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If your period stopped, there is a reason – it is never normal – except if you’re pregnant or postmenopausal – for your period to stop or be irregular. 1
Absent menstrual periods are called amenorrhoea. How long counts depends on your usual cycle – more than three months without a period if your cycles were regular, or more than six months if they were irregular. There are two kinds2:
- Primary amenorrhoea – when your periods have not started by age 15, despite otherwise normal pubertal development
- Secondary amenorrhoea – where your periods have started but then your period stopped
Here we cover what might have gone wrong if your period stopped. Never had a period? See our primary amenorrhoea article.
Possible reasons why your period has stopped
My period stopped – am I pregnant, lactating, or have I reached perimenopause?
Without stating the obvious, the most common reason why women stop having their periods is pregnancy, and while breastfeeding afterwards, due to high prolactin levels blocking other hormones.3 You need to rule out pregnancy before you proceed to other diagnostic tests.
Even if you don’t think it’s possible, if you’ve had a penis or semen anywhere near your vagina in the past couple of months, do a test anyway. This is a process of elimination.
Home pregnancy tests are cheap and easy, and if you go to the doctor, this is the first thing they are going to do. If you are nearing menopause, your periods will taper off and then stop altogether.4
If you are between 40 and 60 years of age, you can go and get some basic tests to see where you’re at hormonally, and to rule out anything serious.
My period stopped – am I doing too much exercise?
This can cause amenorrhoea by reducing the level of circulating oestrogens – that is, the oestrogen in your blood is excreted too quickly to have an impact on your tissues.5
Furthermore, if you are on a heavily restricted diet (calories and/or nutrients) while doing endurance exercises, you can disrupt the hypothalamic-pituitary-ovarian (HPO) axis resulting in hormonal – and period – disruptions.
A lot of vigorous exercise also increases your cortisol levels, a stress hormone, which interferes with your normal body function in lots of ways, including hormones. When this stops your periods, it’s known a hypothalamic amenorrhoea.
My period stopped – do I have too much testosterone?
Androgens like testosterone are masculinising hormones.6 Women have healthy androgens too, but in smaller amounts than men, so having elevated androgen levels can cause your periods to stop.
If your lack of periods is caused by high levels of androgens, you may also experience other symptoms such as excessive hair growth on the face, oily skin, acne or loss of hair on the scalp.
Read more about androgen excess here.
My period stopped – is it because I went off the pill?
If you have recently gone off the pill, wait it out for three months, and it should work itself out on its own. If it doesn’t, see a practitioner for advice.
My period stopped – is it because I am using Implanon, the Depo Provera injection, an hormonal IUDs or use the mini pill?
Hormonal contraceptives can also stop your period due to the hormonal interactions, with these longer-acting hormonal contraceptives being famous for blocking periods for months at a time. In fact, that’s why some women like them.7
My period stopped – is it because I’m on a special diet?
When a woman’s body weight goes below the recommended body mass index (BMI) it may cause disruption to the body’s normal menstrual cycle and ovulation.8
What matters is not hitting a specific body-fat percentage but whether your body has enough available energy to run reproduction. When you eat too little for how much you move – known as low energy availability, part of what is now called RED-S – your body dials down its reproductive hormones and periods can stop.
This is why very lean athletes and people who are under-eating often lose their periods, and why some low-weight teenagers start theirs late. It is about energy in versus energy out, not a number on a body-fat scale.
Very low-carb or crash diets can also interrupt your hormones, because your body reads the shortage as starvation – especially if you cut back abruptly. Make sure you are eating enough carbohydrate across the day; going too low starves the system that runs your cycle.
When you eat your carbohydrate matters far less than getting enough of it overall – the idea that carbs at night are somehow worse is a myth. Very low-carb diets interfere with your HPO and HPA axes, and extreme diets can shock your system, so make any changes gradually.
My period stopped – is it because I’m stressed?
Don’t underestimate the power of stress hormones to disrupt your business. Adrenaline and cortisol have an impact on all body systems, and can disrupt the HPO and HPA axes (hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axis).9
See hypothalamic amenorrhoea for more information.
My period stopped – do I have premature ovarian failure?
Premature ovarian failure is a condition where ovary functions stop before the age of 40.10 The cause is unknown but it may arise from an autoimmune malfunction or can be triggered by chemo or radiotherapy.
In ovarian failure, follicle stimulating hormone (FSH) and luteinising hormone (LH) are usually raised. A raised FSH – above 25 IU/L under current ESHRE criteria (older guidance used above 40 IU/L), measured on two occasions at least four weeks apart – in someone under 40 with several months of absent or irregular periods points to an ovarian problem. Read more about premature ovarian failure.11
My period stopped – do I have cysts on my ovaries?
