Dear Alice,

What is the usual treatment for missed periods? I haven't had my period for half a year (ever since I stopped taking the pill). I have also lost some weight. What are the health effects of missed periods?


Dear Periodless,

Amenorrhea ("a" means without and "menorrhea" means menstrual flow) is the medical term for not having your period for an extended amount of time. When you go off the pill, it can take a while for your body to re-adjust to its natural hormone production schedule. However, since you have missed over three consecutive periods, it is important that you make an appointment with your health care provider. S/he can help determine the causes of your missed periods and any necessary treatment.

It seems that you have already ruled out pregnancy, which is the main reason women stop menstruating. Other common reasons for missing your period include weight loss, hormonal changes, strenuous exercise, and a change in one's environment, and eating disorders such as anorexia. Amenorrhea can also be due to larger causes, including:

  • Problems with your hypothalamus. The hypothalamus (in the center of the brain) controls the production of the reproductive hormones that regulate the menstrual cycle. Problems with your hypothalamus can make your periods stop for months at a time.
  • High levels of thyroid stimulating hormone (TSH). This can lead to increased prolactin production, which can cause amenorrhea as well as breast milk secretion. High TSH production can result from insufficient thyroid hormone production.
  • A tumor in the pituitary gland can also result in abnormal hormone production, and, ultimately, halt menstruation. High hormone production can also alter the menstrual cycle, resulting in a risk for uterine and/or breast cancer.

Amenorrhea can have a negative impact on reproductive, endocrine, and muscular-skeletal systems. If the cause of your amenorrhea is due to low estrogen levels, you may experience vaginal dryness and a loss of bone density (this is particularly relevant for competitive athletes in physically demanding sports). Regardless of diet and exercise programs, it is possible for athletes to have significant reductions in bone mass when their periods stopped.

During your appointment, it will be helpful to give your health care provider a thorough history of your activities, diet, and workload. You can also describe any other symptoms you may be experiencing, even if they seem insignificant. These clues can be beneficial in figuring out your situation.

All in all, speaking with your health care provider is your best bet...period!


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