Does The Pill Affect Hypothalamic Amenorrhea?

I actually don’t talk much about the birth control pill on The HA Podcast or anywhere really, but today I will talk about it just a little.

The reason I don’t talk about it is basically because I wasn’t really on the pill. I mean I was, but that was about 10 years ago now and I knew that it wasn’t the cause of my hypothalamic amenorrhea.

As I’ve been on this path of learning about HA, I’ve obviously learned a lot about what causes it and honestly, it’s not the pill. Yes, the pill has considerations for you to make for your health, but I’m referring specifically to the role of the pill in hindering your efforts to get your period back after you’ve gone off it. (1)

I recently did a podcast episode with Renee McGregor and we discuss this on the episode. She explains the fact that the pill is simply masking your HA, which is caused by something else. (2)

I get a lot of wonderful DMs and emails from listeners which I love, so keep doing it! Many of them will start their story with “I was on the pill for X years” and then go into their backgrounds. I always just skip over the pill facts and look at the rest of their story.

The thing is, your body WANTS to ovulate. It’s SO smart. Once you go off the pill, it will start trying to cycle again pretty soon.

So, if you don’t get your period back after being on the pill it's because you have HA. You don't have HA because you were on the pill.

And remember that this isn't a conversation about whether or not the pill is "good" or "bad" – it's about whether or not your period isn't coming back because you were on the pill.

You’ve heard people say “the pill is masking your HA before” and this is true. Many women will take the pill and also the sugar pills so that they get a bleed, but if they have HA that may not work and they may not get a bleed. However, they chalk this up to being a strong pill or just an effect of the pill. However, it’s more likely to be a case of HA or some other issue that is suppressing the bleed. (3)

So, the reason I don’t talk about it much is because I feel like the role it’s playing in HA isn’t massive. Once you’re off the pill, the protocol is the same for anyone that was never on the pill.

Let’s talk a little about how much your body wants to cycle.

I did a few interviews with people that I know to get some good anecdotes and data of my own on this issue.

I have a friend and her name is Jenna. Jenna is a pretty chill gal, a primary school teacher who lives out in the country with her husband on a nice piece of land. She doesn’t seem to workout particularly intensely. She has 2 kids now.

I asked her about her experience getting pregnant and basically, she came off the pill and got her period back the next month. I connected that maybe her low stress lifestyle mean't a quick turnaround to ovulation after the pill. She had no complications with her pregnancy.

I asked my mum a similar question. This time I asked her how soon after giving birth did she get her period back. She got it back 2 months later. After interviewing her a little, we discovered that because she didn’t breastfeed, her body was likely ready to go back to ovulation sooner than a mother who was breastfeeding. She wasn’t utilizing more calories to breastfeed so her body got a move on. Often it can take 6-16 months to get a period back post partum just due to breastfeeding.

Now let’s look at the women I talk to regularly about HA who are post pill.

One girl, who honestly represents so many, that I spoke to recently said that she was on the pill for 9 years and has been to a lot of doctors. She was finally diagnosed with HA and is excited to get to work on getting her period back.

When we dove more into her background we discovered that:

• She was walking her dog 2 miles every morning before breakfast

• She had a high stress job

• She was working out 6 days a week

I've spoken to many others with basically that exact story, so to tell them would be repetitive. I know these are just anecdotes, but they're my own little studies which I will continue to do.

Really, truly, your body wants you to ovulate. Once you’re off the pill you have to look at your lifestyle and make a real, honest assessment of what you’re doing and how it could be impacting your cycle and delaying your ability to get it back.

You’re able to recover even if you’ve been on the pill.

Take our free masterclass: Restore Ovulation & Get Pregnant Naturally and learn how, even with post pill HA, you could recover in 4-10 weeks.

References:

1. Oral Contraceptive Discontinuation: Do Side Effects matter?

2. Cycle characteristics after discontinuation of oral contraceptives

3. Characteristics of the Menstrual Cycle After Discontinuation of Oral Contraceptives

Some additional studies and articles to support and further educate:

1. This study concludes the connection of post pill amenorrhea to HA, however ignore the conclusion that it only needs intervention if pregnancy is required *sigh*

2. This article by Ava is a great explanation basically of post pill amenorrhea

3. This article by Jolene Brighten talks about the testing you can undergo to find the true cause or at least, the hormone levels that are the cause of your HA

4. This study is actually from 1977 so it's old but it's interesting because it says post pill amenorrhea is rare (haha, oh the good old days) and it's conclusions are kind of rubbish BUT it does find a connection between most women have hypothalamic-pituitary dysfunction.

5. This study found no definitely connection between oral contraceptives and amenorrhea BUT it did find a correlation between significant life events and lifestyle changes and amenorrhea.

6. This article by Babymed cites weight loss by itself as a common cause for post-pill amenorrhea. It also cites other causes that are more rare and totally possible.