Your menstrual cycle is like a monthly health assessment. When you're in good overall health, your periods should arrive at regular intervals, typically every 25 to 35 days. The timing of your periods is influenced by ovulation, which determines when, or if, an egg is released (excluding situations where you're using hormonal birth control like the oral contraceptive pill).
Amenorrhoea is the term used to describe periods that stop for more than 3 months at a time. Outside of pregnancy, breastfeeding, perimenopause / menopause, or contraceptive use, it is considered abnormal. This includes women aged 16-17 years, or within 3 years of breast development who have not yet started menstruating.
Amenorrhoea means having no period for 3 months in a row, regardless of cycle length.
Amenorrhoea is distinct from irregular periods that may come and go at variable intervals e.g. every 30, 45, or 60 days.
Amenorrhoea is primarily caused by the absence of ovulation. The period is the result of ovulation occurring, so when ovulation doesn’t occur, neither does a menstrual bleed.
Ovulation is when a follicle ripens into an egg and is released from an ovary, usually around day 14 of the cycle. Ovulation stimulates production of progesterone which calms the stimulating effects of oestrogen. Not enough progesterone leads to inflammation, causing pain, and conversely, inflammation can also prevent progesterone production, creating a vicious cycle. Irregular cycles, periods that are too light, too heavy, and / or completely absent can also be signs of anovulation. Long term health implications of anovulation can be premature reduction in bone density, cardiovascular health risks, reduced fertility, and psychological wellbeing.
Ovulation is the ‘main event’ for regulating the menstrual cycle, and necessary for maintaining all aspects of health. Your monthly cycle is a report card of health. When there isn’t enough food, or stress is high, the body decides ‘it’s not safe’ to reproduce.
Around 30% of cases of anovulation are caused by hypothalamic amenorrhoea, often due to:
Other causes of absent periods are:
High prolactin (hyperprolactinemia) - can result in missed periods, along with a range of other menstrual symptoms such as loss of libido, breast pain, headaches, acne, unusual facial hair and vaginal dryness. Often mistaken for PCOS, it is determined by a blood test. Causes include an under / over active thyroid, benign pituitary tumour, elevated oestrogen (which can be caused by the contraceptive pill), some medications such as SSRI’s, stomach acid medications (PPIs), or anti-psychotics, under eating, alcohol consumption, or stress.
Withdrawal from contraception / no period after stopping the pill (post pill amenorrhoea) - depending on the type and the length of time on the pill, regaining your period can take months after stopping birth control. Hormonal contraception (oral, Nuvaring or patch) doesn’t balance hormones or regulate periods due to its synthetic molecules (ethinylestradiol, levonorgestrel and drospirenone, or progestins) which aren’t the same as natural menstrual cycle hormones. The bleed on the pill is not a period, but a ‘break-through bleed’ mimicking a period - as there is no ovulation, estradiol or progesterone. As it suppresses symptoms, rather than addressing the root cause, stopping the pill / other contraception may reveal an issue you had before going on it, such as irregular periods, acne, heavy bleeding or pain.
Hypothyroidism - or an underactive thyroid gland is when the thyroid produces insufficient amounts of thyroid hormone which regulates bodily processes. Hypothyroidism affects ovulation, and therefore progesterone production. The standard thyroid stimulating hormone (TSH) screening test does not reveal the whole picture, leaving many unaware of their hypothyroidism. A naturopath trained functional medicine practitioner can order a complete thyroid panel, including T3, T4, reverse T3 and thyroid antibodies to understand your complete thyroid picture and determine where the issue may be.
Toxin exposure - we are all exposed to hundreds of chemicals every day, e.g. herbicides, pesticides, heavy metals, flame retardants, food additives, halogens, and solvents in personal care products, perfumes, make up, plastics, food, and water. Some act as endocrine disruptors, as they either mimic hormones or bind with hormone receptors in the body, thereby disrupting hormone function. Total avoidance isn’t possible, but we can limit our exposure easily by making better choices and filtering water, and if necessary, be guided through a detoxification program by an experienced practitioner.
Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.
These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.
Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected.
The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.
Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).
Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.
Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.
The conventional approach to absent periods may include tests and examinations such as a pelvic examination to rule out more serious medical conditions, or referrals may be provided for:
It’s recommended to see your doctor if you experience:
Treatment will be based on the causes identified above.
Many women who struggle to seek long term solutions with conventional treatment seek out the functional medicine approach for its amenorrhoea treatment strategies that are natural, safe and effective.
Natural functional medicine treatment of absent periods starts with an in-depth investigation to identify the contributing factors, to then address those factors.
