Period stopped because of dieting or something more serious?

[emily165]

I'm 22 years old, and I have not had a period for a few months. My period has always been quite heavy, so the fact that it has completely stopped is particularly worrisome. I believe it is a result of dieting but would like a professional opinion.

I do not think stress, strenuous exercise, or pregnancy could be the cause. (I graduated college in June and now have much less stress than I did during the last four years, and I never missed a period then. I exercise moderately a few times a week but at a much less intense level than I did when I played high school sports, and I never missed a period then. I am a virgin and have not had any sexual contact.)

Over the summer I began dieting to lose weight.  My period in July came the first week of the month, and it was actually heavier than normal. On August 1st, I began the diet. At first I didn't count the calories that I consumed or burned; I only tried to eat less than normal. Around August 14th I got my period, and it was noticeably lighter than usual. On September 18 I began taking the diet more seriously and started recording the calories I ate. I am 5'7", and I weighed 154 pounds on Sept. 18. I ate an average of 1400-1600 calories a day until around October 15th, when I began eating closer to 1300-1400 calories most days. In September I only had very light spotting for a day or two, and I had no bleeding at all in October or November. Since the amount of bleeding I've had has decreased as I've eaten less calories, dieting seems like the obvious explanation. However, I now weigh 144 pounds. I understand that extreme dieting can cause amenorrhea, but I have also read that losing 1-2 pounds per week is healthy. Since I have lost weight at a rate even slower than this, I don't understand why a diet that seems moderate and healthy to me could cause the body to completely stop menstruating.

Would you please tell me why you think my period could have stopped?  Also, if I visit a doctor, can you tell me how he would determine the cause of the cessation (i.e., what tests would be given, body parts examined, etc.)?

Thanks!
Emily

[helpisontheway007]

Heavy exercise and loss of weight could be contributing factors to light or missing periods.  Estrogen decreases with heavy exercise

[Keith Downing, MD]

Hello Emily,

Yes, there are a handful of possibilities of what may be causing the absence of menstruation.  Women who have amenorrhea (absent menses) should be evaluated for a possible pregnancy (it sounds like you are not pregnant), have an endocrine panel checked (including a TSH--thyroid hormone-- and prolactin), assessed for the polycystic ovarian syndrome (notable for irregular periods, hyperadrogenism (e.g., hirsutism), and sometimes multiple small ovarian follicles), as well as for premature ovarian failure.  Also, as you note, significant physical (such as extreme exercise or weight loss) or emotional stress can alter one's menstrual cycle.  


Make an appt to see your ob/gyn.  A timely evaluation is important.

Best regards,

Dr. Downing