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Eating Disorders, Featured, Hormones, Nutrition, Reproductive Health

Not Getting Your Period Is Not Normal

February 8, 2017 By Robyn 74 Comments

Periods.

They’re annoying (because hiii monthly bleeding from down there), yet amazing all at the same time. I never appreciated my period until I didn’t get it regularly for over three years. And I was told by doctor after doctor to do a progesterone challenge or go on birth control. Really, I was just nuts about running and needed to gain a little weight and boom. Period. No drugs required.

Guess what - having your period is NORMAL! So, not having it is not normal. Here's why. | The Real Life RD

 

Nowadays, when I’m regularly getting cycle I’m like…actually, authentically excited because it tells me things are working right in my body. And if it doesn’t come, because there has been a month here and there when it hasn’t, I take a step back and look at what has changed in my life. Am I stressed? How is my sleep? Am I eating enough? (that’s actually now never really the problem) Have I increased how much I’m running without being mindful of that?

I can’t even count the amount of times I was told “don’t worry about it” by multiple physicians and NPs throughout my late teens and early twenties when it came to not getting a menstrual cycle. I had blood work done, DEXA scans, and probably other tests, but not once did a health care provider ask about my exercise or eating habits.

My BMI was lower than my natural set point. Note on BMI –> women menstruate with a whole range of BMIs, what’s most important is that your body is at weight that is healthy for YOU. My senior year of high school and into my sophomore year of college I was on a spring break diet or simply trying always lose a few pounds (that sounds so exhausting now). Then I started to learn about the body and how it works so I ate more, but even though I was eating more responsibly, I still stayed around the same weight, still on the lower end of a “healthy BMI,” not once was I asked about exercise or what I ate by any physician.

Then, when I graduated from my dietetic internship in 2012 and took things into own hands and really started educating myself, I was absolutely baffled when I went to an endocrinologist specializing in women’s health and her solution was to prescribe birth control. I was also once told verbatim when I asked about exercise and its relation to amenorrhea, “There is no medical indication for stopping exercise. It is also not dangerous or unhealthy to skip periods.” WHAT?!

I don’t want to sound like I know more than doctors or other health providers because I most certainly have so much to learn and there are incredible providers out there. But I do think, as a health care profession, we are far undereducated about how lifestyle relates to reproductive health, and way too quick to prescribe a medication rather than getting back to basics with some lifestyle modification. I was at a dinner hosted by Monte Nido with a bunch of RDs who work in eating disorders and we got on this topic, and the passion surrounding this was palpable. I loved it because passion fuels change.

I could go on and on because I get so fired up about this topic. But instead, here are five things I didn’t know, but think you should know about your period and lack thereof.

You don’t have be a marathon runner to have exercise-induced amenorrhea. If energy and nutritional intake are not sufficient enough to support energy expenditure, the body begins shutting down organ systems that are not absolutely essential for survival – including the reproductive system. If your body isn’t getting enough energy + nutrients to support your own needs, then it’s certainly not going to think it’s in a healthy state to grow a baby.

But even if you do eat healthily and adequately, amenorrhea is still a common occurrence since exercise causes the release of cortisol – a natural and normal response to exercise. But these are the same hormones the body releases during the “fight of flight” response to any stressful situation (from you forgetting your wallet to you running from a burning building). Everyone’s body has a different threshold of when stress starts interfering with your hypogonadal pituitary axis to keep your menstrual cycle flowing regularly.

Sure, not having your period is convenient, but it has long term health consequences. So when I was continually assured that not having my cycle “was no big deal,” I began to wonder…how is a process that reproduces other humans no big deal when it goes absent? For me as a patient, as an RD, as an NP…this is a big freaking deal. When your period goes missing, there’s an altered production of reproductive hormones and women often are estrogen-deficient (there are other reasons as well).

Estrogen is like the queen of female hormones and when there’s not enough of it, bone health deteriorates leading to osteoporosis (leading to lots of injuries) in addition to infertility, breakdown of the vagina and breast tissue and there is even research to show prolonged exercise-induced amenorrhea may increase the risk of heart attacks later down the road. I don’t say that to scare you, but instead to perk our heads up and be like ok…this is not normal and not okay.

Just because you’re at a “healthy BMI” doesn’t mean you’re at a healthy weight for YOU. Typically, women need about 17% body fat to have their first period and about 22-23% to maintain a healthy menstrual cycle. That is what research shows. That is not the end all be all. But I hope it puts perspective on how having little body fat is usually not healthy.

In light of all the above though, every woman is different. There are women who run marathons and have very low body fat, yet healthily menstruate. There are also women who have an exercise threshold that is much, much lower. That’s okay. You are YOU. Looking at a woman’s BMI and shrugging off an irregular or absent period because she has a “healthy BMI” is ignorant and shoves the body and healthcare into an algorithm when every single patient is different.

The body’s hypothalamic pituitary gonadal (HPG) axis is super sensitive to changes in the environment. This rhythmic pulse of hormones happens on a regular schedule that is precisely timed. That means lack of sleep or insufficient energy intake or emotional stress or other environmental factors can effect this cascade of hormone release that causes a woman to menstruate. Which is why it’s so important to focus on appropriate sleep, stress management and self-care.  Nobody ever mentioned those things to me or asked me about them for years.

FATS FATS FATS ARE SO IMPORTANT. We need fats in our diet to synthesize hormones. And eating enough calories AND nutrients is just as important. Now, any and all foods are part of a healthy diet. Any and all foods are part of a healthy diet. Any and all foods are part of a healthy diet.

But we would become nutrient deficient if we ate McDonald’s all day. So we need a balance of nutrients AND calories in order for our body to not be under nutritional stress. With intuitive eating, your body will tell you what it needs when, we don’t have to track or overthink things. We need foods that nourish our body and foods that nourish our souls too. Because stressing about eating healthy and avoiding all processed foods, well that’s a big point of stress and that’s not good either.

