Healing & Preventing Amenorrhea
Amenorrhea, or the absence of menses, can be a worrisome situation. It’s defined as the absence of menstrual periods for three or more consecutive months after a normal cycle has previously been present. There are various psychological and physiological factors that can come in to play at different times of your life which can cause stress or imbalances in the body, halting the presence of your cycle. Although usually not immediately dangerous, long-term neglect of resolving the issue can have lasting, harmful effects.
Amenorrhea can appear for various reasons and can at times be a natural, healthy occurrence.
The first thing to consider is pregnancy. Conception will stop menstruation (although some women do naturally experience vaginal bleeding when pregnant, it is not menstrual blood). Keep in mind that menstruation doesn’t return right after a woman gives birth, either, and is usually absent or irregular while breastfeeding. This is the body’s way of preventing another pregnancy too early and allowing itself to heal (our bodies are so intuitive!). The onset of menopause also results in an irregular cycle and eventually leads to the permanent cessation of menstruation. On the opposite spectrum of this, when a girl gets her first period, it may take months or even a couple of years before it becomes regular, and this is generally nothing to worry about. These are all possible causes of amenorrhea, so these considerations should be eliminated before moving forward with treatment.
If the above possibilities have been ruled out, there may be a more serious issue at hand. The cause for amenorrhea can be a lifestyle issue that is easy to address or it may be indicative of a deeper underlying issue.
Lifestyle-related causes of amenorrhea can include:
Low body weight or body fat percentage (common in those with eating disorders or in certain types of athletes, such as ballerinas and gymnasts)
Excessive physical exercise and physical stress
A diet that is lacking in nutrient-dense foods or that is too low-calorie and/or low-fat
Emotional and mental stress
If you suspect a deeper underlying health issue, it’s important to contact your health care practitioner and to begin testing as soon as possible. If a girl has yet to get her first period by the age of 15, this may also be a cause for concern and should be discussed with your practitioner. Healing is promoted through knowledge, and getting to the root of the issue is of utmost importance.
More serious health-related issues that can cause amenorrhea include:
PCOS (polycystic ovary syndrome)
FXPOI (fragile X-associated primary ovarian insufficiency)
Thyroid imbalances
Pituitary tumors (which can be a result of medications, chemotherapy, or the birth control pill)
GUIDE TO HEALING & PREVENTION
Diet
There has been much misleading information about fats over the years, and they are just finally beginning to get a better rep in the mainstream media and wellness industry. Fats are essential to numerous functions of the body. They aid in digestion, vitamin and nutrient absorption, glandular function, hormone synthesis and secretion, and energy production. Fats insulate the body, supporting and protecting the organs. They reduce inflammation in the body and lubricate the musculoskeletal system. Specifically pertaining to the reproductive system and menstruation, fats help to synthesize and modulate the hormones that support the reproductive system, nourish the pituitary gland and the ovaries, and replenish the uterine lining.
There’s a huge difference in the health benefits of various kinds of fats, however, and it’s important to get your intake from the right sources. Avoid any trans and hydrogenated fats as well as excess amounts of saturated fats. These are the culprits for excess weight gain and obesity as well as heart disease, diabetes, cancer, and other health-related issues. Healthy fats are those most commonly known as omega-3s, omega-6s, and omega-9s. They’re unprocessed and come from plant sources and lean animals.
Fats to avoid:
Hydrogenated vegetable oils such as margarine and shortening
Most vegetable oils - canola, soy, corn, safflower, sesame, and sunflower
Commercially baked goods and snacks with long shelf lifes
Fried foods of any kind
Conventionally-raised animal fats and excess animal fats in general
Conventional dairy products
Fats to consume regularly:
Healthy oils including olive, flax, avocado, coconut, walnut, rosehip, and grapeseed*
Avocados
Coconut products including coconut butter, coconut milk, and unsweetened coconut flesh/flakes as well as MCT oil
Limited quantities of saturated fats from animal sources, such as ghee (clarified butter), organic meats, bone broth, and small wild-caught fatty fish
*Look for organic cold-pressed oils to ensure the oil is as close to its raw form as possible. Most of these oils are most beneficial in their raw form. Oils with higher smoke point, such as avocado and coconut oil, are preferable for cooking.
Protein and iron are both building blocks for blood and need to be consumed in large enough quantities to sustain the body. Ensure you’re eating adequate protein throughout the day as well as iron-rich foods consistently. Iron deficiency is very common in women of menstruating age.
