8 Reasons for Missed or Irregular Periods

Irregular periods - Dr. Axe

Abnormal menstrual cycles can be a complicated issue to fix, since women’s hormones (and men’s, too) are impacted by a number of different factors and bodily systems. According to a 2011 report about absent periods published in the Journal of Clinical Endocrinology and Metabolism, frequently missed periods over an extended period of time is a relatively common condition that is present in up to 5 percent of adult women at any time. Meanwhile, many more women experience irregular periods on and off throughout their reproductive years.

The hypothalamus in the brain, pituitary, ovarian, adrenal and thyroid glands all help regulate menstruation and balance hormones naturally, so it’s important to pay attention to widespread lifestyle habits that can be negatively affecting hormonal levels.


The Dangers of Irregular Periods and Missing Your Period

In women with a regular cycle, normal ovary functioning releases one egg about every 25–28 days. Although the average time between periods varies depending on the woman, especially during puberty and the perimenopause periods, most women will have their periods once monthly when they’re in good health.

When a woman stops getting her period – which is called “amenorrhea” – it’s a solid indication that something isn’t right. Primary amenorrhea is when a young woman never got her period to begin with during puberty, while secondary amenorrhea is when a woman has had her period in the past but stops getting her monthly period for three or more months.

Having a regular, moderately pain-free period each month is a good indication that hormones are in balance and the reproductive system is working properly. The opposite is also true: Irregular periods, missed periods, or very painful and intense PMS symptoms are a sign that levels of one of more hormones are either lacking or are too high. Whether it’s an underlying health condition, chronic stress levels, a poor diet, too much exercise or low body weight, frequently missed periods — when you’re sure you aren’t pregnant that is — are not something to ignore.

Alarmingly, some reports show that many women choose not to speak with a doctor about frequently missed periods or irregular periods, which is a big risk considering the fact that irregular hormones and amenorrhea are linked with a number of serious conditions, including an increased risk for: osteoporosis, heart disease, infertility and other further hormonal complications.:

According to researchers from the Mayo Clinic Division of Endocrinology, “amenorrhea may be the manifesting feature of a wide array of anatomic and endocrine abnormalities. Amenorrhea results in impaired fertility. When estrogen levels are low, changes in mineral, glucose, and fat metabolism accompany amenorrhea. These metabolic changes affect bone and cardiovascular health, increasing the risk of osteoporosis and coronary heart disease in later life.”

In the case of secondary amenorrhea, according to expert Nicola Rinaldi, Ph.D, “There are five factors that usually play into hypothalamic amenorrhea (abbreviated as HA): restricted eating, exercise, low weight /BMI /body fat, stress (which can be from many sources such as family, job, grief, work, etc.) and genetics.”


How Your Menstrual Works: The Natural Way Your Body Prevents Irregular Periods 

Menstruation - Dr. Axe

Anovulation is the failure of the ovary to release eggs (or “ovium”) over a period of time, usually exceeding three months. One of the major signs of anovulation is irregular or absent menstrual periods. For non-pregnant women of a reproductive age (between about ages 15–40), anovulation is abnormal and thought to be the main cause of infertility in about 30 percent of fertility patients. Oligomenorrhea is another term for irregular but not totally absent periods, which is defined as more than 36 days between menstrual cycles or fewer than eight cycles per year.

This predictable pattern of a woman’s ovulation and menstruation is regulated by a cycle of change in certain sex hormones, especially estrogen. There are many kinds of estrogens present in a female body. The three main ones are estradiol, estriol and estrone.

Estradiol is produced in the ovaries and in the adrenal glands. It’s considered the most potent of the three main estrogens and is highly related to menstruation, while the other types of estrogen are more related to pregnancy. After about the age of 50, the ovaries produce less estrogen, and it becomes the job of the adrenal glands to supply estrogen or provide the biochemical precursors used to synthesize estrogen. This is why women naturally go through menopause and stop having their periods after their normal reproductive years.