Not having a period isn’t normal. And we can’t just ignore it’s absence. But instead of just taking a pill to slap a band aid on the problem, we have to take step back, look at the overall picture, and get down to the root of the problem.

Seeing clients get a period for the first time in a long time or the first time EVER is my favorite thing, even better when they get pregnant naturally after being told they needed infertility treatment.

Our lady health is so so important.

Want more on this? Here are more posts I’ve written on this very topic <3

Amenorrhea Part 1

Amenorrhea Part 2

Amenorrhea Part 3


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  • How Do I Know If I’m At My Healthy Set Point?How Do I Know If I’m At My Healthy Set Point?

Filed Under: Eating Disorders, Featured, Hormones, Nutrition, Reproductive Health Tagged With: healthy balance, nutrition, period

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Comments

  1. Katryn says

    February 8, 2017 at 10:08 am

    Oh man…this is so good. I’ve said it before and I’ll say it again: I just love you! Thank you for doing what you do! This is such an important message and, as someone who has spent most of the last 10 years NOT having periods, something that I am still working on…especially the weight gain component which can be a hard and slow aspect of recovery. These kinds of reminders are so so helpful. 🙂

    Reply
    • Robyn says

      February 13, 2017 at 12:59 am

      it can be the hardest part! hang in there and keep envisioning the future as healthy, whole you 🙂

      Reply
  2. Rachel says

    February 8, 2017 at 10:44 am

    I LOVE THIS. So freshman year of high school until the end of sophomore year, I wasn’t getting my period. I did not want to go on birth control, but I also didn’t want to gain back all the weight that I had lost from dieting (which now seems so silly!!) the worst part was that I never got “skinny.” So, I didn’t think that my eating habits were a problem. It wasn’t until I started following you that I realized how important my period is and how little I was eating (for MY body) /how stressed out I was/how little sleep I was getting. I started eating more, gained back a lot of the weight (which I’m still learning to accept,) became much more lenient with my workouts (my body only really only likes 4 days of Crossfit a week, which completely goes against my goal of 6 times a week,) sleeping more and stressing less etc. I had to learn that just because I wasn’t skinny, didn’t mean that my body was in a good place. Now, senior year of high school, I’m learning to accept my new body and understand that healthy looks different for everyone. My body is healthy and happy in the middle of the BMI scale (and at this point, I’m not weighting myself bc I lift weights and am gaining muscle + my weight messes with my mind, but focusing on how I feel, my relationship with food and if I’m getting my period.) So THANK YOU for everything ❤️

    Reply
    • Robyn says

      February 13, 2017 at 12:59 am

      Thank YOU for sharing – what a beautiful story Rachel!

      Reply
  3. Kaitlin @ California Endless Summer says

    February 8, 2017 at 10:48 am

    Thank YOU for writing about this. I always love seeing your posts in my inbox and I’ve dealt with this for a number of years. Sure it’s convenient but I always forget the long term health.

    Reply
  4. Fran says

    February 8, 2017 at 11:07 am

    I have been on birth control (the pill) for the last ten years. In the last two years, I have either not gotten a period on my off pill week, or have had a semi normal period. Over 2 years, the semi normal periods have come about maybe 3-4 times. My gynocologist says this is normal if you’ve been on BC for a long period of time. Is the only way to tell if I am normal is to get off the pill? I’m not sure what to make of what they say and what my body should be doing, since the BC is “regulating” my hormones.

    Reply
    • Robyn says

      February 13, 2017 at 1:00 am

      Hope the Q&A video helped!

      Reply
  5. Shelby says

    February 8, 2017 at 11:49 am

    I haven’t gotten my period in about 3 years. I am on both control but it hasn’t caused me to get my period. I exercise quite a bit and am trying to eat more.
    Thank you!

    Reply
    • Robyn says

      February 13, 2017 at 1:00 am

      hope the posts help shelby 🙂

      Reply
  6. Marina @ A Dancer's Live-It says

    February 8, 2017 at 11:57 am

    I regained my period back last year after an absence of 3 YEARS due to over-exercising and undereating. So happy to be fully functioning now! This is such an important issue to talk about.

    Reply
    • Robyn says

      February 13, 2017 at 1:00 am

      I’m so happy FOR YOU!

      Reply
  7. Elise says

    February 8, 2017 at 12:18 pm

    I was told by an OB/GYN in August that I didn’t need to have my period to be healthy – this was given as a rational for putting me on a birth control to stop my periods in order to deal with dysmenorrhea. It can be incredibly frustrating to hear these sorts of things from seemingly highly qualified health care professionals and it can be extremely exhausting to have to continually advocate for better answers.

    Reply
    • Robyn says

      February 13, 2017 at 1:01 am

      I know how frustrating that can be, I’m sorry Elise. I hope the video on Friday was helpful!

      Reply
  8. Julia says

    February 8, 2017 at 12:40 pm

    This is a fantastic post! Thank you for writing. I had an irregular/missing period for a few years and like you, was not getting an answer besides to go on birth control, which I did not want. I went to a new gynecologist (who is also a runner) and explained my lifestyle and what she said next truly changed my life. She told me that, even though I wasn’t underweight, some women just need a little extra fat to menstruate. She encouraged me to increase the amount of dietary fat in my diet and see what happens. So, I did. I ate tons of avocados, peanut butter, cheese, and chocolate and then… I started my period. And I’ve had my period every single month since then three years ago while still maintaining a high level of running. I tell this story to all my girlfriends who, like me, are training hard because it’s so important!

    Reply
    • Robyn says

      February 13, 2017 at 1:01 am

      praise that gyno!!

