September 30, 2019 at 10:24AM
“Is my period ever going to come back?” Amanda asked during our initial consultation. She had gone off the pill five months ago. Since that time, her period had gone MIA.
For many women, coming off of the pill signals the beginning of unpleasant symptoms referred to as post-birth-control syndrome (PBCS), which can include moodiness, fatigue, and headaches, along with saying goodbye to regular periods.
But to be clear: Women do not actually have periods while on birth control. Instead, what they experience is a withdrawal bleed during their placebo week. This is why going off of the birth control pill can reveal underlying menstrual irregularities.
An abnormal loss of menstruation is what medicine refers to as amenorrhea, and there are a few reasons this can happen. If you have just come off of birth control and are wondering where the heck your period is, let’s break down the different types of amenorrhea and some tips for getting your period back stat.
First, what is post-pill amenorrhea?
For many women, discontinuing the birth control pill may be the first time they notice menstrual irregularities. After stopping the pill, missing periods can last for four to six months or even longer for women who previously had irregular periods. But in a woman with a previously regular period, we expect to see them return by month three.
However, we must also recognize that many women are initially given birth control for irregular or missing periods, which means that when you stop, we’d expect these same symptoms to return. This may be contributing to the higher percentage of post-pill amenorrhea statistics and is why irregular or absent periods need investigation before starting birth control.
If you’re a woman who has come off of birth control and lost your period, it’s important to work with a doctor to get proper lab testing to ensure there isn’t another reason for your amenorrhea. Secondary amenorrhea, which is defined by the loss of a regular period for three or more months or the loss of an irregular period for six or more months, can be due to functional hypothalamic amenorrhea, hyperprolactinemia, primary ovarian insufficiency, or chronic conditions.