A functional medicine women's health practitioner spends time investigating all aspects of your cycle and health in your first consultation. At Melbourne Functional Medicine, Vicki van der Meer and Rebecca Hughes are both passionate advocates for women’s health. In your initial 4-hour consultation they will investigate your:
They may recommend functional testing to help determine the cause of missing periods, and to investigate baseline health, with tests such as:
Depending on your results and symptoms, a personalised amenorrhoea natural treatment strategy may target the following:
Natural remedies including dietary, lifestyle, herbal and supplemental strategies may include (depending on your condition):
All herbs are prescribed by a practitioner ensuring correct dosages, there are no contraindications or interactions with medications, and that they are appropriate for you.
Our comprehensive 6-month program offers personalised support and guidance for your amenorrhoea natural treatment. Throughout the program, you’ll be working closely with a skilled functional medicine practitioner who will tailor a treatment strategy to address the root causes of your amenorrhoea. Additionally, a dedicated health coach will be there to provide ongoing support, empowering you to achieve your health and wellness goals.
We understand that making healthy changes can be challenging, but with a knowledgeable health coach by your side, you'll have the encouragement and accountability needed to stay on track. Together, you’ll strive to achieve not only the restoration of regular periods but also the long-term maintenance of menstrual regularity throughout your reproductive years.
Through this collaborative approach, we aim to empower you to regain control over your menstrual health and support you in achieving lasting well-being.
Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how, then book a call today
Your period is like a regular monthly report card, and each month your body decides if it feels ‘safe’ and has the resources needed to make a baby, and therefore produce an egg. This is called ovulation, and it regulates the rest of your menstrual cycle.
There are many reasons why you might be experiencing menstrual cramps outside of your period:
If you’re seeking an absent periods functional medicine treatment, our experienced women’s health practitioners can help you regulate your menstrual cycle.
Missing a period occasionally can happen for various reasons. Here are some common factors that can cause a missed period:
It is important to pay attention to any significant changes in your menstrual cycle or prolonged absence of periods. If you consistently miss periods or have concerns, consult with a healthcare professional to evaluate your individual situation and determine the underlying cause. They can provide appropriate guidance, conduct necessary tests, and develop a treatment plan if needed.
Yes, stress can cause you to miss a period. Experiencing intense physical or emotional stress can interfere with the regular functioning of the hypothalamic-pituitary-ovarian (HPO) axis, potentially resulting in a missed menstrual period.
Various stressors like significant life changes, illness, excessive physical activity, or emotional upheaval can contribute to this disruption.
Supplements can play a role in supporting hormonal balance and addressing underlying factors related to amenorrhoea (absent periods). However, it is important to note that the specific supplements and dosages should be determined on an individual basis by consulting with a healthcare professional such as our women’s health experts. Here are some supplements that are commonly considered in the context of amenorrhoea:
The effectiveness and suitability of supplements can vary depending on individual circumstances and underlying causes of amenorrhoea. Working with a healthcare professional such as those at Melbourne Functional Medicine is crucial to determine the appropriate supplements, dosages, and duration of use based on a comprehensive evaluation of your health history and any existing nutrient deficiencies. They can provide personalised recommendations and monitor your progress to ensure the supplements are safe and effective for your specific needs.
To address post-pill amenorrhoea, give your body time to readjust and regulate its natural hormone production. Support hormonal balance through a healthy lifestyle, including a balanced diet, stress management, regular exercise, and adequate sleep. If amenorrhoea persists or is accompanied by concerning symptoms, consult with a healthcare professional to evaluate underlying factors and receive personalised amenorrhoea treatment.
Low iron levels, particularly in cases of iron deficiency anaemia, can potentially contribute to the development of amenorrhoea (absent periods). Iron is crucial for the production of healthy red blood cells and oxygen delivery to reproductive organs. Inadequate iron levels can disrupt hormonal signalling necessary for regular menstrual cycles. However, amenorrhoea is often influenced by multiple factors, and a comprehensive evaluation by a healthcare professional is necessary to identify all underlying causes and provide appropriate amenorrhoea treatment.
Amenorrhoea (absent periods) can be associated with infertility, as it often indicates an underlying hormonal imbalance or dysfunction that can affect ovulation and fertility. Without regular menstrual cycles, the release of a mature egg for fertilisation may be disrupted or absent. However, it is important to note that not all cases of amenorrhoea result in infertility, and fertility potential depends on the underlying cause. Consulting with a healthcare professional is crucial to evaluate and address the specific factors contributing to amenorrhoea and to determine the impact on fertility.
The best treatment for missing periods (amenorrhoea) depends on the underlying cause, which can vary among individuals. In the context of functional medicine, absent periods treatment focuses on identifying and addressing the root causes of amenorrhoea rather than solely symptom management. This may involve a comprehensive approach that includes personalised dietary modifications, stress reduction techniques, targeted supplementation, hormone balancing strategies, and lifestyle adjustments.
A functional medicine practitioner will conduct a thorough evaluation, including hormonal assessments and identifying any nutrient deficiencies or imbalances. With this information, they can develop an individualised treatment plan that aims to restore hormonal balance and promote the resumption of regular menstrual cycles.
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