      Reply
  9. Dana says

    February 8, 2017 at 1:07 pm

    Thank you so much for this. I have been without a period for 1 1/2 years. It took me a while to get my butt in gear once I realized how unhealthy this is for my body but I’m proud to say that I’m now fully on board with getting healthier. I’m eating more and have already gained 8 pounds. It was very hard for me to accept because I still at a “normal” BMI when I stopped getting my period. But I was exercising a lot and restricting food. Even though I haven’t gotten my period back yet I’m already feeling so much better! My hair is healthier, I’m less constipated, I’m sleeping better, and I just feel better. Thank you for educating women about what being truly healthy is all about!

    Reply
    • Robyn says

      February 13, 2017 at 1:01 am

      so amazing to hear this and what so many women need to hear. we are so not alone – thanks for sharing dana! 🙂

      Reply
  10. Maddie says

    February 8, 2017 at 1:34 pm

    Thanks so much for this post, Robyn! Too many of us have experienced amenorrhea and not addressed the root issue. I would love to hear more about when the mentality behind exercise becomes unhealthy. You provide such great insight so thanks again!!

    Reply
    • Robyn says

      February 13, 2017 at 1:02 am

      hope the Q&A video on friday was helpful for this question!

      Reply
  11. Amaura says

    February 8, 2017 at 2:40 pm

    While I agree you should pay attention to your body, I also believe you should do your research on other things that may be ailing your body that are not fully under your control. I asked for an ultrasound to see if I had PCOS (though I’m lean and healthy), and it turns out I did. Due to that condition, I may never get my hormones on board the way many people do with healthy lifestyle. If I didn’t know this, I would have driven myself crazy trying different lifestyle options with no changes in the frequency of my periods. I struggle when people don’t acknowledge these things, making women like myself feel less than for not functioning how women should.

    Reply
    • Robyn says

      February 8, 2017 at 2:59 pm

      Hi Amaura,

      I completely AGREE with you that you have to rule out medical abnormalities – which I why talk about not getting period because you’re just not getting your period is not normal, which is totally separate from not getting your period…because you have xyz.

      But I would encourage you to seek out a professional who knows about healing PCOS and restoring a natural cycle despite the PCOS…I get this isn’t achievable with all women, but I have had a great deal of success helping women restore a regular cycle who have previously been diagnosed with PCOS.

      Hope that helps! 🙂

      Reply
  12. Amy Skelton says

    February 8, 2017 at 3:12 pm

    Great article! What are those yummy loolong cookies in the 1st picture?! I would love the recipe! Thanks!

    Reply
    • Robyn says

      February 13, 2017 at 1:02 am

      it’s a running from the kitchen recipe – search her blog I forget which ones!

      Reply
  13. Laura @ Surviving 21 says

    February 8, 2017 at 3:21 pm

    Thank you so, so, SO much for what you do, Robyn. I felt like such an alien around my friends when I didn’t have my period. I have suffered with atypical anorexia, clinical anorexia and anorexia nervosa. Pretty much as soon as I began to restrict my intake my period stopped; yet, even after a year of intense restriction, overexercising and weight loss, my OBGYN said “well, we can’t really tell you to gain weight and you’re at a low-healthy BMI (my natural BMI is 25 and I was at 19!!), so we’ll just put you on the pill.” Lost more weight, no period still, no issue with my doctor. Three years later when I began rapidly gaining weight in recovery my doctor said “This is just to get your period back?” She didn’t understand. People need to be educated. I was so scared. So thank you!! 🙂

    Reply
    • Robyn says

      February 13, 2017 at 1:03 am

      I totally agree! I’m so sorry you had a not so great experience with your OBGYN but hopefully we will see change!

      Reply
  14. Jessica says

    February 8, 2017 at 3:57 pm

    Oh my, I know what you mean about getting excited and grateful when you start bleeding each month because same! It really is one of those cases where you don’t know what you’ve got until it’s gone! Talk about taking for granted as well! I never ever hate on my period any more. I know how precious it is.

    I have a question though…do you think people who have lost their periods because of (in my case) anorexia have a higher chance of losing it again even after it’s restored? I am a healthy weight and fat % but my periods have gotten irregular again in the last six-nine months (i.e. much much longer cycles). I lost it 7 years ago due to my eating disorder but had it restored 5-6 years ago and had zero problems until now. The only thing that has changed is that I have regularly been running for 18 months but not more than 20 miles a week so not insane. Is it possible my body is more sensitive because of the harm done to it before?

    Reply
    • Robyn says

      February 13, 2017 at 1:04 am

      email me jessica if the Q&A video didn’t answer this question 🙂

      Reply
  15. Jess says

    February 8, 2017 at 4:31 pm

    THANK YOU, THANK YOU. Although I’ve been lacking my period for five years due to an eating disorder, it’s only in the last two that I’ve really started to focus on recovering that part of myself, especially now that I’m in a much better (and happier!) mental state. I’ll admit: the thought of getting my period again is a little scary. I hated it growing up since mine were so heavy. Even after I was weight restored years ago, I didn’t really want my period, you know? But after racking up the injuries lately and reading advice about the other effects of amenorrhea like yours, I’m starting to realize just how much women are supposed to have their periods. This article was another kick in the rear-end for me. 🙂 I also love all the comments to prove I’m not alone!

    Reply
    • Robyn says

      February 13, 2017 at 1:04 am

      I’m so glad it has been helpful Jess! You are SO not alone! xo

      Reply
  16. Rosamund Feeney says

    February 8, 2017 at 5:25 pm

    The title of this post alone made me cry. I have been trying for over a year to get my period back after losing it from an exercise addition and restrictive diet. I had no idea what was going on as I had recently stopped taking the contraceptive pill and thought the period absence was from that. However after stumbling across your blog last year I had a huge revelation. I read everything you had written about amenorrhea and hormone health, and was just so so happy to be understanding what was going on. My eating was still lacking a lot of fats and carbs, sleeping was just not happening and I was stressed to the max. I have been slowly getting there and am happy to say that I no longer put my body through a grueling exercise regime and am eating so much more food. While my period hasn’t returned, I know that it is baby steps as the sleep and stress thing are still going on. Like you, I don’t want medicine to bring back my period, I want it to happen naturally and am confident that it will return the more I focus on healing my body and balancing my hormones. Thank you, thank you, thank you for bringing all this information to light for me, I can’t explain how much it has helped.

