Healthy, but Amenorrhea

Hey, I know that I've participated in many amenorrhea topics, but I guess I'm just still wondering about my situation. (To anyone who has already talked to me about this and assured me plenty of times, I am so thankful for and appreciate all of your advice, I guess I just am always hungry to hear more stories).

Basically, I haven't had my period since September of 2007. 

Since spring of 2008, I've been changing my diet to help. I've recently taken Provera (acouple of months ago) and got a bleed. I got PMS symptoms a month later, and ever since then, I've put on about 7-10 pounds (with not that great of change in my diet than the one I had already made).

My nutritionist thinks that I am eating pretty balanced, I still only exercise 3 times per week (now I run for 10 mins, walk for 20, when before that I was running for 30). Overall, I've never gone below 110 pounds, and once I made some changes I was staying steadily at 115 and was feeling great! but still no period. So now I've changed even more things to have even a more balanced diet, and I'm usually around 122. Any check up I've went to, no doctor has considered me malnourished (even before I was up to 115). I haven't had vaginal dryness since like March of 2008...When I recently went to the gynocologist, my FSH and LH levels were back to normal. (FSH was 3, LH was 8), but that was more than a month ago, and still no period.

Basically, I feel like 1) I've always been at a healthy weight, 2) I've definitely gained enough to get it back, and 3) It feels like such a long time. I'm so worried that I have developed PCOS and will just never get it back

So, I'm wondering why it's taking so long, if I have the right BMI, the right diet...I mean I've been stressed over it all..but can that REALLY cause me to not have it too? I'm just not sure. 

You should press your doctor to do further research.  If everyone's exhausted the obvious reasons for lack of periods they should start looking for less obvious ones, perhaps.   Stress can halt periods, that's true.  However, your should also be prepared for the outcome that if your reproductive system was badly damaged in the early days, it may never recover.

The thing is, I never did anything drastic! I always have been eating, except in the beginning I was eating little things throughout the day, and then a normal size dinner, and was laying low on the starchy carbohydrates. But I admit, I did have a free day once a week when I ate whatever I wanted, and the rest of the week didn't eat as many calories..probably closer to 800 =/. But I don't know if what I did was drastic enough to so badly damage my reproductive system.

Plus, before losing my period, I was on and off 2 birth control pills because of the side effects. But after I finally went off the 2nd one after 3 months, I got one period on my own about a month after that, and then nothing.

Could the pill have messed with my system for so long too? On top of losing weight quickly? How do you fix something like that..and how am I supposed to know if it's so damaged that I'll never get it back.

Have you discussed your concerns with your doctor and asked him what he suggests? I am not sure your height but are you sure this is a healthy weight for your body?Are you eating enough calories and proper nutrients?I know you stated yes and I am not saying this is you but sometimes it may just not be enough. I know that my nutritionist said if you try to control your weight by even a few pounds in some things like period will not return etc.

I am going to discuss them with my gynocologist, but she initially thinks it's just anovulation because I have a sensitive cycle between going on and off pills and losing weight.

I sometimes wonder if I'm eating enough too; but I am getting full on a daily basis, and since I've gained 7 pounds, you would think that means I've been eating more than enough calories? Granted, in a given day I'm not eating like 2,000. (Which I'm not sure if eating so much is necessary, since I've already gained a lot, and all of my roommates get their periods without being on the pill, and while they don't eat as healthy as me, they probably don't eat 2000 calories either).

But that's interesting that your nutritionist said that about your period not returning if you are trying to control your weight. I'm currently around 122ish, and I'm just below 5'1, so my BMI is around 23 (up from 21).

I'm going to start being more consistant with fish oil supplements, but in all seriousness, I was eating fish and salads with olive oil at least 3 times per week over the summer, and now that I'm at school I usually have fish about twice a week (esp. tuna), plus everyday have olive oil and like some nuts or something. I'm not sure how else to go about this..

Going on and then off birth control, restricting to 800 calories, not having enough fats in your diet, and losing or gaining weight too fast can all effect your hormone levels and therefore stop your period!

