A woman’s period is like a monthly report card, telling us how well her hormones are performing. For a period to occur, an amazing orchestra of hormones have to all play in harmony together to make it happen. This process is very sensitive to stressors such as exercise, weight loss, stress, disease, and so on. During times where a woman is faced with stressors, the body will steal the resources away from hormonal production in order to face the challenges ahead. For example, our body uses cholesterol to make both our stress hormone cortisol, and our sex hormones estrogen and progesterone. When we are stressed, our body will steal the cholesterol used to make our sex hormones, and divert it towards making cortisol. This is known as the “cortisol steal” (SEE IMAGE). This tells us that we need to help her support her stress pathways, so that her resources can be used to make sex hormones.
With that said, it’s common for women to occasionally miss their cycles. However, if it has been more than 3 months since her last period or her cycles are more than 35 days long, its time to investigate what is going on. There are many underlying hormonal conditions that we need to look at if a woman has consistently missed her period. These include pregnancy, polycystic ovarian syndrome, thyroid diseases, and premature ovarian failure, to name a few.
Basic blood tests should be done to evaluate how the hormones from her brain are communicating with her ovaries (FSH, LH), how her ovarian hormones are behaving (estrogen, progesterone), and how her stress response is managed
(AM cortisol, PM cortisol). In addition, if she’s experienced changes in her weight, it’s important to measure her thyroid stimulating hormone (TSH), her insulin, and her blood sugar. If she’s noticed excessive hair growth, acne, deepened voice, weight gain, it’s important that we measure her testosterone.
To recap, women should be getting their periods monthly. It’s common to miss it occasionally due to stress, excessive exercise, or illness. However, when women miss their period, it tells us that something is off with her hormones, and with her health. If we neglect to look at it as a problem, we can miss diagnosing something that can have negative consequences for her life, like infertility and increased risk for cardiovascular disease.
Dr. Shadi Tabaei ND