Dealing With Amenorrhea
Last night, I got my first period. No, not for the first time ever (I'm 22 and had a very regular period from the ages 13-20). But I had a period for the first time in 2.5 years. If you remember my history, you'll know that September 2011 is also the same month that I began to workout and change my eating habits... I had amenorrhea for 2.5 years.
Amenorrhea is defined as the absence of a period for 3 months or more in an otherwise reproductive female. It can be caused by a variety of issues, such as Polycystic Ovary Syndrome, pituitary gland issues, hypo- or hyper-thyroidism, eating disorders, rapid weightloss, and more.
When I first lost my period, I attributed it to me losing weight. I was still overweight after the first 3 months, but I figured the weightloss was the cause. After 7-8 months, I asked my doctor and they basically said the same thing. "Amenorrhea is common in active females. Many professional athletes have it, it's not too much of a worry." I thought 'hm, okay. Not having a period IS kind of nice... I won't stress it.' Until months became years.. In March/April 2013 I decided to finally get extensive tests done at a reproductive specialist to figure out what was up. I got my blood tested multiple times for several levels such as estradiol, FSH, LH, and estrogen. Everything normal. I got an ultrasound of my ovaries. Everything normal; ovaries were producing eggs but they just...weren't doing anything with them. No cysts, no nothing. After a couple of months of tests and appointments, the doctor pretty much said it was because my body fat was too low (I WAS 11% BF at that point, so I'll give her that...). She basically said "eat more" and left it at that. 'Yeah thanks, lady.' I didn't agree; something was wrong...My gynecologist recommended I start birth control to "regulate" my hormones and force the period. I refused. My thoughts were and still are... 'Something is wrong though. I don't want to just mask it with medicine. I can't take medicine forever. It's like sweeping dirt under a rug. I want to find the underlying issue.' I also had a bad experience with birth control (pre-amenorrhea) and refused to take it again. So I left it at that.
This past October 2013, I decided I really should figure this out... It'd been more than 2 years. I'd just moved, I'm in a new area, I'll get a new gynecologist with a new opinion, yeah. She did more extensive tests. Bloodwork. Ultrasound. Same tests. Same results. But she also did a biopsy of my uterus lining because if a uterus goes so long without shedding (aka a period), the cells can build up and lead to cancer. Nobody wants that... So she did a biopsy, which was THE most excruciating thing I've ever experienced... but much needed... Cutting the inside of my uterus and stealing a piece of it? Um... D; The results were useful; no cancer! But more importantly, she said my uterus lining was veryy veryyy thin. She could tell when she tried to retrieve a piece. And from the bloodwork, my estrogen was sort of low. So she believed the eggs were forming, but there was no uterus lining to be shed.
The gynecologist said I need to take a progesterone for 10 days to "kickstart" my period. I thought 'no no no no no medicine' and I hesitantly asked if I'd always need to take the medicine. She said no, with luck it would just need the 1 round of 10 days. So I tried it; she prescribed Medroxyprogesterone. Aaaandddd...nothing happened. I saw her again and she prescribed a second round of the pills, but I had to take it 2x for 5 days rather than 1x for 10 days. ANDDDD...nothing happened. So I went to see her again... She said her next and final idea was to first give me estrogen to prime my hormones, THEN "kickstart" the period with a progesterone. So she prescribed me 30 days of Premarin (an estrogen pill) and 10 days of Progesterone (a different version of the one I took 2 rounds of already). The 10 days of Progesterone were taken on days 20-30 of the Premarin.
I finished my 30 days on Thursday.....and nothing happened. I was telling my boyfriend on Saturday (2 days after) that I must be broken forever... But then, shortly after that at night, it happened. It arrived. :) and my doctor suggested I continue taking birth control to regulate my period.
I know that a lot of girls that are active and into fitness suffer from this. Especially if you are underweight or just very lean, it makes amenorrhea more common. I think the most frustrating aspect about my experience with it was that I lost my period when I was still overweight and only working out 1-3x times a week. Even after I built muscle and healthily added 25 pounds after my lowest weight and 11% BF, I still couldn't manage to have a period! Frustrating frustrating frustrating. And it made no sense.
But if you're going through something similar, I strongly encourage you to stay persistent. Even when all your resources seem depleted, keep trying things. I know there are also options available that I never tried, such as acupuncture or some natural treatments from a naturopath. Like I said, not having a period for such a long period of time can be very dangerous; it can cause changes in bone density and potentially be cancer-causing. No bueno. So just keep truckin.
Update 8 years later: I continued taking birth control this entire time, and only stopped 8 months ago when I decided to try to conceive. Given my history with amenorrhea, part of me expected to have a hard time conceiving (I just didn’t know what to expect!), but I conceived within 5 months of stopping my birth control - mostly by controlling my stress levels, maintaining a healthy bodyweight, and nourishing my body in a balanced way. Just some optimism to share for anyone else who has gone through this. Make healthy decisions as soon as you can and things can & will repair themselves.
