‘How to get your period back’ is probably not something you ever imagined you would be Googling.
As young women, society tells us our period is a nuisance, at best; a gross mess to shamefully hide at all costs, at worst.
Only recently has it begun to hit popular culture that your period is a vital sign – as indicative of your health (and fertility!) as your heart rate and blood pressure.
If you are trying to get pregnant, no doubt you’re realizing just how critical a regular period is to your fertility. Maybe you…
- Took the pill for years, so your period came like clockwork, and no one warned you that when you stop birth control so you can get pregnant, your cycle could go totally AWOL;
- Suffered a miscarriage and now your period isn’t coming back;
- Were/are an athlete – a runner, a dancer, a gymnast, etc.- and you always thought it was normal to not get a period because so many of the girls didn’t menstruate; or
- Maybe you’ve been told you have hypothalamic amenorrhea (HA) or polycystic ovarian syndrome (PCOS) and you’re trying to figure out what to do about it.
Whichever your story, you’re ready to get pregnant and grow your family, and the first step is figuring out how to get your period back.
This blog will walk you through exactly how to get your period back, so you can improve your fertility, conceive more quickly & easily, and go on to have a healthy pregnancy.
We’re going to cover what counts as a missing period (a.k.a. amenorrhea), what causes your period to go missing, when to go see a doctor, and five simple steps you can get started on right away to get your period back, so you can get pregnant.
What is amenorrhea?
Amenorrhea is the technical term for missing your period.
Primary amenorrhea is when you have not gotten your period by age 15.
Secondary amenorrhea is when you have had a period before, but now you have missed three or more periods in a row.
So, if you’re past puberty (and premenopausal), and going on 90+ days without a period, that counts as amenorrhea, or a missing period.
Can I get my period back after amenorrhea?
In most cases, yes! You can get your period back.
While there are potential medical and physical reasons why you may have lost your menstrual cycle, many of those underlying causes are treatable.
In my clinical practice, 9 times out of 10, the underlying cause is due to factors that are well within your control to change – things like diet and exercise.
Before diving into the step-by-step of how to get your period back through nutrition and lifestyle, we first have to figure out the underlying cause blocking your menstrual cycle.
If you’re missing your period, when should you see a doctor?
The first step in figuring out how to get your period back is a visit with your doctor.
Some of the potential causes of amenorrhea that a doctor can help you rule out include things like:
- A pituitary tumor. These tumors growing on the pituitary gland are often benign, but can significantly throw off hormone balance;
- Hormone imbalances (like PCOS or hypothyroidism);
- Side effects from medications;
- Uterine scarring, a cruel potential side effect of dilation and curettage (D&C), or from removal of uterine fibroids. Scarring after these procedures can block the normal growth of the uterine lining.
- Structural or anatomical abnormalities.
If the doctor finds any of these issues, they need to be treated as a first step to getting your period back.
What causes your period to go missing?
There are many potential causes of amenorrhea, including hormone imbalances, lifestyle and nutrition choices, medical conditions and physical abnormalities, which is why it’s important to work with an experienced healthcare professional, and not self-diagnose.
The most common cause of secondary amenorrhea is pregnancy, so start by taking a pregnancy test!
If you’re postpartum and lactating/ breastfeeding, the hormones that support lactation can also suppress your period, making lactation another common cause of secondary amenorrhea.
If the above causes sound like a cruel joke because you’ve been desperately trying to get pregnant, you’re not alone and you’re in the right place. Let’s cover other potential reasons your period is MIA:
How your diet and lifestyle can cause your period to go missing
Once your doctor has ruled out medical and physical causes of amenorrhea, the next place to look is diet and lifestyle.
Here’s the deal: in order to have a regular menstrual cycle, your brain needs to feel safe to reproduce.
When all is well, getting your period starts with the signaling in your brain. It goes like this:
- The hypothalamus, the master control center in your brain, sends hormonal signals to the pituitary gland, the master hormone-producing gland in your brain.
- The pituitary gland then sends hormonal signals to your ovaries:
- Follicle stimulating hormone (FSH) to trigger follicles in the ovaries to grow and mature; and
- Luteinizing hormone (LH) to trigger the release of a mature follicle from the ovary (a.k.a. ovulation).
When you have been chronically:
- Under-sleeping, or
Then the hypothalamus in your brain detects that you’re not safe and that resources are scarce, and it stops sending pro-ovulation signals to the pituitary gland.
In turn, the pituitary gland stops sending FSH and LH to the ovaries, the ovaries stop developing follicles and ovulating, and the entire menstrual cycle gets stalled.
This condition is called hypothalamic amenorrhea.
Can you get pregnant without a period?
If you’re TTC, then this is your burning question; can I still get pregnant?
In most cases, yes!
Once we figure out what’s blocking your menstrual cycle, we can address the root cause, restore your period to optimize your fertility and increase your chances of a healthy pregnancy.