For many women who are of reproductive age, low estrogen can cause missed or irregular periods. In fact, amenorrhea in young women is one of the best clinical indicators for estrogen deficiency. With all the sources of abnormal estrogen dominance in the modern world, thanks to things like toxins and a poor diet, it might be hard to imagine that we could ever have a shortage of estrogen. But some women do.

It’s believed that low estrogen is caused not only by the failure to produce enough sex hormones due to hereditary hormonal problems, but a lot of the time because of the effects of high levels of stress hormones on the body. You need to figure out a way to bust stress if you’re having irregular periods because sex hormones can really be negatively impacted by metabolic, physical or psychological stressors.

Stress hormones can become dominant because of many factors — a low-quality diet and chronic emotional stressors being two of the biggest. We need to have our stress hormones released in quick spurts when there’s truly an emergency in order to help us get out of life-or-death situations, but these days many women are facing ongoing stress that is considered “low level” and often ignored, even though it’s, in fact, strong enough to have an impact on overall health.


The Most Common Causes of Missed and Irregular Periods

Aside from being pregnant and going through menopause, which both normally stop a woman from getting her period, here are the other major causes for irregular periods or amenorrhea.

1. High Stress Levels

When you’re under a lot of stress for an ongoing period, your body can start to conserve energy by preventing ovulation. Experiencing a traumatic event, or even a lot of “ordinary” stress, can suddenly cause the adrenals to work overtime, which can disrupt the production of thyroid hormones, estrogen and other reproductive hormones. Among other factors, like restrictive eating and over-exercising, stress can contribute to hypothalamic amenorrhea (HA). When you don’t have a lot of estrogen— and levels of other hormones including luteinizing hormone (LH) and follicle-stimulating hormone (FSH)— fall below normal, you aren’t able to properly build up the uterine lining, and as a consequence you don’t get your period.

Why does this happen? Essentially, your body makes sure that emergencies get priority. Comfort is nice and being fertile is important, but it’s still secondary to survival. A built-in survival mechanism that is ingrained in all of us is the ongoing production of  crucial “fight or flight” stress hormones like cortisol and adrenaline. Adrenaline and cortisol are the two major players related to our stress responses that help us get away from threats (whether real immediate ones or just perceived ones). Adrenaline and cortisol are completely necessary and sometimes beneficial — helping us to run, climb, exert energy, sweat and regulate our heartbeat, for example — but too much can become a problem.

The body always grants priority to producing these stress hormones that will help you survive a crisis, so sex hormones can take a backseat when your body perceives that “times are tough.” Under chronic stress, there’s not enough raw materials available – such as amino acids that help neurotransmitters to work – to make both sex hormones and stress hormones in some cases, so a choice must be made and the body always chooses stress hormones. Severe stress conditions like dieting, heavy exercise training or intense emotional events are all situations that can induce amenorrhea with or without body weight loss.

2. Poor Diet

A poor diet low in nutrients, antioxidants and probiotic foods yet high in stimulants can tax the adrenal glands and thyroid. For example, a high intake of sugar, hydrogenated fats and artificial additives, or pesticides is linked with thyroid issues and adrenal fatigue that can raise cortisol.

Excess cortisol hinders the optimal function of many other essential hormones, such as sex hormones. It can also promote the breakdown of bones, skin, muscles and brain tissue when high over a long period of time. This cycle of excess cortisol can lead to protein breakdown, which results in muscle-wasting and potentially osteoporosis.

If you’re struggling with menstruation, make sure to eat enough food and make it the right kind. Eat high antioxidant foods that are nutrient-dense, especially plenty of fats (even saturated fats that are good for you) and proteins. Also, choose a high-calorie supplement if you are underweight, have low body fat or are an athlete.

3. Extreme Weight Loss and Low Body Weight

When your body mass index (BMI) falls below 18 or 19, you can start to miss your period due to having too little body fat. Body fat is important for creating enough estrogen, which is why very thin women or those with serious conditions like anorexia and bulimia can experience absent or missed periods. Increased physical activity and nutritional demands of intensive exercise can sometimes lead to a low body weight that put you at risk for hormonal problems.