Having cysts on your ovaries is actually pretty normal, but they usually come and go without you noticing. There is a situation whereby you may have many cysts on your ovaries, or a big cyst, that is blocking your normal hormonal cascade from happening, which would trigger your period eventually.
Polycystic ovaries (PCO – different from polycystic ovarian syndrome, PCOS) involves the presence of multiple immature ovarian follicles that are called cysts, but aren’t really.
Having PCO usually causes failure to ovulate and in turn infertility. It may or may not result in a loss of periods, depending on the state of the hormonal cascade that causes bleeding and ovulation.
One in four women are found to have polycystic ovaries on ultrasound, and is considered normal, as it isn’t a disease or illness. It’s when it interferes with normal ovulation and causes infertility it is a problem.
Read more about ovarian cysts.
My period stopped – do I have polycystic ovarian syndrome (PCOS)?
PCOS is the most common reproductive-age condition affecting women, with around nine per cent of women meeting the criteria (and more under broader definitions). PCOS involves the whole body, and has a hefty link to insulin resistance and blood-sugar dysregulation.12
Insulin resistance causes the pancreas to make more insulin, with the increased insulin levels affecting the ovary. This prevents ovulation and causes a rise in androgens (testosterone and friends). The rise in androgens causes the excess hair and acne commonly associated with PCOS.
My period stopped – do I have a thyroid condition?
Both an under and overactive thyroid can cause imbalances in androgen-oestrogen conversion. This can lead to ovulatory failure and therefore cessation of menstrual flow.13
Thyroid tests are notoriously unreliable, however low T4 with low thyroid-stimulating hormone (TSH) means your pituitary may be struggling. Low T4 causes the hypothalamus to release more thyrotropin- releasing hormone (TRH), which stimulates the release of prolactin – which stops your menstrual cycle for breastfeeding.
My period stopped – do I have Cushing’s syndrome, congenital adrenal hyperplasia or adrenal or ovarian cancer?
These conditions all cause androgen excess and can stop periods in their tracks. Some cancers are androgen-producing which means they upset the natural balance of your cycles. CAH is with you from birth.
My period stopped – do I have cervical stenosis, Asherman’s syndrome or adhesions in my uterus?
Uterine adhesions can be a cause of amenorrhea because they interfere with the ability of the uterus to build the endometrium, the lining that is shed (your ‘period’).
Read more about cervical stenosis.
My period stopped – do I have a pituitary gland problem?
Pituitary gland damage because of tumour or surgical means can interfere with proper hormone regulation needed for the menstrual cycle to occur.
My period stopped – do I have a hypothalamus problem?
Low levels of hormone gonadotropin suggest the hypothalamus is involved, in hypothalamic amenorrhoea.14 The hypothalamus gets involved when you’re stressed or with excessive exercise/weight loss, which may be concomitant with an eating disorder. Serum gonadotropin levels may present as normal, however.
Read more about hypothalamic amenorrhoea.
My period stopped – is it because of a drug or medication I am on?
Some antihypertensive and chemotherapy drugs can cause your period to stop, but so can heroin and other recreational drugs. Phenothiazines and metoclopramide raise prolactin levels (the hormone produced while breastfeeding) that causes the loss of periods.
Diagnosis of amenorrhoea
What your doctor will do if your period has stopped
Your doctor will do a routine check and history-taking.15 Be ready to give details and your own observations. A pregnancy test might be done if appropriate, as well as a BMI calculation.
Other diagnostics might be recommended if deemed necessary such as an investigation for follicle-stimulating hormone (FSH) and luteinising hormone (LH) and pelvic ultrasound.16
Your doctor will be looking for a physical reason why you aren’t having a period, like a blockage of some kind, cancers, growths, or hormonal imbalances that are easy to identify using blood tests.
What your naturopath will do once you have had more serious causes ruled out by your GP
Charting your cycle will be a useful start, even though it seems like you aren’t having one – you are, but you just can’t see it. Your body is doing nothing except trying to ovulate and have a normal cycle, because this is your primary biological purpose in this life: to reproduce.
Charting involves observing your vaginal fluids for changes, and writing down your observations during your cycle. There are spikes in hormones that can be observed using temperature (your temperature spikes ever-so-slightly just after you ovulate, and stays up until you bleed) if necessary.
Stress is closely linked to hormonal disturbances, so your naturopath is going to discuss your emotional picture with you to see what’s going on.
Nothing happens without a cause, so your naturopath will work with you to figure out what that might be, and correct it using whatever method is deemed appropriate: herbs, supplements, lifestyle and diet, plus whatever other therapies may help.
How to treat the underlying cause
Treatment of secondary amenorrhoea is naturally entirely dependent on the cause and vary widely between medical practitioners and naturopaths.
