It’s safe to say that very few, if any, women look forward to the arrival of their menstrual cycle. Between the cramps, mood swings, cravings, headaches, and other PMS symptoms, periods are the bane of most women’s existence.
Despite periods being anything but pleasant, a natural monthly bleed is vital to a woman’s health. They really shouldn’t come with many side effects, but that’s a tangent for another day. Whether or not you’re currently trying to conceive, consider your cycle to be a monthly report card about your health.
Amenorrhea, or missing a period for at least three consecutive months (if you aren’t on birth control) is not normal. There are several reasons why your cycle might be missing.
IMPORTANCE OF THE MENSTRUAL CYCLE
Menstruation has been a taboo topic for ages. As women, we’re expected to hide any evidence of our cycles and avoid talking about them at all costs. We either cover-up in black pants for an entire week each month, or constantly run to the bathroom to check for leaks. Jackets are our best friends while we’re cycling because they can cover up any mishaps in an instant.
It’s about time we end the shame around periods and embrace them for the beautiful, life-giving process they are. After all, menstruation is half the reason any of us are here today. Aside from allowing for the human race to reproduce, ovulatory cycles are critical for a woman’s overall health and well-being. This is true for several reasons, including:
Hormone balance
Ovulation is how women make progesterone, a vital female hormone that strengthens bones and builds a metabolic reserve. Progesterone also helps alleviate anxiety and is often referred to as the “calming” hormone. Each month a woman fails to ovulate, all the other reproductive hormones in her body get thrown off balance. This dangerous imbalance can lead to a host of health problems, which will be discussed shortly.
Indication of health
Getting a natural period each month reassures a woman that her body is functioning optimally. Specifically, it means she is eating enough food (carbohydrates in particular) and managing stress well.
DIFFERENCE BETWEEN PILL BLEEDS AND OVULATORY CYCLES
One of the most dangerous misconceptions about birth control is that it regulates hormones and helps women recover their missing period. This belief couldn’t be further from the truth because birth control does not contain any bioidentical female hormones.
Progestins, the hormones found in most hormonal birth control options, are completely different than progesterone on a structural level. They are manufactured in a lab rather than made by our ovaries, and the female body knows the difference. Progestins are actually more similar to testosterone and can come with some undesirable side effects as a result.
Here are some of the key differences between progesterone and progestin:
Progesterone
- Improves cardiovascular health
- Promotes hair growth
- Anti-androgenic
- Improves mood and sleep quality
- Protects against breast cancer
Progestin
- Increases the risk of blood clots
- Causes hair loss
- Androgenic
- Can exacerbate anxiety and depression
- Increases the risk of breast cancer
Clearly, birth control is not the hormone savior many physicians tout it to be. Instead, it seems to cause much more harm than good, both in the short and long-term.
Women taking birth control should know that their monthly withdrawal bleed is not the same as a natural period. Ovulation is the main event of the menstrual cycle; the blood itself is simply an inevitable outcome.
STAGES OF THE MENSTRUAL CYCLE
We’ve covered the importance of a natural monthly cycle and why withdrawal bleeds from birth control are not true periods. Now, let’s dive into how a woman’s hormones fluctuate throughout the month. These are the four stages of the menstrual cycle:
Menstruation
Day one of the menstrual cycle is the first day of heavy bleeding (spotting doesn’t count.) A healthy cycle lasts anywhere from three to seven days, producing no more than 80 milliliters of fluid in total.
Follicular phase. Once bleeding is over, the follicular phase begins. A woman’s body is preparing for ovulation, so estrogen and LH (or luteinizing hormone) levels are elevated. Most women feel their best during this phase and have ample energy for physical activity. This phase typically lasts between seven and 21 days. (1.)
Ovulation
When estrogen and LH hit their peak, the ovaries release an egg (ovulation.) This egg makes its way down the fallopian tubes, where fertilization may occur if it connects with sperm, and into the uterus. Fertility is at its highest during ovulation. Ovulation is characterized by vaginal discharge that resembles egg whites and a spike in body temperature. Also, the cervix is higher than it usually is.
