If your menstrual period brings unpleasant premenstrual symptoms like bloating, irritability, acne and fatigue, you may almost feel relieved when you skip a period. Occasionally missing a period can be completely normal, especially for young women who are still going through puberty, but it can also signal a problem, especially if you have recently made changes in your diet. If you have experienced amenorrhea, or the lack of a period, you may need to see your health care provider to rule out any problems or the possibility of pregnancy.
Normal Menstruation
Women get their monthly periods because the uterus needs to slough off the extra lining it produces each month in preparation for fertilization. When the woman's egg is not fertilized, her estrogen level drops and her uterus begins shedding the excess lining. Women experience this as "bleeding," but it is actually just a sloughing of excess cells.
Every woman's period is different, but most women menstruate for between three and seven days. Often, younger women have longer periods, but they usually get shorter with age. An average menstrual cycle is 28 days, but your cycle may be anywhere from 21 to 45 days and still be completely normal. It is normal to experience light, heavy or varied flow throughout your period. In other words, you may not be skipping your period at all--you could just be on a longer cycle.
Symptoms That Can Accompany Amenorrhea
There are two types of amenorrhea, or missed periods. Primary amenorrhea occurs when a girl who is at least 15 years old and has experienced other typical changes associated with puberty has not yet had her first menstrual period. Secondary amenorrhea occurs in women who have otherwise had a history of normal menstrual periods but then have their periods stop for six months or longer.
According to the National Institutes of Health, some symptoms that sometimes accompany amenorrhea or a skipped period include headache, noticeable weight gain or loss, vaginal dryness, increased levels of body hair, breast changes, sudden milk production in a woman who is not pregnant or breastfeeding, acne and menstrual pain without an accompanying period. If you experience any of these symptoms along with a skipped period, visit your health care professional.
Possible Reasons for Amenorrhea
Primary amenorrhea is much more rare and is typically caused by conditions that affect hormone production or a problem with the ovaries themselves. Some of the conditions that can cause primary amenorrhea include genetic defects or chromosomal abnormalities, uterine infections, birth defects and tumors either on the hormone-producing glands or the ovaries themselves.
Secondary amenorrhea is associated with some of those issues as well, but can also be caused by external factors like your diet and weight. Women who suffer from an eating disorder such as anorexia nervosa often complain of secondary amenorrhea, but women who restrict their diets in other ways may suffer amenorrhea as a result, as well. A 1991 study published in the "American Journal of Clinical Nutrition" found a positive relationship between study participant's protein and cholesterol intake and their likelihood of having regular periods--women who were vegetarians and thus consumed less protein and cholesterol had less regular periods. Although several other studies produced similar results, a later study conducted by Susan Barr from the School of Family and Nutritional Sciences at the University of British Columbia concluded that vegetarians who kept a stable body weight throughout the investigations were no more likely to suffer from irregular periods than non-vegetarians. More study is needed before vegetarianism can truly be considered a cause of skipping your period.
While vegetarianism cannot definitively be linked to irregular periods at this time, eating disorders and drastic weight loss can be. If you have recently lost a great deal of weight or suspect you may have an eating disorder, meet with your health care provider. Eating too little overall food has been shown to cause amenorrhea.
Visiting Your Health Care Professional
If you are experiencing either primary or secondary amenorrhea, it is important that you visit your healthcare professional. If you are sexually active, he or she will most likely first want to rule out pregnancy, so you will probably need to take a pregnancy test. If you are not pregnant, further testing may be necessary in order to determine what is causing your missed periods.
Your physician will take a very thorough history and ask you many questions in order to determine if your diet could be contributing to amenorrhea. Depending on what he learns from your history, further tests may also be performed. A blood test may be conducted to check your hormone levels, and if any type of tumor is suspected you will likely need a head CT or MRI or a pelvic ultrasound. (ref. 5)
Be sure to give your health care provider a thorough and honest history so she can best address your condition--if you have made recent dietary changes, it is important to relay this information to her as well.
References
- National Institutes of Health: Menstruation - Absent
- US Department of Health and Human Services: Menstruation and the Menstrual Cycle
- "American Journal of Clinical Nutrition"; Menstrual Differences Due to Vegetarian and Non-Vegetarian Diets; AB Pedersen et. al.; April 1991
- "American Journal of Clinical Nutrition"; Vegetarianism and Menstrual Cycle Disturbances; Is There a Connection?; Susan Barr; September 1999
- National Institutes of Health: Primary Amenorrhea
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