It is not unusual for an eating disorder to permanently damage your reproductive system.

But PLENTLY of people DO get their periods back, a lot of people have to just wait it out, some times even for a year or more but a LOT of people DO avoid doing any permanent damage

A BMI of 23 is very healthy and your weight sounds unlikely to be the problem - it is far more likely to be all those other factors I mentioned above. I am not doctor but I do know that those other factors cause amenorrhea more often then a BMI of 23 would.

hi! i just posted a thread! im pretty much in the same boat as you - was underweight (but not crazily so - and in quite a healthy way relatively speaking.. well - super low fat diet but all natural high fruit/veg one) ANYWAY ive been eating properly for a while now - i have a healthy BMI and ive been maintaining my healthy weight for like 4 months now. i got a period (yipeeee) month before last but sine then nada. its SO frustrating isnt it!? anyway i dont really have any proper advice but i just wanted to say IF anything EVER happens for me i will totally let you know. its such a horribel situation i know. ALSO im kind of the same as you as i had a really bad experience wtih BC and i kind of combined coming off it with dramatic weight loss and a recoevry from a pelvic infection brought on my chalmydia (gross i know)... ANYWAY i dont really know if that was related cos i havvent had a properly normal period since (the ONE i did get few months back was really light). my doctor doesnt really want to know and just keeps telling me to gain more and more weight until it comes back.. sorry this probably sounds relaly confusing (i confuse myself with the time line of it all sometimes!) but u can read a more accurate breakdown under my post (if i havent totally bored u already :) ) anyhow i hope things work out for you. it sounds like you are doing ur best to be heatlhy and i think as long as we know we are giving our bodies what they need there isnt much else we can do! i guess some pople just have more functional and well recovering bodie sthan others and we should just be grateful for the health we do have (OMG i sound SO much less calm on my own post :) ). good luck!xx

A couple less obvious things your doc can test for is

• Thyroid function (excessive/prolonged dieting can mess this level up and effect your hormones)
• Estradiol (estrogen) dominance (this is when you have a result closer to the UL of estrogen and nearly no or very low progesterone - it causes what you said and can permanently throw the body for a loop and it makes getting your period back hard. Happens mostly to body builders or women with low body fat levels)
• Progesterone (should be at a minimum of 3.0 but optimally rides between 10-45 throughout a month). This is what the doc normally gives to get you to bleed. It can put a little water weight on but not real weight.
• Diabetes - suprisingly small pre-diabetic levels can also halt your period
• Blocked fallopian tube (this usually only comes from a prior STD, but it can cause a lack of ovulation, sometimes pain that feels close to cramping, and can stop the period due to hormones effected)
• Cortisol levels can effect thyroid levels; stress builds this hormone and stress really does cause probs. This nasty hormone will effect just about everything in your body. It's hard to gauge this level even when tested, but it's all relevent; so have it drawn. They usually will tell you to fast 12 hours prior (just dont eat later, sleep in, and go in for the bloodwork)

So I would make sure you get all that tested. If you have then that's a good start. PCOS can be diagnosed by your doc. Make sure to get a 2nd opinion. Eating fats helps - as you said omegas, adding olive oil to everything, peanut butter, nuts, etc. Those actually are what got my period back the first couple times. I also take a bunch of natural herbs (maca root, black cohish, etc). You can get a women's multi that has all these from NOW Foods... I think it's just the typical women's multi but it has a lot of "fertility enhancing" herbs that have been known to help amenorrhea... and hey it's worth a shot.

Mind you I am at a BMI of 23.5 (5ft 4.5 at 133-138) and mine dropped off a while ago too. Mainly related to exercise and diet I'm sure.