    Reply
    • Robyn says

      February 13, 2017 at 1:05 am

      It is baby steps but keep your head focused forward on the healthy, whole woman you want to become 🙂 thinking of you!!!

      Reply
  17. Karlie says

    February 8, 2017 at 6:43 pm

    I love this! You are actually the first person to bring amenorrhea to my attention as a problem. I wasn’t get my period for years. Not because of too much exercise, but the combination of a high-stress lifestyle + not enough food. And once I learned to take a freaking nap and eat more – not just when I’m hungry but when I know I need to – it came back. And I’m the same way, every month is like a celebration of my beautiful body and femininity. And obviously the above formula worked for ME, it won’t work for everyone, and part of the journey is finding what YOUR body needs. xo thanks as always Robyn

    Reply
    • Robyn says

      February 13, 2017 at 1:05 am

      I’m so with you on the celebrating!! xoxo

      Reply
  18. Shannon says

    February 8, 2017 at 8:17 pm

    Thank you for always being so honest in your posts! You bring things back to reality and it is so much appreciated.

    Sidenote: reading your blog has inspired me to finally pursue what I really want to do in life, which go back to school for nursing. Right now I am super stressed taking only anatomy (albeit I and II) while working full time as a preschool teacher. It’s a little scary, but I’m pushing through!

    Reply
    • Robyn says

      February 13, 2017 at 1:05 am

      I’m so glad! You will be an amazing nurse – hang in there with the anatomy!

      Reply
  19. Rebecca Lwin says

    February 8, 2017 at 8:52 pm

    Thank you, Robyn, for this beautifully written post. We all SO need to hear this. ????

    Reply
  20. Molly says

    February 9, 2017 at 12:55 am

    I love this post! I’m a 26 year old woman and a nurse and I just stopped taking birth control for the first time in 10 years! My OBGYN prescribed it to me for menstrual cramps and no one ever suggested I trial off of it. I tried to stop it one other time and felt pressured to go back onto it because my hair began thinning and I didn’t feel pretty. I’m a strong, educated, clever woman and I felt enslaved to birth control because I didn’t think I could find a boyfriend without it! This time I’m determined to listen to my body and let my hormones balance themselves out.

    Reply
    • Robyn says

      February 13, 2017 at 1:06 am

      listen to your body, take care of yourself, and if you need help reach out 🙂

      Reply
  21. Abigail Trainor says

    February 9, 2017 at 3:37 am

    As always, I love your thoughts. I agree that primary care physicians can not be concerned about periods. Thankfully, my doctor saw that I was 10lbs down from my last visit and encouraged me to eat some more healthy fats/food in general and see what happened. But if she hadn’t had my past visit information, she might not have mentioned it, especially since I was in the normal BMI range. Also, I think they are misconceptions about what EDs look like. The stereotype is super skinny means ED. Anyways, those are my thoughts/agreements.

    Reply
    • Abigail Trainor says

      February 9, 2017 at 3:42 am

      Also, after the first visit, I still hadn’t gotten my period and was given the option of birth control as a way to “fix it” at the next few visits.

      Reply
    • Robyn says

      February 13, 2017 at 1:07 am

      agree with having to think outside the box of your stereotypical ED patient abigail – I actually did my entire capstone research project on eating disorders in normal and overweight BMI patients

      Reply
  22. alisha says

    February 9, 2017 at 7:42 am

    Robyn, I have a really important question that I cannot seem to answer despite my efforts in research and talking with doctors. I have been suffering from an ED for years, and I am definitely underweight, and trying to gain weight. I have had ammenorhea for years, and of course, the “solution” was birth control, which I am on. I have two questions: (1) is there any benefit to being on birth control while I am trying to gain weight – many people suggest that being on the pill will supply estrogen to my system that is completely lacking estrogen in order to prevent any bone issues like osteoporosis while I am in the process of gaining weight – is that true? should I stay on birth control for my bones? (2) what are you thoughts on birth control in general, are there health reasons to not be on it? bad for the heart, etc.? I typically think going natural is best, but I also don’t want to have bone problems, so if being on birth control helps prevent bone issues while I gain weight, then fine, but I can’t seem to find hard evidence of that. And if being on birth control introduces further negative effects on health, then I don’t want to be on it. Anyway, I know you are busy, but if you could answer, that would be awesome!!! Thank you so much for this amazing post and forcing us to look at ourselves instead of putting fake bandaids on real issues. You are a rockstar. Thank you.

    Reply
    • Robyn says

      February 13, 2017 at 1:07 am

      email me alisha! [email protected]

      Reply
  23. Bridget Burke says

    February 9, 2017 at 12:30 pm

    Thank you for this! Several years ago I was a running nut while also on Weight Watchers. This is something that worked in some ways but I don’t believe that the WW program (at least back then) was geared towards a runner’s needs nutritionally. I believe I was not fueling my body in a way that it could properly function and I did stop getting my period for about 3 or 4 months. When I saw the doctor they told me that it probably wasn’t the running because although I was exercising a lot I was still a bit overweight. To them they figured if I wasn’t emaciated then it must not be from exercise. I was left without answers and just sort of waited for things to return to normal. Cut to a few months later when I actually came down with SHINGLES! Again, I believe that this was due to the stress that I was putting on my body with all the exercise. However, because the shingles kept me from running, my body was able to return to normal and my period came. I have always found it amazing that my doctor didn’t put all of that together and instead I did years later! Thank you for addressing this topic so that other women don’t go through the same concern and confusion.