I like the term “subfertility” rather than “infertility” because it more accurately describes the fact that your fertility may be currently suppressed, but your ability to reproduce is not gone forever! (This was my story!)
If under-eating, over-exercising, under-sleeping or over-stressing, are the reason for your missing period, then I’m here to show you how to get your period back, so you can get pregnant!
Can you ovulate without having a period?
Technically, yes, you can ovulate without having a period, but it’s very rare and unlikely.
If you’re pre-menopausal and not pregnant, then technically you can ovulate at any point (note you can only ovulate once per menstrual cycle).
Ovulation comes first, then your period, so If you do ovulate, you will either get pregnant or get a period.
Although possible, it is very rare to ovulate and NOT then get a period. This can happen if:
- You get pregnant; or
- You have uterine scarring preventing the build up and shedding of your uterine lining.
If you’re not getting a regular menstrual cycle, between 25-36 days in length, then most likely, you are not ovulating- yet!
How to get your period back after amenorrhea, in 5 simple steps:
Now that we’ve covered the basics of amenorrhea- what it is, what causes your period to go missing, and what it means for your ability to get pregnant, let’s talk about what you can do about it: How to get your period back in five simple steps.
Remember, these steps come after you have seen your doctor to rule out the issues listed above that could cause your period to go missing.
Many of the women who I help get pregnant tell me that they did all the testing and everything came back normal. But, their period is still MIA.
While confusing and frustrating, this circumstance is also hopeful. It means diet and lifestyle – things well within your control- need some attention.
Here’s where to get started to get your period back:
Step #1. Make sure you’re eating enough to get a period
Among the women who come to me, the most common nutritional issue I see is not eating enough.
This is true for women of all body shapes and sizes.
Women with higher BMIs can still be under-eating.
No matter what the number on the scale, if you’re not eating enough, it puts your body in a state of stress. Your brain detects that there’s not enough energy to reproduce.
Read more: Am I Eating Enough to Get Pregnant?
Signs you might not be eating enough include:
- Missing periods or cycles longer than 35 days
- Constipation and bloating
- Fatigue, not matter how much you sleep
- Poor recovery from exercise
- Always feeling cold
- Feeling depressed, grumpy, anxious or irritable more than you have “reason” to
- Difficulty focusing, feeling foggy-brained or poor concentration and memory
- Frequently catching colds and getting sick
While this is not a complete list, these are some of the most common side effects I see of under-eating. If you’re nodding yes to two or more of these symptoms, your next step is to focus on eating enough.
How do I know if I’m eating enough?:
There’s no one-size-fits all calorie target, or threshold, above which everyone will menstruate. How much fuel your body needs to feel safe to reproduce is highly individualized, depending on many factors including genetics, health, exercise, metabolism, age, lifestage and more.
I recommend you work with a registered dietitian who can help you identify the appropriate calorie target for you.
If you want to DIY, start with a calorie tracking app and make sure you’re eating at least 2500 calories per day. If you’re very active, this may still not be enough, but it’s at least a starting point.
If your current calorie intake is much lower than this, you may need to increase slowly, giving your appetite and metabolism time to catch up.
Ultimately, to get your period back so you can get pregnant, you need to focus not on calories but instead on truly nourishing yourself.
Rather than viewing food as the enemy, we have to view food as nourishment needed to have energy and to feel good.
For many women who have lost their period, they’ve spent countless years restricting and dieting – fearing foods that they think will cause weight gain. If this is you, your first step is to start loosening the reins and eating those scary, forbidden foods.
Step #2. Make sure you’re eating enough protein, fats and carbs to get your period.
After you make sure you’re eating enough in total, the next step in how to get your period back is to make sure you’re eating enough of each macronutrient.
Macronutrients provide energy (in the form of calories), and they include: proteins, carbohydrates and fats.
For specific food recommendations on which proteins, fats and carbohydrates are best for your fertility, check out this guide: The Mediterranean Diet for Fertility.
You need to eat enough carbohydrates to get your period back
You need enough of each macronutrient, including carbohydrates, to support regular ovulation and healthy menstrual cycles.
Research on the keto diet among adolescents aged 12-19 years old found that 45% of the research participants suffered menstrual dysfunction (i.e. loss of their period).
If you have insulin resistance, you may benefit from eating less carbs, and sticking to complex carbs (those with fiber like whole grains, beans, lentils, and fruit), but if period recovery is your goal, don’t limit carbs.
You need to eat enough protein to get your period back
Proteins are the literal building blocks of your hormones, including the hormones responsible for healthy follicle development in your ovaries, and then for ovulation so you can have a period.
Protein also supports healthy blood sugar levels, which in turn helps to prevent insulin resistance, one of the most common causes of anovulation (failure to ovulate) among women with PCOS.
