For many women, coming off of the pill signals the beginning of unpleasant symptoms referred to as post-birth-control syndrome (PBCS), which can include moodiness, fatigue, and headaches, along with saying goodbye to regular periods1. An abnormal loss of menstruation is what medicine refers to as amenorrhea, and there are a few reasons this can happen. If you have just come off of birth control and are wondering where the heck your period is, let’s break down the different types of amenorrhea and some tips for getting your period back stat. While post-pill amenorrhea is more common than you might think—3 to 6% of women2 may lose their period post-pill—it shouldn’t be assumed that there aren’t other factors at play. However, we must also recognize that many women are initially given birth control for irregular or missing periods, which means that when you stop, we’d expect these same symptoms to return. This may be contributing to the higher percentage of post-pill amenorrhea statistics and is why irregular or absent periods need investigation before starting birth control. If you’re a woman who has come off of birth control and lost your period, it’s important to work with a doctor to get proper lab testing to ensure there isn’t another reason for your amenorrhea. Secondary amenorrhea, which is defined by the loss of a regular period for three or more months or the loss of an irregular period for six or more months, can be due to functional hypothalamic amenorrhea, hyperprolactinemia, primary ovarian insufficiency, or chronic conditions. Among its havoc, the pill depletes nutrients, raises inflammation, disrupts your stress response, affects thyroid hormones, can lead to insulin resistance, and may disturb your gut health. All of these things can affect your post-pill period (or lack thereof). Here are some of the factors I consider when working with a woman to get her period back: FHA is often associated with overexercising, low body weight, and stress, but it is a diagnosis of exclusion. This means that all other possible factors need to be investigated first. The Endocrine Society guidelines4 clearly advocate against the use of the pill in women with functional hypothalamic amenorrhea solely to restore a period or even improve bone mass. They also recommend educating patients who are currently using the pill that it may mask these issues. • Vitamins B2, B6, B12, C, E, and folate • Magnesium • Zinc • Selenium • CoQ10 Any kind of zinc deficiency, for instance, will cause issues with your hormones overall and make it hard to recover your period. Over the next few months using these strategies, Amanda was finally able to create predictable periods. By correcting her thyroid function, improving her nutrition status, getting her stress levels down, and supporting healthy digestion, she was able to recover her period. She was also able to balance her mood, boost her energy levels, and eliminate her confidence-sabotaging acne all without needing to go back on the pill. But a heads-up: PCOS, PBCS, hypothyroidism, and the loss of your period can be a lot to navigate on your own. I recommend working with a naturopathic or functional medicine practitioner to help you understand the specific needs of your body and help you create an individualized plan for healing.