    Reply
    • Robyn says

      February 13, 2017 at 1:08 am

      an unexpected way to regain your period but I’m so glad that was a blessing in disguise Bridget!

      Reply
  24. Irina says

    February 9, 2017 at 1:14 pm

    Loved this post because I relate to it so much. I too lost my period for very long periods of time (upwards of 8 months sometimes!) and was told the exact same thing you were – try birth control, take progesterone pills, this is normal, etc. etc. And it drove me insane because I KNEW it was not normal by any means. I went to an endocrinologist as well, which showed no distinct issues. So for a while I was in the dark about everything. My period started being consistent when I moved to NYC in June of 2013 and has been coming monthly since. My weight stayed the same and I’m still running quite a bit (trained for 2 marathons during this timeframe), but my diet naturally changed – much more fats and protein, less carbs. It wasn’t really intentional although I actively tried to add in more fats until it became second nature in my meal prep. I’m so glad that I got my period back naturally and I really wish that physicians would put more effort into their patient’s needs and not just prescribe birth control as a way to mask the problem.

    Reply
  25. Danica says

    February 9, 2017 at 4:45 pm

    I heard all of those same things from doctors years ago when I was experiencing ammenorrhea. I knew there was a connection in my lifestyle as well and honestly quit seeing medical professionals all together – it was ‘natural medicine’ (chiropractors, holistic health coaches, etc.) that aided me – along with my own daily choices that finally brought back my period.
    The medical field (and, of course, all of the people you’re going to help) is absolutely BLESSED to have you as a part of it.

    Reply
  26. Bridget McGahen says

    February 9, 2017 at 5:14 pm

    I used to have super irregular periods, since I was like 16. I’d go 6-9 months without one. As an adult, I often skipped months, but didn’t go that far in between. Birth control didn’t help this at all. The weirdest thing is that when I started doing 60-miles a week with marathon training, my period has become more regular than EVER. I can predict it to the day. It’s insane and counter-intuitive. My theory is that because I run so much, I don’t avoid carbs. I eat a lot of carbs. I eat a reasonable amount of fats and proteins, but definitely heavy on the carb. I guess this pescetarian, carb-heavy, lots of exercise lifestyle works for my body.

    Reply
  27. Ash V says

    February 9, 2017 at 8:24 pm

    Love this! A few years ago I had an unhealthy obsession with exercise and “nutrition” (eat real food! nothing processed! you’ll rot your body if you eat anything not organic!) and lost my period for about 9 months. The thing is, my BMI was technically over the ideal limit, and I was “overweight” for my height. My ob/gyn did ask me about my eating/exercise habits, but I downplayed it because I didn’t want to admit I had a problem. She recommended birth control, and I reluctantly went on it for about a year before I had enough. I eased up on myself and put on about 10-15 pounds. I got my periods back, and they’re about as regular as they were before (which is to say not quite like clockwork, but still every 21-28 days or so). I haven’t weighed myself in 6+ months, but I know that I’m a little overweight (sometimes it’s just a fact, not a body perspective issue). However, I’m so much happier than I was when I wouldn’t let myself enjoy a single bit of food without tracking it or planning it ahead of time down to the hour. When I see pictures of myself from a few years ago, slimmer, I get a little desire in me to wish to be that size, but then I remember how the night before a vacation with friends I was sitting on the floor crying because I wouldn’t be able to plan my meals ahead of time. That is not the life I want!

    Reply
    • Ash V says

      February 9, 2017 at 8:26 pm

      Also, I am extremely blessed to have a good friend who was a WHNP (is that a right title?) at the time and gently encouraged me to take a closer look at my habits. She’s now a DNP and pretty much the best friend a girl could have because she is so passionate about women’s health!

      Reply
      • Robyn says

        February 13, 2017 at 1:17 am

        she sounds amazing!

        Reply
  28. Saah says

    February 9, 2017 at 10:09 pm

    I LOVE your passion for this topic. It seems that there needs to be more curriculum on this in med school, especially for OB/GYNs and endocrinologists. I am so glad you are going on to be an NP and will be able to reach even more people and teach about the importance of having a period, and how diet and exercise play a critical role in menstruation, and health in general!

    Reply
  29. [email protected] says

    February 9, 2017 at 11:30 pm

    Yes absolutely love this! In Australia they don’t even acknowledge HA as a possibility when your period goes missing. Even after having an ED for years not one Dr has ever asked me to I eat enough and do I exercise to much, they just prescribe something to make it go away. Pretty sad really!

    Reply
    • Robyn says

      February 13, 2017 at 1:16 am

      oh goodness I’m so sorry Kate. but know you can regain it naturally if no medical problems are preventing your cycle!

      Reply
  30. Heather @ Polyglot Jot says

    February 10, 2017 at 10:35 am

    YES! I was put on birth control around 17 years old because I had heavy periods and very bad cramps. After 8 years on the pill, my cycles were so light and then one month it simply didnt come. I knew this wasn’t normal and was told by my DR it “wasn’t a big deal” either. Well, I knew I wanted a baby within the year when this happened, so I swiftly went off of those dang pills! Luckily, I had a normal cycle after this but I hate how its just perceived as normal and okay! I do not plan on ever going back on a pill as a form of birth control!

    Reply
  31. Emily says

    February 10, 2017 at 11:17 am

    this is still a struggle for me. I have my period, and then I don’t have it the next month. You really got me thinking; I’m just not sure where to start on getting help or assistance!