A low-calorie, low-fat diet can also result in nutrient deficiencies and lowered body-fat percentages that may contribute to irregular periods and bone loss. Some reports also show that very lean vegans and vegetarians, including those on fully “raw” diets, might also be at a higher risk – likely because they are more prone to becoming underweight and suffering deficiencies. However not every women with irregular or missed periods will be underweight; many are at a normal weight, and some are even in what’s considered the “overweight” or “obese” BMI range.

4. Over-Exercising

Although moderate exercise is very important for ongoing heart health, mood regulation, sleep and maintaining a healthy body weight, too much exercise can also put excess pressure on your adrenal, thyroid and pituitary glands. Women who rapidly start exercising at high intensities — for example, by training for a marathon or some other major event that requires a high level of physical excretion — can stop getting their period suddenly.

Like other stress hormones, cortisol is released in response to any real or perceived stress, which can be physical (including exercise) or emotional. Such stressors include overworking and overtraining, in addition to things like under-sleeping, fasting, infection and emotional upsets. Today, with pressure to stay thin and in shape, some women feel they need to exercise intensely and “break a good sweat” too much and too many days per week.

This kind of exertion can actually increase stress and deplete the body of energy needed to regulate sex hormones. One University of Michigan report found that running and ballet dancing are among the activities most closely associated with amenorrhea. As many as 66 percent of women long-distance runners and ballet dancers experience amenorrhea at one time or another! Shockingly, among women bodybuilders, 81 percent experienced amenorrhea at some point and many had nutritionally deficient diets!

Exercise-induced amenorrhea” can be an indicator of an overall energy drain and is most common among young women. In fact, female participation in high school athletics has increased 800 percent in the last 30 years, and at the same time hormonal imbalances have also risen. Other concerning issues that sometimes come along with this phenomena include bone density loss and eating disorders. That’s why addressing skeletal problems, heart complications and nutritional deficiencies in this population is a very high priority for physicians.

 

Causes of irregular periods infographic - Dr. Axe

 

5. Thyroid Disorders

You may never suspect it, but it just might be that your thyroid is the cause of your problems related to hormonal imbalances. Some reports show that thyroid disorders may be one of the leading causes of missed periods, with roughly 15 percent of amenorrhea patients experiencing thyroid irregularities. The thyroid gland, often called a “master gland” and considered a crucial controller of the endocrine system, largely controls your metabolism and impacts many sex hormones.

Thyroid disorders, including hypothyroidism or hyperthyroidism, can cause widespread symptoms like changes in estrogen and cortisol hormones and missed periods. Too much cortisol circulating in the body can lead to overall hormone resistance, including thyroid resistance. This means that the body becomes desensitized to these hormones, and more may be required to do the same job.

6. Stopping the Birth Control Pill

Some women stop getting their period somewhat intentionally while on birth control, but even when they stop the pill their period doesn’t return. While some doctors advise that a woman’s period should adjust and return within a few months of stopping the pill, many women experience missed or irregular periods for years afterward.

A woman’s natural menstrual cycle is composed of rising and falling levels of estrogen and progesterone, but taking birth control pills keeps estrogen at a sufficiently high level, which fools the body into thinking it’s pregnant and results in irregular periods. It takes the body many months or even years to correct this and return to homeostasis.

One report published in the American Journal of Obstetrics and Gynecology found that about 29 percent of women experience missed periods for more than three months after going off the pill. My advice: Just say no to birth control pills.

7. Ongoing Hormonal Imbalances and Disorders

Polycystic ovarian syndrome (PCOS) is a hormone imbalance in women that negatively impacts ovulation. When a woman has PCOS, she experiences altered levels of sex hormones — including estrogen, progesterone and testosterone — that can result in abnormal body or facial hair growth, weight gain, blood sugar problems, acne, and irregular menstrual cycles. PCOS can be diagnosed by a woman’s gynecologist who will test for hormone levels, review symptoms and family history, and potentially examine the ovaries for cyst growths.

It’s also possible to go through “premature menopause” prior to the age of about 40, which can missed periods, hot flashes, night sweats and vaginal dryness – although this is a less common reason for irregular menstruation.