G'luck

Thank you to everyone who has replied!

personaltrainer - I hope you're right. I feel like I've had problems with my period ever since I went on the pill (only for one month the first time!) and then didn't get my period for 2 months (though I was bloated and couldn't lose weight still..I think it was post-pill amenorrhea, if my blood levels had been checked, I'm sure I would have had elevated prolactin from it). I went straight onto Yasmine after that for 3 months, felt awful, couldn't eat anything because of how uncomfortable I was (it was just like livable), so I went off, got one period on my own after I went to college, and then had started to work out, then nothing. I just feel like it has been so long, and even though I changed my diet a while ago to add more fats and stuff, people were still telling me that wasn't enough, even though I was really really really happy. So now I've been eating much more, only weird thing is, it's like 1200-1400 calories, I don't know why I feel so crappy on that amount. Maybe it's something unrelated to what I'm eating, why my body just doesn't feel good. I don't know. Could this really take more than a few months (I think I've made the most changes since February).

Bermond - Already replied on your thread.

LittleMalynda - Thanks for the list. I'll just tell you what I've already had done/what I'm going to have re-done.

In November, I got my thyroid function checked, along with a lot of other stuff. The thyroid was normal.

My estrogen levels were checked in November and February (while I was having PMS symptoms), both times they were low. November I had 14, February I had 23 I think. Progesterone was in follicular stage both times. This monday, I am going to ask for another check with my bloodwork (because I am going to my gynocologist to get FSH and LH tested). LH was low in the beginning of February when I got it checked (I think it was 2), but at the end of February, when I got it checked, LH was 8. Hmm..

I was tested for Diabetes multiple times in November because out of nowhere I started having really bad stomach problems (like an overproduction of stomach acid they think), and frequent urination. But the insulin tests came back normal, and actually optimal. Only abnormality they found was my Amylase was a little over the regular amount, but they don't think that has to do with anything.

I've had an transvaginal ultra sound, so I think they would have seen a blocked fallopian tube? Also, there were a few small cysts on my ovaries, but I've been assured numerous times by doctors that this does not indicate PCOS and that a lot of women have them in any given time, (and especially me because I've my hormones haven't been working correctly).

I have not had cortisol levels checked. I'm not sure if my endocrinologist thought it necessary, but I've mentioned it to her a few times. Maybe I'll mention it to my gynocologist too. I had an MRI of the brain to rule out a pituitary tumor, too.

I've been having olive oil forever! I don't think I ever really stopped having it. Nuts and peanut butter and all that other stuff I've just been putting into my diet for a few months. I don't know what else I can do. I'll talk to my gynocologist about the natural herbs and a women's multi-vitamin.

I'm just so distraught over this, because I'm not going to feel like I can move on (now that I'm like uncomfortable all of the time, and have gained weight) until I get my period. I know I'll have to, but it just hurts a lot.

Well at 1200-1400 cals I doubt it's enough but you probably messed your metabolism up significantly. I was at a balancing act of 1150-1300 (at very most) every day and I worked out 6x a week. I was at a healthy weight but I lost my period. It was the diet/heavy exercise/stress/life and it's just now starting to come back (which is good since the bf wants to start a family now.) Keep at the oils/fats. It's an easy way to add cals without feeling bloated or fat. You should slowly increase your cals to a maintenence level over the next month and see if it helps. Do it slow so you don't gain. What I did was average an extra 100 cals per week until I got up to where I am now. I still run a deficit of 600-1000 per day (I take in 1800-2k and burn 2600-3500 per day) but I am slowly working my way up. I have only gained 5lbs (and that was planned... I ate at maintain of 3500 cals/day for 45 days).... and I think most of it is muscle rather than fat as I have been able to lift heavier weights.

Good luck, and try sleeping a little more. Take a yoga class, try meditation... all that reduces your cortisol levels naturally and might help reduce the stress in your life :).

Good luck to you!!!

Malynda: Congratulations on regulating yourself again! I'm so happy to hear it! (Just a question, I know I've seen you before. Were you saying something about PCOS at one point?)

I gained even though I wasn't eating 3500 calories per day, about 7 pounds. But I think I've been maintaining around 122. Do you really think I'm not eating enough even though I've gained weight? I don't work out too much either. (Just 3 times per week for about a half hour). My jeans are tighter too. I just don't understand.