    Reply
    • Robyn says

      February 13, 2017 at 1:16 am

      email me if you’d like emily

      Reply
  32. Amber @ Madden Wellness Counseling says

    February 10, 2017 at 2:33 pm

    This is so great! I loved reading this. As someone that has struggled with Bulimia, compensating eating with exercise, this really hit home. I also began having very irregular periods while training for a half marathon last Spring. I didn’t know what the problem was and when I saw my doctor, she recommended birth control, saying that my estrogen levels were most likely too low. I suspected I was overexercising and mentioned this. She seemed to shrug it off, but did confirm that it could be a factor. I did take the birth control for a couple of months, but determined it wasn’t for me. The one thing I changed for myself was I began exercising less and taking care of myself more. My period has returned – like clockwork, and without the use of any medications!

    Reply
    • Robyn says

      February 13, 2017 at 1:14 am

      thank you for sharing amber! so so so glad you were able to regain your cycle.
      and also, I will email you back before march is over 🙂 xoxo

      Reply
  33. Victoria says

    February 10, 2017 at 3:03 pm

    Hi Robyn,
    I always read your blog but don’t generally comment. I wanted to know, as this post worried me. I’ll explain you my situation. I was taking birth control for 3 years, but stopped because I was getting a lot of hormonal problems (I was crying a lot, lost my sex drive, had huge mood swings, etc.). I recognised it was too much, out of my control, and so I stopped taking birth control and those problems went away. I have not had the period since then, 3 years ago. I went to the doctor and they did lots of tests, hormonal treatments (progesterone challenge but also another one that was like 6 months long) and even brain scans to see if my glands in the brain were ok, and everything was ok, my blood tests show healthy hormones and everything. They don’t know what can be happening. I’ve always exercised, maybe a bit too frequently before (5-6 days) but now it is more like 3 days of weight lifting a week, so not so much I think. I’ve always slept wonderfully, but I do clench my teeth (I don’t notice but my boyfriend sometimes does). A few years ago I didn’t eat much fat, but now I eat loads of nut butters, avocado, olive oil, coconut oil, etc… And I eat a lot, and very frequently because I’m hungry very frequently! Whilst taking birth control, but after all the problems were there, I went vegan (I don’t know if this is relevant, but I’m mentioning just in case). I was stressed last year and the year before, but this year is being super chilled… I also just checked what my BMI should be (I don’t really know how much I weight, but approx) and it’s 21. I really don’t know what to do anymore… 🙁
    I mean, my tests are all good, and I don’t know if I can improve my lifestyle more… Do you have any suggestion?
    Hope you had a good weekend, and sorry for the long comment!

    Reply
    • Robyn says

      February 13, 2017 at 1:14 am

      email me victoria and we can chat further 🙂
      [email protected]

      Reply
  34. Jewel Tan says

    February 10, 2017 at 8:28 pm

    In fact, Chinese medicine do say that one’s exercise and diet affects a menstrual cycle. If you’d like you can do some research on that????

    Reply
  35. Christina says

    February 11, 2017 at 8:46 pm

    What are your thoughts on birth control to get a period? I had an eating disorder for a year but have now been at a healthy weight for a year and half and am on the pill to try to regulate my period.

    Reply
    • Robyn says

      February 13, 2017 at 1:10 am

      will talk about this in my next video!

      Reply
  36. Kelly says

    February 12, 2017 at 2:52 am

    This is so interesting. So I’ve been wondering about my own period. I’ve always been irregular due to pcos. Usually too frequent. But currently I am nursing a baby quite frequently and going about 6 weeks between cycles. Any opinions on this situation?

    Reply
    • Robyn says

      February 13, 2017 at 1:09 am

      email me kelly! 🙂

      Reply
  37. Mei says

    October 31, 2017 at 4:50 am

    Hi Robyn. Have you heard of post pill amenorrhea? I went off the pill in April 2015 and still haven’t got my period back! We want to start trying for a baby soon and I’ve been to a fertility specialist who diagnosed me with mild PCOS. As you can imagine, it’s very difficult trying as I can’t track any cycles. Any advice would be much appreciated.

    Reply
    • Robyn says

      October 31, 2017 at 10:24 am

      There is some evidence, but it is limited, that women who have been on OCPs for many years may have a higher rate of irregular periods following stopping the pill – but that is really only in about 5% of women. Post pill amenorrhea is really not a thing- less than 1% of women could be affected by this. If anything, the pill could have been masking an underlying diagnosis – such as PCOS or HA all along.

      hope that helps!

      Reply
  38. Ragan Kelley says

    November 28, 2017 at 3:28 pm

    Hello Robyn! I am really struggling to get my period back, and I wonder if you could help give me some advice? How would that work?

    Reply
    • Robyn says

      November 29, 2017 at 12:27 pm

      Hi Ragan! Email me at [email protected] and we can go from there 🙂

      Reply
  39. Lizzie says

    November 25, 2019 at 5:28 pm

    Hi!! I have never had a period on my own…EVER! And I am 18 years old. I go to a specialist in Houston and my doctor says all my hormone levels are normal which is weird that I don’t have a period. Do you have any tips?

    Reply
    • Robyn Nohling says

      November 26, 2019 at 11:20 am

      Hi Lizzie! You’re so not alone. You’ll find lots of helpful blog content here if you keep reading (and use the search box at the top to find specific posts – search “period” and many posts will come up) I also have an online course (under the course tab in the navigation bar) to help you and we work with women like you 1:1 in our private practice. Our website is http://www.reallifewomenshealth.com

      We are rooting for you!

      Reply

Trackbacks

  1. How I Recovered from Primary Amenorrhea (WITHOUT the Pill!) | Nourished Reality says:
    December 15, 2017 at 1:50 pm

    […] https://www.thereallife-rd.com/2017/02/healing-amenorrhea/ […]

    Reply
  2. From PCOS to Pregnant: My Pregnancy Journey - Wellness with Edie says:
    March 28, 2020 at 10:04 pm

    […] Ultimately, I sought help from a functional medicine doctor in Colorado. She was the first person to diagnose me with PCOS. She also told me I had an under-active thyroid, likely due to the years I spent over-exercising, not managing my stress, not eating enough calories, etc. Despite the news, I was determined to regulate my cycle — not only for the sake of my fertility, but for the sake of my overall health. […]

    Reply

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A non-diet dietitian and nurse practitioner helping women find peace with food, accept their natural body size and heal from hormonal issues and period problems.

