"I never thought I'd say this, but... I miss my period."

We often receive this phrase in private messages. Like a cry of distress in the face of an incomprehensible reaction on the part of our body... theabsence of our long-awaitedperiod.

Whether it's just after you've stopped taking your last pack of pills, or a few months later when your cycles seem to have returned to normal, if your periods aren't coming back after being on hormonal contraception, or if they've stopped, this article is for you.

What's the difference between normal cycles and cycles on the pill?

Normal cycles are subject to hormonal variations in the ovarian hormones estradiol and progesterone, depending on the phase of the menstrual cycle ( Discover the hormones of the menstrual cycle ).

Cycles on the pill can also be subject to variations, especially if the hormone doses vary from week to week (this is the case, for example, with biphasic, triphasic or multiphasic pills).

However, whereas natural cycles involve natural hormone production, taking the pill involvessynthetic hormones. The production of estradiol and progesterone is then down-regulated, and synthetic hormones "replace" them. It therefore takes some time for production to return to normal after prolonged use of a pill. But for how long?

How long does it take to get your period or fertility back?

Several studies have evaluated the time it takes to regain fertility after stopping a contraceptive. In particular, they assess how long it takes to become pregnant after stopping contraception.

In a group of studies including more than 14,000 women who were stopping oral contraception (used from 24 to 84 months) or not (other types of contraception were included, such as implants) with the aim of having a child, the duration or the type of contraception had not necessarily impact on the return to fertility.

Around 85% of women declared a pregnancy at 1-year follow-up. It would appear that contraceptive methods are not a problem when it comes to future fertility (although other factors, such as age, may come into play).

With regard tostopping the pill, there are reports of menstruation returning as early as 30 days after stopping the oral contraceptive, and even of pregnancy within 3 months, in women (aged 24-36) who had regular cycles (21-35 days) before starting to take the pill.

• Further research is awaited, but it seems that the return of menstruation is fairly rapid after stopping the pill.

Why worry about missing your period?

In general, gynecological check-ups are important for menstrual and hormonal health. On the other hand, an absence of periods is abnormal and can be a symptom of many pathologies or pregnancy 😉 !

Absence of menstruation or amenorrhea: What is it?

The absence of menstruation is called amenorrhea. Amenorrhea can be :

• Primary : menstruation has not occurred by age 15.
• Secondary : menstruation has started but has stopped. Amenorrhea is defined as the absence of menstrual periods for 3 months, or 6 months if cycles were previously irregular.

What causes missed periods?

In the case of secondary amenorrhea, the doctor will look for the cause of the cessation of menstruation, including :

• A pregnancy!

• Polycystic ovary syndrome : the diagnosis of this syndrome is not based solely on the polycystic appearance, but is complex and involves a biological examination. Amenorrhea oroligomenorrhea (irregular cycles that consistently exceed 35 days) is one of the symptoms of PCOS.

• Hypothalamic amenorrhea : hypothalamic amenorrhea results from low energy availability. Amenorrhea originates in the hypothalamus, which produces GnRH, which in turn enables the production of LH and FSH. As a result, ovarian function is "suppressed" and menstruation is absent.

• Premature ovarian failure

• A tumor

• Other endocrine (hormonal) disorders

TELLA, understand and act to get your period back naturally

Tella is an accompaniment created by Barbara Vulpinari (the author of this article). It's the result of several years of synthesized research, to help women suffering from hypothalamic amenorrhea regain their cycles naturally.

Tella is now followed by over 200 women and professionals. It includes video modules to help you understand hypothalamic amenorrhea and how to cure it. Barbara also runs a private support and exchange group, where she offers live and video meetings on a variety of topics.

When should you worry about missing your period?

Since the absence of menstrual periods can be a symptom of a more or less serious pathology, if it's not pregnancy, it's essential to check that all is well with a specialist, a gynecologist.

Amenorrhea is defined as the absence of menstrual periods for 3 months or more. Research shows fairly consistently a fairly short period for the return of menstrual cycles after stopping contraception. It seems reasonable to consult your doctor 3 months after stopping the pill (if not before, of course). Only your doctor can tell you whether further tests are necessary.

However, not all doctors are aware of the consequences of missed periods. We advise you to find someone who can be explicit about the importance of regular menstrual cycles.

Recovering your fertility

In short, as you can see, there are many causes and we need to investigate them. What's more, even if you're not menstruating, depending on your situation, you may be ovulating.

If you have hypothalamic amenorrhea, for example, as you get closer to recovery, ovulation may occur, meaning you're... fertile! All the more reason to consult and discuss it with a specialist.

The menstrual cycle: a health indicator

The menstrual cycle is now recognized as a major health marker for women. You have every right to ask questions, to doubt, to worry. No healthcare professional should refuse to answer your questions, in a caring and understanding way. If you don't, others will, so don't hesitate to ask 😉

Article written by Barbara Vulpinari (author and amenorrhea expert on Ma Vie Après)

SOURCES

Barnhart, K., Mirkin, S., Grubb, G. and Constantine, G., 2009. Return to fertility after cessation of a continuous oral contraceptive. Fertility and Sterility, 91(5), pp.1654-1656. https://doi.org/10.1016/j.fertnstert.2008.02.122.

Barnhart, K.T. and Schreiber, C.A., 2009. Return to fertility following discontinuation of oral contraceptives. Fertility and Sterility, 91(3), pp.659-663. https://doi.org/10.1016/j.fertnstert.2009.01.003

Davis, A.R., Kroll, R., Soltes, B., Zhang, N., Grubb, G.S. and Constantine, G.D., 2008. Occurrence of menses or pregnancy after cessation of a continuous oral contraceptive. Fertility and Sterility, 89(5), pp.1059-1063. https://doi.org/10.1016/j.fertnstert.2007.05.012

Girum, T. and Wasie, A., 2018. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contraception and Reproductive Medicine, 3(1), p.9. https://doi.org/10.1186/s40834-018-0064-y