If you haven't had your period for a while, you might feel a sense of relief at first. At least you don't have to deal with the hassle that comes with it each month: planning around it, feeling moody, remembering to take your hygiene products wherever you go, maybe getting a headache. But a missing period is actually a hassle in itself.
It's your body telling you that something's wrong, something's off. Having a regular, healthy cycle is often described as a vital sign. It's like your pulse or blood pressure because it reflects how well your body is doing overall.
Let's look at some of the most common reasons your period might have stopped, what your doctor may check for, and when to book in.
Doctors call a missing period amenorrhoea (also spelled amenorrhea). If your periods were regular and have stopped for three months or more, it's worth getting checked. The same goes if you've had fewer than nine periods in the past year, or if your cycles are often longer than 45 days.
The most obvious thing is to rule out pregnancy before anything else. If there's any chance you could be pregnant, just go in to take a test. Simple. If you're reading this, it's probably not pregnancy, but make sure it's definitely not.
Hypothalamic amenorrhoea (HA). This is one of the most common reasons, especially for active, busy, driven and high-achieving women. Your brain senses too little fuel, too much training or too much stress, and pauses your cycle to save energy. It's usually a mix of all three, and many women don't realise they're under-eating, over-training or have high stress (all three of those was me a few years ago). I've written a separate post on HA, for women who are "doing everything right".
Polycystic ovary syndrome (PCOS) - now called PMOS. A common hormonal condition that can cause irregular or missing periods, often with acne or extra hair growth.
Thyroid or pituitary problems. An underactive or overactive thyroid can upset your cycle. So can a raised level of prolactin, a hormone made by the pituitary gland.
Coming off hormonal contraception. The monthly bleed on the pill is a withdrawal bleed, not an actual natural period, so the pill can hide what your own cycle is doing. Once you stop, it can take a few months for your cycle to return. More on that in No period after coming off the pill?
Life stages. Pregnancy, breastfeeding and menopause all stop periods. Sometimes the ovaries stop working earlier than expected, which is called premature ovarian insufficiency.
Less common causes. These include scar tissue inside the uterus after surgery (Asherman's syndrome).
If you'd like a simple list to take to your doctor, my free guide, Your Period Is a Vital Sign, covers the tests to ask about and gives you a four-week check-in to track what changes.
Download the free guideBook an appointment if:
See your doctor sooner if you notice:
It helps to bring a simple record of your last few periods: the date they started, how long they lasted and how heavy they were.
Your doctor will want to rule out other causes before deciding what's behind your missing period. Tests often include:
HA in particular is diagnosed by ruling out other causes, so the full picture matters.
A missing period usually means your body is low on oestrogen, and oestrogen is important for way more than just fertility. Over time, low oestrogen speeds up bone loss and raises the risk of stress fractures and, later, osteoporosis. It can also affect your heart health, energy, mood, sleep and libido.
I'm not sharing this to scare you. Most causes of a missing period can be treated, and many women get their cycle back. The sooner you know what's going on, the sooner you can start.
Go see your doctor first. Then download my free guide for the questions to reflect on, what usually helps, and the signs your cycle may be coming back.
If you've ruled out other causes and suspect your body has hit the brakes because you're not fuelling enough, are over-training or have high stress (even if it doesn't feel like it), let's chat and see if I can help. You can book a free 30-minute call and we'll talk about where you are at.
This post is general information, not medical advice. Please see your doctor about your own situation.