Imagine a scenario such as the following. You used to get your period regularly but haven’t had your period for quite some time (anywhere from ~3 months – a decade or more). You make an appointment with your doctor to inquire why this may be and/or what can be done about it. Without taking the time to ask important and relevant questions regarding lifestyle factors like your stress level, nutrition, exercise, and sleep, your doctor prescribes you the birth control pill to “solve” your period problem. Take this and you’ll have a regular cycle, clear skin, and balanced hormones — problem solved! 

Fast forward several years to when you decide you want to get off the pill for whatever reason. Maybe you decide to go off it because you want to hopefully start having kids soon. Or maybe you want to be done taking a pill every day given that you’ve heard there may be negative side effects associated with it. The months go by and… low and behold, no period! Only now the situation is even more dire and stressful than before, due to increased confusion as to what could be wrong, length of time spent on the pill, and possibly even a strong desire to start a family soon.

Unfortunately, this type of situation is all too common!

I can relate, and I know several of my clients, a number of my friends, and many other women whose stories I have read about on the Internet can, too.

My own story involves losing my period when I was fourteen (after three years of regular cycles with no problems). Not knowing any differently, at first I thought this was no big deal. I had a friend from basketball mention that she didn’t always get her period either, so I figured it was fine and that it would come back soon. LITTLE DID I KNOW.

After spiraling into a full-blow eating disorder and eventually climbing out of it, I was mostly fully recovered physically and psychologically. However, it had been six years and I still hadn’t had my period. Month after month would go by, which turned into year after year. By the time I turned twenty, I had spent years at the weight I had been before the eating disorder, and still no period. Ugh. What one would do in this scenario to start bleeding monthly again, vowing to never complain going forward!

I saw a number of doctors, seeking any help and insight that they could provide. And, as is unfortunately quite common, the OB/GYNs and endocrinologists I went to had one solution – the birth control pill.

This infuriated me, because I knew at the time that going on the pill for “hormonal regulation” would be merely a band-aid solution. In other words, it would be giving the facade that the problem had been solved without doing anything to address the actual problem / underlying root cause. It would be fooling myself into thinking I was getting my period when it actually would be an artificially-induced cycle with little to no relevance to my real cycle (or lack thereof) and natural hormonal health.

As a dietitian, I am passionate about helping others get their periods back (or experience a more regular cycle) by addressing the underlying root causes. (Hint: these are often LIFESTYLE factors like food + exercise + stress!)

Before diving into what can be done to ACTUALLY get your period back (instead of an artificial “period”), let’s explore what is different about “periods” while on the pill as well as any potential negative side effects to taking the pill (for any reason you may choose to do so).

What is different about a pill-induced “period” versus an actual period?

To understand how birth control pills function, it is important to have a base layer of knowledge regarding how a woman’s cycle typically works.

A brief rundown, if you aren’t familiar: In the first half of one’s cycle (the follicular phase), estrogen is rising and peaks right before ovulation (when the egg is released). After ovulation, progesterone starts to rise during the second half of the cycle (the luteal phase). Progesterone peaks right before menstruation (which happens if no fertilization has occurred). Progesterone levels then drop dramatically, triggering bleeding. The bleeding is caused by the shedding of the uterine lining, as there is no baby the uterus needs to prepare for.

Birth control pills contain artificial progesterone and/or estrogen that STOP ovulation – meaning (if functioning properly) no egg is released and pregnancy won’t occur. When you stop taking the pill on day 21 of your “cycle” (or as directed by the specific type of pill you are taking) this leads to a decrease in hormone levels which then triggers a withdrawal bleed. Looks and acts like a period but is in fact NOT a natural, normal period. It is a shedding of the uterine lining WITHOUT ovulation ever having occurred or experiencing a normal hormonal pattern/cycle.

Doctors commonly prescribe birth control pills to “regulate” a woman’s cycle, decrease hormonal imbalance symptoms, or to give her her “period” back. The reality is that the pill does not balance hormones or give you your real period back –> it simply turns our natural reproductive hormonal cycles OFF.  