All treatments can be effective, so you and your practitioner will determine the right one for you. Make sure you are informed before undertaking any treatments, and if necessary, get a second opinion. There is more than one way to get your periods back.
Some examples of treatments for a loss of periods are:
- If it is found out that your BMI is less than normal, a nutritional program may be recommended to get you a little fatter (you need the fat to have a period).
- If the cause is excessive exercise or stress-related, an appointment with a health counsellor or psychologist might be warranted.
- For premature ovarian failure, hormone-replacement therapy may be suitable.
- For amenorrhoea caused by thyroid and pituitary problems, menstrual flow would most likely resume after treating the underlying thyroid or pituitary illness.
There are a lot of possible reasons why your period may have stopped, so it is important that you get help to find out why, and do it soon. If it turns out to be something bad, get it treated sooner rather than later.
Don’t underestimate the beauty of a good, solid, regular period – it means a bunch of awesome things are working properly.
Frequently asked questions
When should I see a doctor about missed periods?
First rule out pregnancy. Then see a doctor if your periods have stopped for more than three months (if your cycles were regular) or six months (if they were irregular), or if you also have symptoms like excess hair growth, milky nipple discharge, hot flushes or severe pain. Missing periods always has a cause worth finding.
What are the most common reasons periods stop?
After pregnancy and breastfeeding, common causes include hormonal contraception, low energy availability from under-eating or heavy exercise, stress, thyroid problems, PCOS, high androgens, and approaching menopause. Less commonly, pituitary, ovarian or uterine problems are involved.
Can stress or too much exercise really stop your periods?
Yes. Stress hormones and low energy availability can switch off the hypothalamic signals that drive your cycle – this is called functional hypothalamic amenorrhoea. It is common in athletes and in people under-eating or under pressure, and periods usually return once energy, weight and stress are addressed.
Will my periods come back?
Usually yes, once the underlying cause is treated – periods often return after adjusting diet, weight, exercise or stress, or after treating a thyroid or pituitary problem. Some causes, such as premature ovarian insufficiency, are permanent, which is why getting a proper diagnosis matters.
This article is general information about why periods stop, not medical advice. Absent periods always have a cause, and some of those causes are serious, so please do not ignore it – see your doctor to rule out pregnancy and check your hormones. If you are also losing weight quickly, over-exercising or restricting food, please reach out for support, as these can quietly affect your health well beyond your periods.
- Amenorrhoea; NICE CKS, June 2009
- Heiman DL. Amenorrhea. Primary Care: Clinics in Office Practice. 2009;36(1):1–17.
- Pitts S, DiVasta AD, Gordon CM. Evaluation and Management of Amenorrhea. JAMA. 2021;326(19):1962.
- Analysis of Factors Involved in Lactational Amenorrhea. Journal of Biosafety & Health Education. 2013;01(04).
- Hale GE, Robertson DM, Burger HG. The perimenopausal woman: Endocrinology and management. The Journal of Steroid Biochemistry and Molecular Biology. 2014;142:121–131.
- Barrack MT, Ackerman KE, Gibbs JC. Update on the female athlete triad. Current Reviews in Musculoskeletal Medicine. 2013;6(2):195–204.
- Deligeoroglou E, Athanasopoulos N, Tsimaris P, Dimopoulos KD, Vrachnis N, Creatsas G. Evaluation and management of adolescent amenorrhea. Annals of the New York Academy of Sciences. 2010;1205(1):23–32.
- Pereira K, Brown AJ. Secondary amenorrhea. The Nurse Practitioner. 2017;42(9):34–41.
- Nezi M, Christopoulos P, Paltoglou G, et al. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome. Journal of Pediatric Endocrinology and Metabolism. 2016;29(6).
- Podfigurna A, Meczekalski B. Functional Hypothalamic Amenorrhea: A Stress-Based Disease. Endocrines. 2021;2(3):203–211.
- Maclaran K, Panay N. Premature ovarian failure. Journal of Family Planning and Reproductive Health Care. 2011;37(1):35–42.
- Lord M, Jenkins SM, Sahni M. Secondary Amenorrhea. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
- Casas RS, Chuang CH. Menstruation and Secondary Amenorrhea. Sex- and Gender-Based Women's Health. 2020:71–81.
- Kakuno Y, Amino N, Kanoh M, et al. Menstrual disturbances in various thyroid diseases. Endocrine Journal. 2010;57(12):1017–1022.
- Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhea and its influence on women’s health. Journal of Endocrinological Investigation. 2014;37(11):1049–1056.
- Dickerson EH, Raghunath AS, Atkin SL. Initial investigation of amenorrhoea. BMJ. 2009;339(aug04 1):b2184–b2184.