Protein-rich foods to include:
Nuts: walnuts, cashews, pecans, and hazelnuts
Seeds: hemp, flax, chia, sunflower, and pumpkin
Legumes: black beans, kidney beans, mung beans, lima beans, and lentils
Lean, organic meats and small wild-caught fish
Pastured, organic eggs
Superfood proteins: spirulina, maca, bee pollen, and goji berries
Certain grains such as quinoa
Iron-rich foods such as liver, lean red meat, blackstrap molasses, and beans
Spinach
SUPPLEMENTS
Because estrogen levels are likely to drop during amenorrhea, low vitamin D and calcium levels are important considerations in healing. Vitamin D supports healthy estrogen utilization and is also essential in calcium absorption. To avoid bone loss associated with calcium deficiency, consider supplementing with these two nutrients.
HERBS
The body can be supported and brought back into balance through the use of herbal preparations.
The following herbs can be used in the treatment of amenorrhea:
Mugwort: helps to bring on menses; drink in infusion form daily.
Chaste tree berry/vitex: a powerful emmenagogue which supports the pituitary gland and balances prolactin levels, which indirectly suppress menstruation; can be taken daily in infusion form (1-2x/day) or tincture form (1-3x/day).
Rhodiola: helps to restore ovulation in women with amenorrhea due to its stress management and hormonal balancing effects; best in powder form.
False unicorn root: promotes healthy menstruation and acts as a natural fertility aid; tincture form is best.
Blue cohosh: a uterine tonic which is especially helpful in bringing about a regular cycle in the first years of menstruation; best in infusion or tincture form.
Shatavari: a common herb used in Ayurveda as a female tonic to support the reproductive organs and balance hormones; best in tincture or capsule form.
Dong Quai: a well-rounded herb used to support the female reproductive system as well as a nervine relaxant used to reduce the stress and tension that may cause amenorrhea; best in tincture form.
Lemon balm, lavender, and chamomile: nervine relaxants that reduce mental and emotional stress; all best as a tea/infusion.
LIFESTYLE
Physical Stress
Amenorrhea is a common condition in female athletes who are pushed past their limits and don’t replenish their bodies with the nutrients needed to recover. Gymnasts, weight lifters, swimmers, marathon runners, and other types of professional athletes are prone to amenorrhea due to constant overexertion. Ensuring proper breaks and recovery time combined with a nutrient-dense diet and high calorie intake will help to support the body and prevent deficiencies. Incorporating mindful-based exercise into a training routine will also allow the body to rest and repair in between high-intensity training periods.
Restorative yoga, leisurely swimming, and calming walks in nature are great options to help decrease physical stress levels and to support athletes’ bodies in a nurturing way, while still encouraging their goals of athleticism.
Mental & Emotional Stress
Life is a rollercoaster and we must learn to identify and support ourselves when things are getting too hectic. Make it a practice to check in with yourself on a weekly basis and to explore what stressors are peaking in your life. We can become so consumed with our day-to-day grind that we lose connection with ourselves. Our bodies are smarter than we think, and are highly aware of external stressors. They can put themselves into a protective state, inhibiting menstruation to prevent the possibility of pregnancy in a less-than-desirable situation or environment.
To manage mental and emotional stress, practice daily mindfulness through a practice such as meditation, journaling, or yoga, make it a point to connect with your support group of friends and family on a regular basis, and seek professional help if needed. Practicing self-care as a necessity, as opposed to a luxury, will allow you to give yourself the care you need. Self-care looks different for all of us, so tune into your intuition and support your body and mind in the unique way that will best serve you. It’s important to take time out of every day to honor yourself and bring love and care to your body. This will help to reduce cortisol levels and lower stress.
Connecting to the Womb
Menstruation is a beautiful part of womanhood that has the potential to be honored and celebrated. When we shy away from this function of our bodies, we belittle its importance and fail to truly honor every part of ourselves without shame. Cultivating a deeper connection to your womanhood can strengthen the potential it has. Follow guided womb-healing meditations, take part in a women's circle, or begin working with a womb healer. Connecting to our place of creation and potential will shine a light on this area and help to awaken it.
This protocol takes all aspects of the body and mind into consideration, promoting whole body healing and prevention. Dealing with an issue such as amenorrhea requires a comprehensive and holistic approach, as the causes and underlying issues can be varied. If you follow these practices for several months and your period is still absent, it’s best to consult with your health care practitioner for further advice.