You keep missing your period but you’re definitely not pregnant!
— Medical experts share possible causes of irregular menstruation.
Most of us curse the onset of that monthly cycle, but what happens when your periods suddenly stop? If you’re definitely not pregnant and your menstruation has all but disappeared, it can be a concern. We speak to the experts about absent periods.
It’s fairly common to experience irregular periods from time to time – lifestyle changes and environmental factors such as shift work can make you late – but absent periods (amenorrhea) should always be checked out.
According to the National Institute for Health and Care Excellence (NICE), amenorrhea affects between 3-4 per cent of people in the UK.
1. You’re stressed
Stress can have a major affect on your periods. High levels of stress hormones such as cortisol in your body interfere with menstrual hormones surges, resulting in a cycle that’s delayed – or that just stops. Both mental and physical stress have the same affect on the body, but your periods should return.
‘With mental stress, evolution is at work,’ says Dr Morton. ‘It’s something in the body and brain saying it’s not ready for babies.’ This is likely to be so that you don’t become pregnant in a threatening environment or when you are too thin.
Possible Solution: Find a stress management tool that works for you. This could be meditation, mindfulness or socialising with friends. Exercise can help clear your mind, while working smarter – prioritising important tasks and accepting that your in-tray will always be full – may help reduce stress in your job.
2. You exercise excessively
Working out is good, right? Well, yes, usually – but if you exercise too much, your hormones will be disrupted in a similar way to when you’re stressed. According to the University of Michigan, around 66 per cent of long-distance runners and ballet dancers experience amenorrhea, while it affects 81 per cent of female bodybuilders.
‘If you are an avid gym-goer or athlete and you have very little body fat, there is a good chance you will begin to skip periods and have anovular cycles,’ says Ms Shiran Irani, consultant gynaecologist at Spire Parkway Hospital in Solihull. ‘Even if you do have a cycle, you may have very light bleeds as the womb lining is thin.’
Possible Solution: Regulate the amount of exercise you do each week. If you’re a professional athlete, a GP specialising in sports medicine may be able to help you maintain performance as well as your cycle.
3. You may have PCOS
Polycystic Ovary Syndrome (PCOS) affects one in five women in the UK. It’s an endocrine disorder that has many symptoms, such as lack of or irregular periods, ‘cysts’ on the ovaries, fertility issues and weight gain. It can also cause excess body hair, acne, thinning hair and depression.
Not everyone shows all these signs, however – it affects women in different ways. Untreated, it can sometimes lead to more serious conditions such as type 2 diabetes and heart problems, so don’t ignore it.
Possible Solution: If you think you may have PCOS, go and see your doctor. ‘Your GP will work out a plan and possibly refer you to a gynaecologist,’ says Dr Morton. ‘If weight is part of the picture, then losing weight will dramatically affect how the ovaries work. The birth control pill can be used to induce periods if you’re not trying to conceive.’
4. It could be early menopause
The menopause is something that we associate with older women, but premature ovarian failure (POV) can happen to younger women, too. ‘The more we look for it in the under 40s, the more women we are picking up,’ says Irani. She estimates that the incidence is one per cent.
The usual treatment for POV is hormone replacement therapy. ‘In younger women, it is best given via the contraceptive pill so as not to have the HRT stigma,’ explains Ms Irani. ‘It also allows them to feel normal by having a period. These women have been known to get pregnant, and there are now cases of women who have got pregnant with IVF.’
Possible Solution: If you’re experiencing any menopausal symptoms such as hot flushes, night sweats, vaginal dryness or reduced libido, see your GP. A simple blood test to measure your hormones may be carried out if you’re aged 45 or under.
5. You have a low body weight
We know not all fat is good, but some fat is essential. If your body weight sinks too low, you may stop ovulating.
‘If you are underweight or you lose 15 per cent of your bodyweight quickly, your body starts to think famine is around the corner and it shuts down systems that are not essential – among them your reproductive organs,’ sys Dr Marilyn Glenville, a nutritionist specialising in women’s health. This can also prevent pregnancy because, as far as your body is concerned, there is not enough food to sustain both you and a baby.
Obstetrician and gynaecologist, Mr Jayanta Chatterjee, agrees. ‘Once the appropriate weight gain is achieved and maintained – 90 per cent of the predicted weight for height – periods often resume within a year.’
Possible Solution: If you think you may be suffering from an eating disorder, see your GP or call a specialist helpline. ‘Establishing regular menstrual cycles is an important milestone for women recovering from anorexia,’ says Chatterjee. ‘Fertility is often restored with the appropriate treatment of the eating