More On Lady Hormones

How Birth Control Methods Affect Your Hormones, Period and Fertility

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women's reproductive health

Women’s Reproductive Health 101

I have yet to experience postpartum myself, but I've had many clients and readers that have been through that season of life. Or perhaps you are currently living through the postpartum period. Every woman's body is different, therefore every woman's experience after giving birth will be different. What works for one woman, might not work for the next. While one woman might go through postpartum and adjust to newborn life quiet seamlessly, another woman might find it much more difficult. She might need the support of medication, therapy, extra help and many other things. One way is not better than the other - they are simply two different ways of navigating the postpartum period. I hope this post helps you better care for yourself, whatever that means for you. There's no right or wrong way to care for yourself as a mom or your new baby.

Postpartum Hormones: what’s happening in your body and how to care for yourself

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A little way I’m learning to enjoy these years o A little way I’m learning to enjoy these years of getting to spend so much time with my kids: aka another way I’m discovering some pockets of peace so my heart & mind & soul don’t crumble under the reality of dependent & emotionally dysregulated tiny humans.  About once a week we go somewhere for baked goods. We drive or walk, buy something buttery & then find a beautiful, relatively quiet outdoor spot where the boys can romp and I can sit and think my thoughts while I watch them play. This past week we were found ourselves at the Wool Factory where the boys threw rocks & whatever else off the bridge while I ate 90% of this almond 🥐 from @coucourachou that will blow your mind. Boys ate the other 10% bc they were busy playing and didn’t ask for more quickly enough 😜  I’m finding *for me* playgrounds have a time & place but they aren’t where I enjoy motherhood & my two toddlers the most. Baked goods & a pretty outdoor spot without high drops my 15 month old could launch himself off of…I’m here for it.
I brought this bag of snacks along when I took the I brought this bag of snacks along when I took the boys to hike out at one of our favorite spots last week and when I ripped it open I was regretting my choice to share them with my kids. @baresnacks randomly sent me a box of snacks and I usually eat free food we receive or give it to a friend/neighbor and move on. But I felt it my duty to tell you about these bc they are THAT GOOD. I’m not getting paid and this isn’t sponsored - I was just shocked at how tasty these were and felt you needed to know. We ate them with some buttery roasted nuts and the combo was 👌🏻 but they are good just on their own.  The boys climbed rocks and swam in the reservoir - leave it to my almost 3 year old to want to strip down naked and fully submerge himself in chilly water on a sixty degree morning. “Mama can I get super nakey?” Sure baby. Sure. This is your childhood.
It’s a hard sell to get me to accept an offer of It’s a hard sell to get me to accept an offer of extended alone time away from the babies to just be. And that isn’t something that’s best for me, it’s an area I gotta grow in. So this afternoon when Nick pushed me out the door and was like - get out of here plzzzz - I walked to my favorite cafe and ordered a thick pastrami sandwich and sat there for a good LONG while before taking a long, peaceful walk in the rain to wrap up the afternoon. Note to self: stop being such a control freak and go be by yourself sometimes.
a girlfriend brought me a 🍪 the size of my face a girlfriend brought me a 🍪 the size of my face from @mariebettecafe this morning when she came to get her toddler who played with us all morning and it is v good. even better when paired with an iced latte 😍
#AlignPartner I left off a few weeks ago sharing a #AlignPartner I left off a few weeks ago sharing about how taking @alignprobiotic regularly has improved my digestive regularity.  And I’m still taking them! I’ve permanently added Align 24/7 Digestive Support* into the roundup of supplements I take before bed (prenatal, vitamin D, choline & DHA - all which help keep me healthy while breastfeeding) so I can keep seeing the benefits.  Just because you see benefits, doesn’t mean you should stop taking your probiotic. Keep taking Align daily (under the supervision and recommendation of your health care provider of course) to keep seeing the benefits!  I’ve said it before and I’ll say it again - one of my favorite parts of Align probiotics is that they don’t need refrigeration AND they come in a convenient little blister pack that has the days labeled. It’s the little things people! #MyAlignGuutJourney #guthealth  *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
I realized it was going to be a long, hot afternoo I realized it was going to be a long, hot afternoon (91 and muggy in MAY 🤯) when a toddler nap was refused and a baby nap was cut wildly short ....so my tired mom brain pulled out two plastic storage bins, filled them up with soap & hose water and striped ‘em down naked in the yard. Two hours later, it was almost time for an early dinner and I had magically been able to sit for most of that time and we already had baths checked off the list. 👍🏻 I’m archiving this idea for my future self, hope it helps another tired mama out.
#AlignPartner I left off a month ago sharing about #AlignPartner I left off a month ago sharing about getting better at doing the basics to care for myself which included taking my supplements and @alignprobiotic regularly.  Probiotics take time to work so I wanted to give it a full month to see the full effects of @alignprobiotic. So here are my honest thoughts: it took a few weeks to notice any differences, but near the end of the month I did notice some changes in my digestive balance - even while traveling! I’m not someone who experiences occasional gas, bloating or abdominal discomfort frequently enough to notice a difference, so I don’t feel like I can comment on how well Align works for those benefits.  All in all though, taking @alignprobiotic was a positive experience and I really appreciated how the capsules don’t need to be stored in the fridge, making it convenient to take them with me anywhere #MyAlignGuutJourney #guthealth  *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Where we will spend a good majority of our summer. Where we will spend a good majority of our summer. Because the swampy VA summer has already begun (it’s in the low 90s today 🥵 lord help) and creeks are our retreat - not only from the heat but also from the noisy world. I need this just (if not more) than they do! We’ll be at the splash pads and pools too, but the quietness of the creek...my mental health is so about it. And it’s hours of play for them! Win win.  A couple things to note: this scene also included a few toddler reminders on finding another direction to throw rocks instead of at his brother - so not all is serene 🤪 and also, yes I am now that mom who buys the same clothing for both kids bc it keeps things simple & i think i kinda like it too 🤷🏻‍♀️
Things I love about midwifery among many: the appo Things I love about midwifery among many: the appointments, no matter how long, feel so unhurried. 
Just walked in from an appointment with my midwife because I was due for a Pap test + an overall wellness visit. My last pap was during my first trimester with Cal which feels like a jillion years ago, but it’s only actually been three years. Life changes so fast! Pre-baby life feels like a whole other life.  I’m wayyyy overdue for a visit to my PCP bc I’ve been under OBGYN or midwifery care for the majority of the past three years while having babies, but I am pretty good with keeping up with my paps. It seems women often think they need pap and/or HPV testing way more frequently than they do (and providers sometimes perform these tests more frequently than necessary - remember more testing doesn’t always mean better outcomes!)  So if you need it, here’s a quick little reminder on this chilly spring Friday afternoon on how often you need this testing (these are the recommendations from ACOG)  Women aged 21–29 years should have a Pap test alone every 3 years. HPV testing is not recommended.  Women aged 30–65 years should have a Pap test and an HPV test (aka co-testing) every 5 years (preferred). It also is acceptable to have a Pap test alone every 3 years.  If you get abnormal results, this testing frequency could change - but for healthy women with normal results, you actually don’t need testing as frequently as you might think. Which is great news for those of you who hate the speculum.  Ok, off to finish up some things on the to-do list (including cleaning this kitchen) during nap time and then come 5 o’clock, crack an IPA with our neighbors 🍻
#AlignPartner Over the past seven months since bec #AlignPartner Over the past seven months since becoming a mom of two, caring for myself has gotten shoved to the back burner. And it's been a challenge to make it a priority. My routine-resistant personality has upsides and downsides when it comes to motherhood. So I'm starting small this year with a consistent bedtime routine that includes taking my supplements and @alignprobiotic and hoping as that becomes consistent, my mornings will naturally shift too.  In short my bedtime currently goes like this….jammies & face care when putting the babies to bed. Before I go to bed (anytime between 9pm and 12am...) I’ll pump, take my supplements and fill my water. Then I go upstairs and brush my teeth. And then get in bed. The kicker: 70% of the time I find myself finishing up tasks on my phone IN BED. I hate this habit.  Back to supplements. This is something I have been able to stick with. On top of fish oil, my prenatal, choline and vitamin D, I recently added @AlignProbiotic 24/7 Digestive Support*§ to see if it helps with abdominal discomfort and regularity because when I don’t drink coffee or am traveling that can get thrown off.  I’ll be taking it every day for the next 28 days since it takes TIME for our bodies to adjust to probiotics - and I'll be taking you guys along with me as I share my honest thoughts. Many people think if they don’t see changes within the first 7-10 days then the probiotic isn’t working, but that’s not the case. I’m giving myself more than just a week or two and instead a full month to see the full benefits. I’ll keep you posted over the next month. Check out my stories to learn more! #MyAlignGutJourney #guthealth
 
