I missed my period! What could it be?

By Dr Micaela Gregory, ND

Have you missed your period and wondering why? What could it be? When we do not get our normal menstrual cycle, this is known as amenorrhea To differentiate, there are two types of amenorrhea, primary and secondary. Primary means you never had a cycle. In this case, we’re going to be discussing secondary amenorrhea, which means you had a normal cycle and it’s now ceased for 3 months, or your cycle has been irregular for 6 months.

Missing your period can be completely normal in certain circumstances, say, if you were pregnant (which if this is not your goal, and you have had unprotected sex, I would suggest doing a pregnancy test!). However, outside of pregnancy, or being on a birth control where you’re supposed to miss cycles, missing one or a few may be an indication of something deeper going on. As they say, our menstrual cycles are an indicator of our overall health, so it’s important to know what it could mean.

Let’s take a look at some of the most common reasons for a missed period:

Over-Exercising/Low Body Weight – This is known as functional hypothalamic amenorrhea. It is when there is not enough body fat to create a healthy period. It is common among female athletes, or those suffering from an eating disorder. It is often associated with high levels of exercise, and poor bone density. The cycle normally returns once a healthy weight is restored.

Polycystic Ovarian Syndrome – PCOS is the most common endocrine disorder in reproductive women. It involves insulin resistance and high levels of androgens (testosterone) which impacts the ability to ovulate normally. It is a common reason why women experience missed or long cycles along with acne, facial hair growth and weight gain.

Stress – This is another type of functional hypothalamic amenorrhea, like low body weight. When our bodies are under extreme stress, whether emotional or physical, our body reduces hormonal output from our brain, and this impacts the communication with our ovaries. This can result in delayed, missed, or completely absent cycles.

Thyroid – Our thyroid regulates our metabolism, When this over-, or more commonly, under-functions it is common to experience changes in our cycles, especially with longer or missed periods. You may also notice your period is heavier or lighter than it used to be. In addition when the thyroid is under-functioning, we often get constipated, feel cold, fatigued, and gain weight.

Premature Ovarian Insufficiency – This is a condition where a women’s egg quality begins to deteriorate earlier then it normally should. This results in a premature transition into menopause. Women might also experience other menopausal symptoms such as hot flashes that have an onset before the age of 40.

It’s always important to address the root cause of why something is happening. Above are some of the most common causes, but there are many other reasons why you might have missed a period. Other less common causes include: autoimmune disease, trauma, infections and celiac disease.

It’s important to investigate the cause so the treatment fixes the problem. It might be common to miss a period, but it is not normal, it means something is going on. Ensure to get proper investigation done to figure out what your body is trying to tell you.

References:

Briden, L. (2018). Period repair manual: Natural treatment for better hormones and better periods.

Klein, David A., Scott L. Paradise, and Rachel M. Reeder. “Amenorrhea: a systematic approach to diagnosis and management.” American family physician 100.1 (2019): 39-48.

Rebar, Robert. “Evaluation of amenorrhea, anovulation, and abnormal bleeding.” (2015).