormonal problems, but essentially is the lack of menses by the age of 16.
Some possible causes of primary amenorrhoea: http://en.wikipedia.org/wiki/Amenorrhea#Prima ry_amenorrhoea
But what about secondary amenorrhoea? Secondary amenorrhoea is the loss of a menstrual cycle for three months or more in women who have otherwise been regular with their bleeding, or six months in women who are less regular.
Some possible causes of secondary amenorrhoea:
One thing that needs clarification is that three months/six months thing, first of all. If you've missed your period ONE month or even two, this could be perfectly normal. I remember when my periods were still regular and I'd skip a cycle around the months of my exams because I'd be gnashing my teeth and pulling my hair trying to focus on doing well in the exams. If you're overly stressed or other things occur to throw your body clock off-whack it's quite common to skip a cycle. It's after three (or six) months you should begin to raise a brow.
Saying that, if you're pursuing behaviours that would commonly result in amenorrhoea and start missing periods then it is better to amend your behaviours BEFORE you hit that three/six month mark. Just because you're not there yet doesn't mean you could be in danger.
Amenorrhoea means your body doesn't trust you to carry a baby to fruition. It can lead to infertility if not treated, as well as osteopenia and osteoporosis as your bone density is slowly leeched without the proper regular menses and hormones supplying it. If any of the causes below ring a bell with you, look to amend them - and that means ALL of them if more than one goes on your checklist!
COMMON CAUSES OF SECONDARY AMENORRHOEA:
- An eating disorder. Anorexia nervosa, bulimia nervosa, ED-NOS, and yes, even binge-eating, COE and other forms of overeating related eating disorders; all of these can result in you losing your period. This is less due to the very disorder itself and more the behaviours associated with it, which I will list below.
- Overeating or frequent binge eating. If you overeat on a regular basis you can affect your weight and your hormone levels - and the stress can ultimately lead to cessation of regular cycles.
- Purging behaviours of any type. This includes compulsive overexercise, which I detail more below, but other forms of purging can also lose you to lose your period as it's too much stress on your body.
- Being underweight. Anorexia nervosa being so commonly associated with being underweight, but you don't have to be starving just for your period to go away: a BMI sub-20 can result in losing your period, even if you eat enough.
- Being overweight. In the same way being underweight can stress out your body so can being too heavy.
- Eating too little for your needs, too great a deficit, and starvation dieting. Starvation, and even just excessive restriction (even if you eat to the minimum sedentary levels for your age and gender) can lead to cessation of your period. And you do NOT have to be underweight to fall into this category!
- Deficiencies and restriction of food groups - especially fats. You might think "low-fat" is the in thing but, actually, too little fat in your diet can cause your period to stop. It's an essential food group and is responsible for the absorption of vital vitamins A, D, E and K. Furthermore a deficiency like an anemia can result in your period stopping.
- Too low a body fat percentage. Women are supposed to have a certain amount of fat on their bodies! Too little and your body no longer thinks you capable of cushioning a possible pregnancy.
- Too much exercise. Yes, there is such a thing. Doing too much of a workout can stress your body out.
- Too much stress. Work long hours? Bad sleeping patterns? Generally chomping your pencil down to a nub and tearing your hair out? General stress, when there's too much of it, can actually make your periods stop. And this can include:
- Losing weight too fast. Sudden rapid weight loss can lead to losing your period!
- The menopause. Women 40 and over usually suffer amenorrhoea as they enter the menopause.
- Hormonal treatments and various medications. While birth control is the most commonly associated medication with amenorrhoea, many other meds also have this side-effect.
- Hormonal issues and underlying causes, like polycystic ovary syndrome (PCOS). Underlying causes are best left to be looked into by a doctor.
So, what to do once you've checked your possible causes of your lost menses and want to tackle them? First: GO TO YOUR DOCTOR. Tell them how long you've been without your period and run through your possible causes. Whether it be if you think your medication has resulted in it, if you have an eating disorder history, or anything else putting your health at risk.
If you can't find a possible cause then your cause might be underlying - ask for a blood test and look particularly to your thyroid levels and for possible deficiencies. Underlying causes of amenorrhoea can be quite serious, so if you can't think of a plausible reason you've lost your period again, you need to raise that with your doctor.