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
We had an AFTERNOON today. Toddler didn’t care f We had an AFTERNOON today. Toddler didn’t care for a nap. Putting baby down was harder than I wanted it to be. Miraculously, I had a moment of clarity as I was covered in tiny humans and decided I wasn’t doing the nap battle thing a on 60 degree, gorgeous, sunny spring day 🙅🏻‍♀️ so I piled both babies into the car half naked, opened the sun roof, put on white noise for them and an audio book for me and drank a kombucha as I drove a meal to a postpartum mama. Thirty five minutes later we had a sleeping baby and a toddler who at least had a rest. Baby transferred without waking HALLELUJAH and although my toddler didn’t nap today (lord help) at least we got soaked in breezy sunshine 😎🤘🏻💆🏻‍♀️
We veered from our usual Friday night homemade piz We veered from our usual Friday night homemade pizza (minus the dough, we leave that to @albemarlebakingco) because we are eating pizza tomorrow with some friends - instead I called my mom and asked her how she makes her chicken fingers and we fried up a big ole batch of chicken nugs 🙌🏻🤤 along with a sheet pan full of sweet potato fries and a simple arugula salad dressed with parmesean, olive oil and s&p. Oh and my moms honey mustard recipe for dipping. It’s SO DANG GOOD.  Over the past 6ish months we’ve been practicing (and practicing and practicing bc it doesn’t come naturally) unplugging from technology and slowing down and resting and just being for one day a week. Some call it Shabbat. Some call it Sabbath. Maybe you call it something different. All I know is IT IS SO GOOD FOR MY WEARY SOUL and the day I look forward to ALL WEEK. Sundown on Friday to sundown Saturday. Nothing but rest. For us that means hiking (or something outside) and napping and reading and being with friends and eating really good food. And drinking some really good wine or craft beer. Sometimes whiskey. 😛  And because I know I’ll get asked about the chicken finger recipe and also because it’s too good not to share and Momma Coale said I could, here ya go:  Cut chicken breast into thin strips or small pieces (I prefer nug size bc the breading to chicken ratio is perfection). Salt and pepper those babies really well. Then dredge them in all purpose flour, then egg, then panko - just like you would bread anything else. Then fry them up in a light oil - I use avocado oil because that’s our everyday oil. You could also use canola or peanut oil. Just fill a pan with an inch or so of oil on medium high heat. They only take 2-3 minutes per side. You can always temp them to make sure they are at least 165 degrees F to really make sure they are done. Dunk in all the sauces and enjoy!  Happy weekend!

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