How long did it take to come back, and what are you typcially eating in a day (just to see what's making up the calories). What were you eating when you got it back?

I just wanted to say im in the same situation too :(

I came off the pill in Jan 08 and didn't get a period until June 08, around that time I lost weight. I went from about 115lb to 107lb but I did it in a healthy way and never cut my calories below 1500. I didn't get another period until Nov 08 but it was really really light and only lasted about 3 days.

Since then I have gotten nothing :( From Jan 09 I have concentrated on gaining back all the weight I have lost, I have cut down on exercise im eating over 70g of fat everyday and eating 1800-2200 calories everyday. I have been to the doctor lately and got all my hormones tested, they all came back fine other than estrogen being a little low but now too low she said.The doctor says my period will come back I just have to wait, which is the most frustrating thing! Oh I also started taking omega 3, iron, zinc, vitamin B and C supplements to see if this helps!

Wow, I had no idea I wasn't the only one! It seems like anyone who loses weight and becomes underweight and loses her period, generally gets it back a month or two after eating more. Not my case, and I guess not many others' either.

My roommate mentioned that the situation we're all in could be because we never lost a significant amount of weight, but still lost our periods, and so we are having a harder time getting it back because we never really stopped eating or purged. Makes sense I guess. But that makes it so hard!

Also, I don't want to be kidding myself if I just physically can't get it back due to something like PCOS. It's so horrible that this kind of disease can happen to women..all of it affects us everyday because it's so contingent upon what we eat, how much we eat, how we work out, etc., while we still feel the urge to be happy with our images as well, and fit into our new clothes, etc.

At this point, I don't care about weight, but it worries me that I'm at a healthy weight already.

xxsarah - Seems to me that you get your periods every 5 months since coming off of the pill. Atleast you've gotten two afterwards! Did you get prescribed those supplements by your doctor?

I have been doing ALOT of research lately and have found some studies done showing a lack of them vitamins along with over exercise can cause amenorrhea. Im not sure if I am actually lacking in anything but I figure its worth a try at this stage. I was worried about PCOS but guess the dr wouldve picked it up with all the tests they have done.

Since gaining weight I have started getting a small bit of white discharge (sorry if thats TMI) which I havn't had in over a year so im guessing thats a good sign. Im stressed cause I want it back so bad :(

Im doing the proestrogen challenge next week after convincing the doctor to leave me, even though I know the bleed I get after it will just be because stopping taking the proestrogen but Im hoping it will kick start everything!

Yea I've had white discharge for a while too lol. A few times over the past couple of weeks I had like a clearish-eggwhite discharge (but I had that 3 times when I wiped, and they were at least 5 days apart from each other), never a large amount or anything.

What tests have they done for you? Because at this point my doctors are basically saying they have no idea whether or not I have PCOS which really doesn't comfort me. Every day I'm looking to see if I have like extra hair growth or something. =/ . I really never thought anything like this could ever happen.

I had around 1700 calories today, but it's so weird, I like don't even know how to get 2000. I think I make healthy choices, usually have protein/carb/fats with every meal, and I've been upping my calories for months and still feel pretty full at the end of each day. I think that's essentially why I changed my diet anyway, I hated feeling so full from all of the starchy carbs. Well anyway...I'm so glad so many people replied.

From what I can rememer I have had my thryoid tested, estrogen, proestrogen, LH, FSH, Testosterone, and I think a test for diabetes maybe. She said everything was fine but estrogen a little low but not pre menopasual low.

I eat very healthy, I don't track my food here I use another website. My maintanence is 1800 calories, I have been experimenting and have come up with that number. Last week I did no exercise and eat that amount and stayed that same weight. I lift heavy weights but I have cut down to 3 workout days per week (used to do 7!), I wear a heart rate monitor and I eat back everything that I burn.I eat nearly 100g of natural peanut butter a day as its calorie dense and helps me to meet my fat and calorie goals.

I think that it may be a energy balance as to why my period is gone so thats why I have cut down on exercise, Im also planning on taking a full week off every 3-4 weeks. Both other times my period has come back I was 107lb and exercising 7X week, the only difference was that I wasn't stressing about it or thinking about it!!