If that’s not enough, protein is a critical building block of the uterine lining that needs to grow and thicken to support a pregnancy, and then shed (i.e. your period) if you don’t conceive.
Critical to telling your brain that it’s safe to reproduce so you can get your period back is getting enough protein. I recommend including protein in every meal and snack, aiming for:
- 20-30g of protein at each meal and
- 10-20g of protein at each snack
This is just a starting point. Your needs may be higher, depending on your activity level, age, metabolism, etc.
You need to eat enough fats to get your period back
Fats are the most energy-dense foods, so eating more fat makes it easier to get the energy you need to kickstart your period.
Whatsmore, vitamins A, D, E and K are fat soluble, meaning you need to eat enough fat to be able to absorb these critical nutrients.
Your ovaries depend on adequate dietary fat to produce estrogen, and thus preserve your reproductive health and regular menses. Cholesterol in particular is the building block of all your sex hormones.
What meals look like for period recovery and fertility
The best, easiest way to make sure you’re getting enough carbohydrate, protein and fat to get your period is the fertility plate method.
For each meal, make your plate like this:
- Fill ¼ of your plate with protein
- Fill ¼ of your plate with complex carbs
- Fill ½ your plate with a beautiful rainbow of veggies
- Prepare and season your food with healthy fats.
For specific food recommendations, check out this guide: The Mediterranean Diet for Fertility.
Step #3. Make sure you’re getting enough sleep to get your period
One essential factor that too often goes overlooked in the quest to get your period back is sleep. Getting enough sleep can play a crucial role in restoring a healthy menstrual cycle and your fertility.
Poor sleep can disrupt hormone production and ovulation, which may cause irregular cycles or missing periods. We know from research that women with insomnia are 4x more likely to struggle with fertility.
Getting enough sleep is not just about feeling well-rested; it’s also about promoting hormonal balance and supporting your overall health. If you’re experiencing irregular or missing periods, consider making sleep a priority in your life.
A well-rested body is better equipped to regulate its menstrual cycle.
Step #4. Cut back on high intensity exercise to get your period
If you’re addicted to the runner’s high or the endorphin rush from hard workouts, or if you depend on exercise for stress management, I totally get it. I’ve been there and so have so many of the women that I’ve helped to get pregnant.
However, with exercise, more is not always better. Intense workouts day after day can put too much stress on your body, causing your menstrual cycle to shut down. Hitting the pavement for miles on end is not serving your body, and may actually be harmful.
If you’re ready to get your period back so you can get pregnant, it’s time to replace your high-intensity sessions with low-impact activities like walking or yoga.
In addition to intensity, you may also need to reduce the frequency of your workouts to give your body more time to recover. Aim for at least 1-2 rest days per week.
By taking a more moderate and mindful approach to your workouts, you can work towards a healthier hormonal balance and menstrual regularity.
Step #5. Reduce stress and soothe your nervous system
One critical factor in the period recovery process is reducing stress, as chronic stress can have a significant impact on hormonal balance and fertility.
Chronic stress on your system can be psychological, like stress about work (or stress over not getting your period!). But it can also be physical. As discussed above, under-eating, over-exercising, not sleeping enough, etc. place significant stress on your system, telling the hypothalamus in your brain that it’s not safe to reproduce.
Stress, in all its forms, can lead to an imbalance of key hormones such as estrogen, progesterone, and luteinizing hormone (LH), which are necessary for a regular menstrual cycle.
Here are some strategies to get started reducing your stress for period recovery:
Don’t dismiss this as cliche. Think of self-care does not have to look one certain way – like getting a massage or taking a bubble bath. Self-care is figuring out what recharges your batteries, and making time for whatever activity that is.
“No” is a complete sentence.
You don’t need to take on more at work to prove yourself, or be the one your friends and family turn to for everything. You don’t owe it to anyone to attend a party or baby-shower. You can do what’s best for you.
Reach out to friends, family, or a therapist to talk about your stressors and emotions. TTC can be super lonely, but it doesn’t have to be. There are communities of women, and providers like myself, in your corner. Isolation won’t help.
Mindfulness and Relaxation:
Practice mindfulness techniques to stay present and reduce anxiety. Breathwork, progressive muscle relaxation, and guided imagery can help manage stress. I love guided meditations specifically for the fertility journey from Expectful.
By addressing emotional, physical, and nutritional stressors, you can support your body’s natural healing processes and work towards regaining a regular menstrual cycle.
If you’re wondering how to get your period back, remember that it’s crucial to first identify the underlying causes and work with a healthcare professional.
With lifestyle adjustments, proper nutrition (and patience!) you can restore good reproductive health!
While the above steps may be simple, they are not necessarily easy.
I explained what to do to get your period back, but knowing what to do is not the same as knowing how to do it.
As a fertility dietitian and nutrition coach, I’m here to help you put all of this into action. Working together, you get the accountability to stay on track and the support to ensure your success.