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Period gone MIA? Here’s some ideas on how to investigate the root cause of any issues.

Our menstrual cycle is our best indicator of our underlying health.

If our cycle suddenly goes missing or becomes irregular, it’s often a reflection of our bodies response to our nutrition, exercise, lifestyle, and/or environmental exposures. We could also have underlying health conditions at play.

Worth reiterating: pill bleeds are not real bleeds, they’re simply drug-induced bleeds. A menstrual cycle includes ovulation and progesterone, and we do not ovulate nor do we produce progesterone while taking hormonal birth control.

Probably best to run from any doctor whom tries to prescribe hormonal birth control as the only solution to remedy a missing menstrual cycle – A drug that shuts down your hormone levels cannot “fix” your cycle. Hormonal birth control is doctor-prescribed hormonal imbalance – that’s why it prevents pregnancy.

First things first: rule out the obvious, by taking a pregnancy test.

If we’ve been 3 months without a cycle, then consider further lab work and testing. Reminder: we cannot test sex hormones while utilizing hormonal birth control. We need to be 3 months-free of hormonal birth control use prior to testing.

Dutch testing, which is testing done via urinalysis, is the gold standard for hormone testing as it tests sex hormones and metabolites. Dutch not only shows hormone levels, but what pathways things are going down in the body as well. Meaning, we’re able to point-point exactly where anything may be “going wrong” in the body. Worth mentioning that Dutch does not test thyroid values in any fashion, so a separate thyroid panel will have to be ordered.

Consider Testing:
1️⃣ Thyroid – make sure to get a full panel, which would consist of TSH, free t4, free t3, TPO, & TgAB. Our thyroid is our master gland, so unhappy thyroid levels can be a major contributor to period problems.

2️⃣ Androgens – these might include Testosterone, Free Testosterone, DHEA, DHT, etc. If any of these are out of range, it may interrupt ovulation and/or having a healthy menstrual cycle.

3️⃣ Adrenals – A chronically stressful environment might be deemed an unsafe environment by the body, thus no menstrual cycle. A 4-point cortisol test might be worth checking.

4️⃣ Prolactin – Abnormal prolactin levels may negatively impact FSH levels, which are crucial to a healthy cycle.

5️⃣ FSH, LH, Estradiol – High LH levels may indicate PCOS, while low LH may indicate Hypothalamic Amenorrhea. Low estrogen levels can be a result of under eating, overexercising, chronic stress, etc.

Want to learn more? Lara Briden’s Period Repair Manual and Jolene Brighten’s Beyond the Pill would be great resources for further learning.

Don’t be afraid to get multiple doctor opinions as well. Practitioners that align to Functional or Integrative Medicine may be a better fit. You could also search for NFP (Naturally Family Planning) OBGYN’s. Naturopathic or Holistic Physician’s who specialize in women’s health could be a great fit as well. Many doctors these days even work virtually / remote as well!

This is one of those departments where you really have to advocate and be the CEO of your own health. Do your research, implement changes to nutrition, exercise, supplementation, and environment as needed, and work closely with a doctor to build a plan catered to you and your needs.

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