Just as an fyi the discharge is a good sign... things are moving along and you might even want to consider that your ovulation. Hope so!! If that's the case you'll get a bleed within 14 days... so lets keep our fingers crossed.

I eat most of my cals in the morning, and like you I am not a big fan of carbs unless I do heavy cardio days. I tend to have about <400 cals for breakfast (2 whole eggs, 2 egg whites, 1tbs olive oil mixed in, 1/2c kashi go lean, 1/4c silk unsweetened soy milk, and 5-6 oz fruit.) Then 2-3 hours later I'll go for a protein bar (if it's an off day from the gym it's a luna bar & espresso, if it's a high cal burning day I'll go for a builder's bar @ 300 cals and half & half in my espresso). Lunch is balanced: 4oz fish, 1/4c complexed carbs like quinoa or black beans or lentils, and 2-4 oz of dark green veggies like asparagus, snap peas, or broccoli. Then a 4-500 cal protein shake (two scoops no carb protein powder, an EAS ready-to-drink carb control shake, 1/2-1 scoop waxy maize and some frozen fruit). Then work out, then dinner is usually 4oz of meat or tofu, 5-6 egg whites, 1oz fat free cream cheese, and 1tbs of olive oil (love scrambles). Then I'll check my macros and my end-of-the-night snack will be something light but fill any gaps I have: ie if I am low on fat and fiber like I always am I'll have a 1/4c natural PB and 3 stalks of celery.

Also for the PCOS your doc can run a number of tests for it. Also don't confuse your peach fuzz from being mal-norished with hair from PCOS. I often thought I had it bc of my peach fuzz but nope... it's just not eating enough and working out hard. It might help you to get a heart rate monitor or your RMR and BF% tested to really analyze how much you need to maintain. Your not unhealthy but at this point you might need a few months of just "nothing" as far as weight and BF changes are concerned for your bod to say "ok let's go ahead and ovulate and give this girl a breather".

Be patient, I have faith it will return like mine did... it's just going to take a little while. Don't give up hope :).

Hi,

I have a similar problem, but mine is much more complex. This is my first time blogging about it; but I decided to do it because I think I can help.

First, try to stop stressing out so much - it helps to realize periods do go away for some people (especially nowdays with the pills, dieting, exercising, stress, enviromental.. etc) The body tries to protect itself and goes into a survival mode. Everything you do is right, but things like period do not come by a command unfortunately.. Another thing, doctors and lots of web sites are making us quite scared of what amenorrhea might MEAN.. if the doctors are not finding anything drastcally bad, relaxing, eating right, doing moderate exercise, enjoying your life and hoping for the best - is the only thing, maybe the best thing we should be doing.

I personally think that in addition to good diet (organic as much as possible) , reducing the amount of chemicals, pills, and sentetic vitamins is very helpful - our bodies generally do not like that garbidge.

I do want to say, that  I stopped having periods for quite a long time. However, I got them back initially very regular.

Here it is: I felt terrible on the pill, I took it for about 8 months. After I stopped taking it, I lost weight, some exercise.. etc. My periods were irregular, then they stoped altogether. I went to Whole Foods and bought cycle 1 and cycle 2 herbs from company HERBSETC. I did not take provera, I believe that all those hormone pills including THE PILL are very very bad, that's what messed up our reproductive system in the first place. For some people the pill is ok, but for others it is not.

After taking cycle 1 and cycle 2 my periods came back and were very regular. If you want you could give it a try. What stomach problems do you have? Do you currently take anything? How old are you?

For me, after solid periods for several years, I had to get immunizations for my Green Card, after which I got mono. That's a long story and no matter what I tried my periods did not come back. However, your case seems to be very common: pill, lost weight, etc. If you want , you could go to herbsetc web site and read about cycle one and cycle two herbs, consult with your OBGYN about them if you want. [again, I think that the least amount of chemicals we put into out body - the better it operates].

good luck to you