Where is my period? Amenorrhea and what to do about it

Amenorrhea or absence of periods (or just 2-3 per year) is really distressing when you are trying to conceive, not least because you are not sure when, or whether, you have ovulated.  The causes are similar to the condition Oligomenorrhea, the medical term for infrequent periods i.e. fewer than 6-8 a year and in most cases misbehaving hormones are to blame

• Hyperprolactinemia – occurs when there are high levels of the hormone Prolactin which is normally seen in women who are breast feeding as it helps with lactation. When not pregnant prolactin produced by the pituitary gland can suppress ovulation completely, or slightly so that ovulation may still occur, but the corpus luteum function which produces progesterone is suboptimal, in this case you may still get a period but could be difficult to support a pregnancy.
• Hypothalamic anovulation – heavy weight loss, drugs or excessive exercise can be a cause here, the hypothalamus function is compromised and it stops giving timely messages to the pituitary to begin ovulation
• PCOS – Poly cystic ovary syndrome – commonly a cause of anovulation and a subject which will be featured later in the ABC series on Instagram. Here there are plenty of follicles but they are immature, an imbalance in hormones prevent a dominant follicle from maturing to release an egg.
• Post pill (OCP) amenorrhea – the pill prevents you from producing the FSH (follicle stimulating hormone) and LH (lutenising hormone) required for ovulation, and so prevents the ovaries from releasing an egg. It can take some time for the body to return to normal production of these hormones but periods usually returns within 6 months and should be investigated if not.

And the scary but rare things

• Tumours in the ovaries, pituitary or adrenal glands can prevent ovulation and will require surgery
• POI Premature Ovarian insufficiency – the cycle completely stops before 40 because the ovaries are not producing enough oestrogen a trans vaginal scan will reveal few or no follicles.The causes have thought to be hereditary or have an auto-immune component but a woman is still able to become pregnant with a donor egg and should be offered support for this.

 Action Plan – if you are worried

• Get your hormones checked.You can do this by going to your GP (free but can be a devil of a job getting them to release the results to you which is important) or by using an online at blood test service such as @medichecks, @hertility_health, to name a couple.
• Acupuncture is an efficacious and natural way to balance your hormones and regulate your periods, if you chose an @fertilitysupport trained acupuncturist who will have an understanding of how to read your tests – hence make sure you get the print out from your GP – it’s your information.
• Seen a functional medicine nutritionist check out @victoriasmith_fertily or @anna_marsh_nutrition.  Functional medicine and acupuncture are a great combo if you can do alongside.