These signs are important if you are transitioning off birth control or trying to get your period back. Recognizing ovulation is crucial to understanding your cycle.
Luteal phase
Once ovulation is over, the luteal phase begins. During this time, LH and estrogen levels drop and progesterone rises as the body prepares for implantation (a precursor to pregnancy.) This increase in progesterone is often the culprit behind many PMS symptoms, such as fatigue, cravings, breakouts, and oily skin. Many women also experience constipation, anticipation of which can be alleviated with dietary modifications. The luteal phase should last right around 14 days.
Menstruation begins after the luteal phase, and the entire cycle repeats itself all over again every month until menopause. A healthy cycle lasts anywhere from 21 to 35 days in total.
SIGNS THAT YOUR PERIOD ISN’T REALLY A PERIOD
We already discussed how withdrawal bleeds as a result of birth control are not true periods. However several other situations can cause anovulatory cycles (periods not caused by ovulation.) (2.) Some of these reasons include:
Having recently undergone puberty
- PCOS, or polycystic ovarian syndrome
- Recovering from hypothalamic amenorrhea, or a combination or over-exercise, undereating, and psychological stress
Transitioning off hormonal birth control
Approaching menopause
Anovulatory cycles typically don’t look like regular ones, and can thus be distinguished. Here are three signs to keep an eye out for:
- Bleeding that lasts more than seven days
- Cycles that last less than 21 days
- Cycles that last over 35 days
- This all might sound confusing, but it doesn’t have to be – when in doubt, test! Taking your temperature daily and looking out for a spike is the most accurate method of confirming ovulation.
WHY YOU SHOULD BE CONCERNED IF YOUR PERIOD GOES MISSING
Now you know all about what a healthy cycle looks like and why pill bleeds are not true periods. Now, it’s time to discuss what it means when a woman’s menses go completely missing. Here are some of the most common things to be concerned about when this happens:
Stress
Being overly stressed out can affect the hypothalamus, which is responsible for regulating reproductive hormones.
Low body weight
Weighing less than 10% of what is considered normal for your height puts physical stress on the body. This can also trigger a hormonal cascade that stops ovulation. Women who participate in intense exercise, regardless of their weight, can also experience amenorrhea (loss of the menstrual cycle.)
Obesity. Much like being underweight, an obese state also stresses the body out. Getting your BMI back into the normal range (under 25%) can restore reproductive health.
PCOS
Polycystic ovary syndrome is a complex endocrine disorder that causes the body to overproduce androgens, or male hormones. Cysts form on the ovaries as a result, which can impair or stop ovulation altogether. Insulin resistance, typically associated with diabetes, is also a factor in PCOS. Treating this is key to getting the entire hormonal dance back in sync. (3.)
Chronic diseases such as diabetes and celiac
As previously stated, blood sugar dysregulation can affect the menstrual cycle. Celiac disease, or a gluten allergy, causes inflammation in the small intestine. This can impair nutrient absorption and cause late or missing cycles.
Perimenopause
Menopause typically occurs between ages 45 and 55. The period just before menstruation stops is known as perimenopause, which means a woman’s egg supply is approaching zero. Missed periods are common (and normal) during this time.
Thyroid issues
The thyroid is the body’s master regulatory gland, so hormone levels can be affected when it’s over or underactive. Luckily, thyroid dysfunction can be easily regulated with medication.
This is not an exhaustive list, but rather the most common causes of missed periods. Contact a doctor or call 911 right away if your missed periods are accompanied by severe abdominal pain, fever, nausea, or vomiting.
FINAL THOUGHTS ON WHY YOU SHOULD BE CONCERNED IF YOUR PERIOD GOES MISSING
Menstruation is vital for not only the continuation of humanity but also for women’s health and well-being. It allows us to make essential hormones, combat depression, protect against cancer and gives us insight into our health.
A woman’s period can go missing for a variety of reasons, none of which warrant celebration. Thyroid issues, PCOS, stress, and being underweight are just several catalysts for the loss of menses. Regardless of the trigger, amenorrhea should be always be taken seriously. It should be treated as soon as possible to restore reproductive function and overall vitality.
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