A monthly bleed caused by the pill’s mechanisms can thus easily delude you into thinking your hormones are balanced, your period is regular, and that there is no underlying problem causing your missing or irregular period. Years or even decades can go by, without addressing an actual existing hormonal problem.

What are potential side effects of the birth control pill?

Decreased ability by the liver to remove toxins from the body

The pill / its ingredients needs to be metabolized (broken down) by the liver, which leads to significantly increased stress on the liver over time, causing a decrease in the liver’s ability to clear other toxins from the body.

Depletion of micronutrients, such as zinc, magnesium, folate, vitamins A & C, B vitamins

Largely caused by the increased use of certain micronutrients by the liver due to the increased burden on the liver.

Increased risk of yeast infections and gut microbiome imbalances

Gut microbiome imbalances also impact our ability to absorb the nutrients we are ingesting in food, leading to further deficiencies.

Increased risk for certain cancers, such as breast, uterine, and cervical

The synthetic estrogen in the pill is not recognized and broken down by the body in the same way natural estrogen is, keeping estrogen levels consistently higher than is normal.

May decrease bone mineral density

Other common side effects such as fatigue, mood swings, low sex drive, and poor concentration

What can be done to get your *actual* period back naturally instead? 

Usually, the reason someone has lost her period has to due with LIFESTYLE factors. So, addressing these root cause lifestyle factors is often the pathway to hormonal balance and period recovery (barring anything else going on medically).

When the body is experiencing too much stress, it recognizes that it’s not a good time to have or prepare for a baby (whether or not you are actually trying to get pregnant) and it will “shut down” the reproductive system by decreasing hormone levels and thus inhibiting ovulation. Hence, the lack of period.

By STRESS, I am talking any number of things. Stress to the body can include emotional and mental overwhelm, too much exercise, not enough nutrition/caloric intake, lack of sleep, toxin overload, and more. Often, with the clients I work with, it is primarily a “too-much-exercise-not-enough-food” sort of problem.

The threshold at which someone will lose their period is different for everyone. Each woman’s cycle is going to be slightly different as far as sensitivity to stress goes. One woman may be able to run marathons, work a high-stress corporate job, and get 6 hours of sleep per night and still have her period (likely provided she is at least eating enough). Someone else might have period troubles with the loss of only a few pounds, or a relatively slight increase in emotional stress, exercise, etc.

In a nutshell, to get your period back, you want to make sure you are…

• Eating ENOUGH
• Eating a VARIETY
• Incorporating lots of FATS (I recommend foods like high-quality red meat, eggs, coconut and other oils, nuts + seeds, avocados, ice cream, organic full-fat dairy, butter, etc.) Do not fear the fats! 🙂
• Eating enough CARBOHYDRATES
• Addressing any disordered eating behaviors
• Minimally exercising (or better yet, taking a total break aside from maybe some walking and light yoga)
• Focusing on SLEEP
• Focusing on mental + emotional health
• Limiting toxic exposure (such as from beauty/skin products, scented products, plastics, mold, water contaminants, etc.)

In general, it boils down to reducing the stress on the body as much as possible, helping the body to feel “safe” and cared for enough to start ovulating again!

Oftentimes, a bit (or a lot, depending on your starting place) of weight gain is required. In some cases, you may need to “overshoot” what may end up being your typical set point weight range in order for your hormones to come kicking back into gear. Given enough time, rest, and proper nourishment, your body will likely lead you to where it is meant to be longer term.

I’ll have to do a post sometime soon with more specific details on what this all looked like for me and what you might expect in your period/hormone recovery journey. For now, hopefully these are some thoughts to get you started!

Relate to this post and interested in connecting more?

–> Leave a comment below or message me with your questions, insight, or experience!
–> Book a consultation call where we can chat about whether working together on food, hormones, or exercise issues might be a good fit.
–> Check out this post for more tips on getting your period back / regulating your cycle.
–> Subscribe to my monthly newsletter where you can stay updated on all the latest business + blog + life happenings!