Amenorrhea literally means that there is an absence of a period. I have never experienced this myself (I missed real periods when I was on the pill but this is very different) but I have heard stories and have had friends that have experienced this. Most of them lost of their periods due to severe eating disorders that either started in high school or college. It is really sad to see and not all of them were completely open about the absence of their periods until they went to therapy and felt more comfortable opening up about their struggles.
I want to talk about a few of the tings that can cause amenorrhea because there are quite a few!
Over Exercise
"This is often referred as the relative energy deficiency in sport (RED-S) which is defined as 'energy relative to the balance between dietary energy intake and energy expenditure for health and activities of daily living, growth, and sport activities." So the problem does not come down to too much exercise but more that there isn't enough energy from the food to have a workout the expends that much energy!
Under Eating/Eating Disorder
This usually goes in conjunction with over exercise but not always. Your hypothalamus makes this decision for you when it realises there isn't enough food in your system. Imagine, that you are living in the stone ages and during this time there is a massive drought so you have no water and your crops aren't growing. In that type of environment, do you think it would be the best if you were to on purpose or accidentally get pregnant? Definitely not! So your body makes the conscience decision to shut down ovulation and your period so that it can focus on fundamentally getting food into its system.
This does not only mean too few calories but also too few carbohydrates can also lead to this. I myself don't eat. a lot of carbs like I used to because carbs are essential to our health and with the continually growing diet industry we are losing focus of what our body needs rather than what society wants of us.
Hypoathalmic Issues
This is the type of missing period that has no medical diagnosis because no doctor can find one! This means that your doctor should have ruled out any other issues that could be causing this such as high prolactin, celiac disease, PCOS, thyroid disease, etc. It's not considered a disorder but actually a normal response to underrating or stress.
Post-Pill
Dr. Lara Briden likes to ask the question, "what were your periods like before you took the pill?" Were they regular or irregular? Were they heavy or light? These are all important because when you decide to go off of the pill all of those same issues will arise once again. If you had a pretty normal cycle before going on the pill it may take a while for your period to come back after getting off but this would be under post-pill amenorrhea when your period does not return like it should.
There are a variety of treatments but most focus on you working with your body. For example, if you are overexercising and underrating, a psychologist would best be able to identify if this is under an eating disorder which is unfortunately becoming more common amongst us in the western states. There is all of this unrealistic pressure to have this body type that we see in ads that are non-existent. I grew up with more friends than I can count on my hands, that had either anorexia or bulimia. My aunt was bulimic her whole life and that led to her having a lot of health difficulties which ultimately led to her passing away at 60 pounds in her 60's. One of my closest friends had to admitted to a rehab facility because her doctors did not know if she would survive at the weight she was dropping to. Eating disorders are completely real and not your fault if you are experiencing these issues but finding help to deal with it will not only help your body recover and get your period back but it will give you the peace of mind about yourself that you deserve to have.
If you have hypothalamic issues than this would be again, addressing the eating issue and addressing your stress levels. For those that come off of the birth control pill, wait to see if it comes back but also work closely with a a healthcare professional that is understanding in this field. This is incredibly important as, in my experience, I have come off of birth control and have received a lot of judgements amongst doctors. There was only 1 doctor that ever asked me if getting back on birth control was what I really wanted. If I was aware of the side effects (I went off birth control for a year but when I was returning back to Australia to live with my fiancé I wanted something to protect me from getting pregnant). This doctor was from Boulder and at that time I know she was giving me a heads up before she wrote the script.
I have never experienced amenorrhea but I wanted to talk about it because some of you out there might be dealing with it now or know someone that is. It is not normal and there are causes for it. If you want to find out your truth and how to care for your body you have to advocate for yourself. Research, find a healthcare professional, read and listen. Listening to stories and reading books are great ways to learn more about what you are suffering with. I hope this post helps clear up what exactly amenorrhea is!
Xoxo,
Moonli
Briden, Dr. L. (2018) Period Repair Manual. Sydney, Australia: Macmillan.
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