And what else can you do? Again - work to fix any behaviour that might be affecting your menses. Stressed out? Find a peaceful pasttime and make sure to have "me-time" for at least 30 minutes a day. Work out too much? Wean off slowly, bringing your time down until you're at a reasonable level of exercise. If you're compulsively overexercising and begin feeling guilty if you cut down, you need to tell your doctor.
Eating too little, too little of a food group, or have too big a deficit? Eat more! Up your calories to an appropriate level after you work out your needs. If you are 21 or older use CC's tools to work out your BMR so you have a number to work from for your diet: http://caloriecount.about.com/cc/calories-bur ned.php. If you are under 21, CC's tools are inaccurate and you should use this calculator instead: http://www.bcm.edu/cnrc/bodycomp/bmiz2.html as you are still growing.
If you suffer an eating disorder that is obviously not so easily righted, so if you do struggle with an eating disorder, please seek your doctor's help and the help of family and loved ones. For online support, there is also http://www.something-fishy.org and CC's Eating Disorders Health, Resources and Info Thread.
And last of all: have patience. Your period won't come back in a snap. Saying that, it returning isn't a sign of good health either if you still engage in behaviours or are in a state than can result in it being lost again. If you regain your period, but are still underweight, for example, you may easily discover your period does not return the following month. So take precautions and measures to KEEP your period around if you get it back - and that means a healthy weight, body, and lifestyle.
I hope this helps everyone that keeps asking!
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What an incredibly informative post Lala, thank you.
great post :)
thanks so much! that is really helpful (:
I'd like to add other reasons you may experience amenorrhoea: undergoing surgery or multiple anesthesia sessions, or chemotherapy, as well as serious illnesses. If you have a serious illness, your body may shut down reproductive functions until your overall health is such that you can carry a child full term.
I was baffled at the loss of my period when I was undergoing multiple medical procedures, because although I had lost some weight in my illness, I had certainly weighed less and still menstruated. The nurses explained to me that it is common for a woman to miss cycle/s after being put under; the drugs mess you up for a bit.
Here is some info from the Ask Mary section of Calorie Count:
Under-eating, rapid weight loss, excessive thinness, and low body fat can disrupt your hormones to make ovulation and your periods stop. The condition is called amenorrhea (a’.men.or.rhe.a), the absence of menstrual periods. amenorrheaamenorrhea can lead to infertility and other medical problems ,such as thinning of the bones. Visit your doctor for a complete assessment.
No, For women who have begun to menstruate, missing three periods in a row is one of the diagnostic criteria for anorexia nervosa. It's also diagnostic if a women needs to take estrogen for her period to occur. Of course, if a woman isn't pregnant, missed periods might be due to a variety of medical and emotional conditions. Consult a gynecologist for the correct diagnosis and treatment.
You are growing and developing and so you need at least 2000 calories a day. Presently, your body is coping with a food shortage by suspending your reproductive function in favor of supporting growth. Return to the weight you were when your period stopped. You need to stop the restrictive diet. Find female role models who are not rail thin. When you are older, your body might naturally drift to a lower weight.
Women need a critical level of body fat to menstruate because estrogen production is dependant on fat. Women who exercise strenuously may be “all muscle and no fat”, and so they may not meet the minimum requirement of 12% body fat for good health. Furthermore, many individuals need as much as 17% body fat to function normally. You could have your body composition assessed at your gym to check your percentage of fat, or just gain weight to see if your period returns. Either way, you need to see your doctor anytime you miss three periods in a row.
Amenorrhea (a’.men.or.rhe.a), the abnormal cessation of menstruation, is associated with low body weight, rapid weight loss and excessive exercise. You should always consult your doctor if you miss three periods in a row. Undereating and being underweight disrupts your hormones and so ovulation stops. While your weight omay be technically within the healthy range, it might be too low for you. To maintain your present weight at your activity level, you need to eat at a lot more calories a day. You could need even more calories for your period to return.
Your period won't return until you gain some weight. You had a lot of weight loss in in a short time, consistent with malnutrition. You've lost not just body fat, but also protein from your muscles and organs, and now you don't have enough protein to spare for normal processes, like your period. Your BMI is in the underweight range. You should have a healthy BMI and gain weight.
Hi, is it still considered a period loss if you have discharge? it's been happening to me the past two weeks, and my period hasn't come back since may...
thank you for this very informative post! :)
Very very informative. I guess I should get my BI as well as body fat measured
Which makes you justify staying at an unhealthy weight, amirite?
Either you are stupid, either you are so very ignorant.