Why Is My Period Missing?

If you’ve been missing your period for a few months or maybe even years and you don’t know why, you probably have hypothalamic amenorrhea.

This is a situation where your brain suppresses your reproductive system to both preserve your bodies energy stores and because it doesn’t think that it’s safe for you to menstruate have a baby right now.

Your missing period could definitely be one of many other things, like PCOS, but if the following descriptions sound like you then it’s likely that ‘HA’ is the reason for your missing period.

Reasons Your Menstrual Cycle Is Missing

Wondering where the heck your period is?! Well…it could be gone for a few reasons. Today, we’ll cover some of those possible reasons.

You exercise really regularly

Do you work out 5-7 days a week and push the intensity? Regular long distance running, CrossFit or HIIT workouts, a lot of weight training and even a lot of cardio sessions can take more of a toll on your body than you often expect, especially when paired with any of the below three situations too. (1)

You have recently lost weight

A lot of women think that they should live in a chronic calorie deficit...I get it, the world is telling us to eat less, be smaller and take up less space.

Living in a caloric deficit even if it’s only a couple of hundred calories less can cause your period to go missing (see How I Lost My Period). Who knew that your period needed that extra hundred calories?!

So if you can lose your period on just a couple hundred missing calories and you’re someone who is on a 1200 calorie diet then it’s even more likely that your missing period is hypothalamic amenorrhea due to under fueling your body. (2)

You focus on your food quality A LOT

You may not be in an intentional calorie deficit, but your restriction of certain food groups and your rules about what you can and cannot eat may be taking more of a toll on your health than you realize.

It might be physical, with a lack of nutrients or calories coming in due to your food option restrictions or it might be mental thanks to the stress of having to focus on what you can and can’t eat.

Many women who try to recover their missing periods by eating more often struggle until they finally ease up on the food rules. That being said, sometimes hypothalamic amenorrhea can be helped by restricting certain things like gluten or dairy. It just depends on the person and often, recovering from HA can require a bit of individualization of your diet. Working with a professional is recommended! (3)

You’re going through a stressful time either mentally or physically

If you’ve moved cities, lost a loved one, lost a job or have a tough boss (if you’re your own boss this is very likely!) then that stress alone can be enough to see your period go M.I.A. Feeling unsafe, uncertain and extremely busy can send a signal to your ovaries and uterus that now isn’t a good time to develop follicles, release eggs and build a uterine lining (aka have a period).

Typically a combination of one or all of the above mentioned factors will cause your period to disappear but it’s important to stress that your period is extremely important and you need it. Being on the birth control pill doesn't count as a real period, either.

I know it sounds a little strange because you’ve probably been led to believe that the above mentioned things are normal facets of just being a woman in the 21st century but they’re not.

Society puts pressure on us to have a successful career, work hard, workout hard and ‘watch what we eat’ but the truth is, all of those are adding stress to our lives.

It can be really hard to come to terms with the fact that all of these things we’ve been told to believe are the way a woman should be are, in fact, not helpful for our overall health but it’s true – they're not!

The good news: your period can come back pretty easily by backing off the workouts and increasing your food intake.

The bad news: it isn’t always that easy to make these lifestyle changes. Like I said, we’ve been conditioned to think that dieting, working out hard and being a successful business woman are the right things to chase...so it can be very very hard to back off from those beliefs and do what it takes to get your period back.

Again, your period is really important for your overall health. Your reproduction doesn’t just work independently in your body like an optional extra. There are long term effects to your missing period. You’ll want to get it back asap! (4)

How to diagnose if you have hypothalamic amenorrhea

The diagnosis is actually rather easy, however not every medical professional is well trained in identifying it.

A diagnosis of hypothalamic amenorrhea can be made when you’ve taken a hormone test and observed that most of your hormones are low OR low to normal.

Also, if you rule out the major symptoms of PCOS like unexplained weight gain, facial hair growth and acne and you acknowledge that you work out a lot and/or diet a lot, that is a strong sign it could be hypothalamic amenorrhea.

Get a trained professional to look at your blood work (that’s us) and confirm that your levels indicate HA, crossed checked with your lifestyle habits to see if they align with a likely diagnosis of HA too. (5) (6) (7) (8)

We have a free Lab Guide to help compare how your lab results stack up to the functional hypothalamic amenorrhea criteria or if they look like something else such as PCOS or POI.

References:

1. Reference: Warren, M. P. (1999). The effects of exercise on pubertal progression and reproductive function in girls. The Journal of Clinical Endocrinology & Metabolism, 84(12), 4344–4350.

2. Loucks, A. B., & Thuma, J. R. (2003). Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. The Journal of Clinical Endocrinology & Metabolism, 88(1), 297–311.

3. Drewnowski, A., & Almiron-Roig, E. (2010). Human perceptions and preferences for fat-rich foods. Hormones and Behavior, 58(2), 106–110.

4. Khashan, A. S., McNamee, R., Abel, K. M., & Mortensen, P. B. (2009). Rates of preterm birth following antenatal maternal exposure to severe life events: A population-based cohort study. Human Reproduction, 24(2), 429–437.

5. Warren, M. P. (1999). The effects of exercise on pubertal progression and reproductive function in girls. The Journal of Clinical Endocrinology & Metabolism, 84(12), 4344–4350.

6. Loucks, A. B., & Thuma, J. R. (2003). Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women. The Journal of Clinical Endocrinology & Metabolism, 88(1), 297–311.

7. Drewnowski, A., & Almiron-Roig, E. (2010). Human perceptions and preferences for fat-rich foods. Hormones and Behavior, 58(2), 106–110.

8. Khashan, A. S., McNamee, R., Abel, K. M., & Mortensen, P. B. (2009). Rates of preterm birth following antenatal maternal exposure to severe life events: A population-based cohort study. Human Reproduction, 24(2), 429–437.