8. Food Allergies and Sensitivities

Undiagnosed gluten sensitivity or celiac disease can both impact hormone levels. Because these conditions can cause nutrient deficiencies, negatively impact gut health and add chronic stress to your adrenal glands, they have the ability to affect sex hormone production.


How to Rebalance Hormones and Bring Back Your Period

As you can see, a woman’s diet, level of stress, relationship with family and friends, habit of exercise, environment, and a host of other factors contribute to the quality of her life and, therefore, her state of hormonal health. While hormone imbalances can often go ignored, it’s crucial for all women to pay honest attention to how each element of their lifestyle affects their health — this way they can make choices to eliminate or tweak any aspects that are causing irregular periods.

If you’ve been missing your period for a while, speak to your doctor about running some important tests. According to a 2010 study, “Evaluation and management of adolescent amenorrhea,” the essential laboratory examinations you should request include follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) and prolactin measurements. Your doctor will also likely completely rule out pregnancy and check for signs of PCOS and early menopause through weight changes, acne, hair growth and other signs related to changes in androgen hormone levels.

Many experts recommend a three-tier treatment strategy for regaining your period and hormonal health:

  1. Make appropriate diet, lifestyle and stress-reduction changes first.
  2. Use natural herbs and remedies when extra support is needed.
  3. Only then consider trying hormonal pills or procedures with a healthcare provider, if need be.

Lifestyle changes to make include:

1. Reduce Stress

Healing Prayer

Use various lifestyle techniques that are a natural remedy for anxiety in order to combat stress, such as light exercise, healing prayer or meditation, essential oils, journaling, and acupuncture or massage therapy. Few studies have looked at the use of acupuncture for treatment of amenorrhea, but some preliminary trials have found it helpful for women who have widely separated menstrual cycles.

You can also try taking adaptogen herbs, which are a unique class of healing plants that promote hormone balance and protect the body from a wide variety of stress-related diseases. Adapotgens like maca root, ashwagandha and holy basil help with immune function and combat the ill effects of stress. Ashwaganhda can help heal thyroid and adrenal fatigue, for example.

Also, consider if you should also re-evaluate your need for intense competitive exercise, drinking coffee and using other stimulants, pushing yourself too hard at work, under-sleeping, and exposing yourself to toxic or irritant pollutants. Remember that rest and sleep are crucial for hormonal balance, so don’t let an avoidable lack of sleep run you down.

2. Improve Your Diet 

Mediterranean Diet

Eating a variety of nutrient-dense foods is key to keeping your hormones in check. You also want to be sure to have plenty of short, medium and long chain fatty acids that are essential fundamental building blocks for hormones. Some healthy fats to add to your diet include coconut oil, nuts and seeds, avocados, grass-fed butter, and wild-caught fish like salmon.

Probiotics can also help your body produce certain vitamins that affect hormone levels like insulin. Some probiotic foods and supplements to try include: goat’s milk yogurt, bone broth, kefir, kombucha and fermented vegetables.

3. Revaluate Your Exercise Routine

woman lying on a yoga mat

Both too much and too little exercise can be problematic for controlling cortisol and stress hormones. If you experience menstrual problems, trying gentle forms of exercise in moderation might be able to help the problem.

Focus on exercising as a way of reducing stress rather than burning calories to lose weight. Walking, yoga, dancing, light resistance training, and tai chi or qi gong are soft forms of exercise that emphasize and support gentle movement of the body. Doing 30-45 minutes most days can be beneficial, but more than an hour daily, or not giving yourself enough rest, can trigger period problems.

4. Steer Clear of Environmental Toxins

tea tree oil

You can greatly eliminate toxins in your body by avoiding conventional body care products that are high in hormone-disrupting ingredients like DEA, parabens, propylene glycol and sodium lauryl sulfate. These are all related to altered estrogen production and possibly thyroid and adrenal issues, so check your skin care and household product ingredient labels carefully.

Also, try to use glass and stainless steel kitchen equipment and containers instead of plastic or Teflon whenever possible in order to avoid BPAs, hormone disruptors and other chemicals.

Read Next: Evening Primrose Oil Treats PMS Pain & Infertility


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