Many women who have missing cycles (amenorrhea) or long cycles (oligomenorrhea) are told this is not a concern until they are ready to have a baby. Contrary to this advice, a regular cycle is a vital sign of health and a missing or very long cycle indicates an underlying issue that needs to be addressed.
The two main sex hormones produced in a menstrual cycle, estrogen and progesterone, have essential roles in a woman’s body. Consistent and balanced exposure to both of these hormones is important for proper bone development, cognition and mood, breast health, and libido just to name a few.
If you have ever been told that your missing or long cycles are not a concern unless you want a baby imminently, this is simply not true!
The Importance of Estrogen
Estrogen should be present throughout the entire menstrual cycle. It should be lowest at the beginning of the cycle and peak mid-cycle to trigger ovulation. After ovulation, estrogen will drop temporarily and then rise again to a lesser extent. Finally, before the period begins, estrogen levels will fall and the cycle will begin all over again.
If you are experiencing long or missing cycles your estrogen levels could either be low, normal or high depending on the cause. Issues can arise with both low and high estrogen levels.
Here are some of estrogens essential roles outside of reproduction:
- Supports sexual development and libido
- Plays an essential role in bone development and bone density maintenance with age
- Plays a role in the health and elasticity of our skin, hair and nails
- Supports a healthy cardiovascular system (estrogen promotes elasticity in the blood vessels and dilates blood vessels)
The Importance of Progesterone
Progesterone is present half of a normal menstrual cycle, and only after ovulation. After ovulation, the cells that were previously surrounding and nourishing the developing egg turn into something called the corpus luteum which secrets the progesterone hormone.
If a woman is not ovulating, she will not be exposed to progesterone. If she’s not ovulating regularly, she’ll have lower exposure to progesterone overall.
Progesterone is just as critical as estrogen for a woman’s health! Ovulating regularly and producing progesterone should be a goal for any woman of reproductive age.
Here are some of progesterone’s essential roles outside of reproduction:
- Thins the uterine lining, counteracting estrogens proliferative effects (low progesterone can result in heavy and flooding periods)
- Has a calming, anti-anxiety action on the nervous system
- Slows cell division in the breast tissue
- Supports healthy bone development and bone density alongside estrogen
The Birth Control Pill
If you are someone who has missing or long cycles, you may have been put on the birth control pill or other hormonal contraception. Although this does induce a monthly withdrawal bleed, it does not address the underlying issue.
The birth control pill contains synthetic hormones that essentially shut the bodies own hormonal system down. The synthetic estrogen and progesterone contained in the birth control pill are not identical to the hormones produced in a real cycle and don’t provide all the same benefits and protections listed above.
If you are someone who isn’t cycling at all, the birth control pill can be used to induce withdrawal bleeds to reduce excess growth of the uterine lining, known as endometrial hyperplasia, and to protect against bone loss. However, identifying and treating the cause of your missing cycle would provide many more benefits to your health long term!
Getting Your Cycle Back on Track
To get your cycle back or support more regular cycles, step one is to figure out what is going on in your body. Two of the most common causes of long or missing cycles in women of reproductive age are PCOS and hypothalamic amenorrhea. These conditions can often look quite similar. However, the treatment for hypothalamic amenorrhea is almost opposite to that of PCOS so could be harmful if not properly diagnosed.
A good starting place is to test some hormonal markers in the blood. These include; LH, FSH, and estradiol on Day 3 of a cycle if you are still having them or any day if you are not.
If you need support with your cycles, please book an initial visit with one of our Naturopathic Doctors.