How To Get Period Back

As a woman who’s navigated the ups and downs of my own menstrual health, I know how unsettling it is when your period goes missing. It’s not just about a skipped cycle—it feels like your body is trying to tell you something important. Whether you’ve never had a period by age 15 or you’ve suddenly stopped getting them for three months or more, amenorrhea can be a sign of an underlying issue that’s often treatable.

In this comprehensive guide, I share my insights and research-backed strategies to help you get your period back naturally. From adjusting nutrition and stress levels to understanding conditions like hypothalamic amenorrhea, I’ll walk you through practical steps and professional support options to restore your cycle and reclaim your vitality.

Let’s dive into this journey together to bring back that vital sign of health.

Understanding Amenorrhea: What It Is and Why It Happens

Amenorrhea is the medical term for the absence of menstrual periods. It’s considered a vital sign of health, alongside blood pressure, temperature, pulse, and breathing rate, as it reflects the body’s hormonal balance and overall well-being. There are two types of amenorrhea:

Primary Amenorrhea: When someone over 15 hasn’t had their first period or hasn’t menstruated within five years of puberty signs (e.g., breast development). This is often due to genetic conditions, hormonal imbalances, or structural issues in the reproductive system.

Secondary Amenorrhea: When someone who previously had regular periods stops menstruating for three months or more (or six months if periods were irregular). Common causes include pregnancy, breastfeeding, menopause, or lifestyle factors like stress or weight changes.

The menstrual cycle is orchestrated by the hypothalamic-pituitary-ovarian (HPO) axis, where the hypothalamus signals the pituitary gland to release hormones (follicle-stimulating hormone [FSH] and luteinizing hormone [LH]) that prompt the ovaries to produce estrogen and progesterone. These hormones prepare the uterus for pregnancy, and if no pregnancy occurs, the uterine lining sheds as a period. Disruptions to this axis—often from stress, low body fat, or excessive exercise—can halt menstruation, leading to conditions like hypothalamic amenorrhea (HA).

How Common Is Amenorrhea?

Approximately 1 in 4 women who aren’t pregnant, breastfeeding, or menopausal experience amenorrhea at some point. Hypothalamic amenorrhea, a common form of secondary amenorrhea, affects over 1.5 million women and people assigned female at birth in the U.S., often linked to eating disorders, overexercise, or stress.

Symptoms of Amenorrhea

The primary symptom is the absence of periods, but other symptoms depend on the cause and may include:

1. Hot flashes
2. Nipples leaking milk (galactorrhea)
3. Vaginal dryness
4. Headaches
5. Vision changes
6. Acne
7. Excess facial or body hair (hirsutism)
8. Hair loss
9. Low sex drive
10. Anxiety or depression

These symptoms signal underlying issues, such as hormonal imbalances or energy deficits, that require attention.

Causes and Risk Factors of Amenorrhea

Amenorrhea can stem from natural or medical causes. Understanding these helps tailor strategies to restore your period.

Natural Causes

Pregnancy: The most common cause of secondary amenorrhea.

Breastfeeding: Lactation amenorrhea suppresses ovulation due to prolactin production.

Menopause: Periods naturally stop, typically after age 45.

Surgical Removal: Hysterectomy (uterus removal) or oophorectomy (ovary removal) eliminates periods.

Medical Causes of Primary Amenorrhea

Genetic Conditions: Chromosomal issues like Turner syndrome can affect reproductive development.

Hormonal Imbalances: Problems with the hypothalamus or pituitary gland may disrupt ovulation.

Structural Issues: Missing or underdeveloped reproductive organs, such as the uterus or vagina, can prevent periods.

Medical Causes of Secondary Amenorrhea

Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS), hypothyroidism, or adrenal disorders can disrupt the HPO axis.

Hypothalamic Amenorrhea: Caused by stress, low body fat, excessive exercise, or energy deficits, leading to reduced gonadotropin-releasing hormone (GnRH) production.

Primary Ovarian Insufficiency (POI): Ovaries stop functioning before age 40, reducing estrogen levels.

Pituitary Disorders: Benign tumors or excessive prolactin production can halt menstruation.

Medications: Certain birth control methods (e.g., Depo-Provera, IUDs), chemotherapy, or antipsychotics may cause amenorrhea.

Uterine Scarring: Previous surgeries like dilation and curettage (D&C) can prevent bleeding.

Chronic Illness: Conditions like kidney disease or inflammatory bowel disease may disrupt cycles.

Eating Disorders: Anorexia, bulimia, or restrictive eating can lead to energy deficits, triggering HA.

• Risk Factors
• Family history of amenorrhea or early menopause
• Genetic or chromosomal conditions
• Obesity or low body weight
• Eating disorders
• Over-exercising
• Poor nutrition
• High stress levels
• Chronic illness
• Complications
• Untreated amenorrhea can lead to:
• Osteoporosis: Low estrogen increases bone loss risk.
• Infertility: Lack of ovulation prevents natural conception.
• Cardiovascular Issues: Estrogen protects heart health; its absence may increase risks.
• Pelvic Pain: Structural issues may cause discomfort.
• Diagnosing Amenorrhea

If you’re over 15 and haven’t had your first period or have missed periods for three months, consult a healthcare provider. They’ll conduct:

Medical History and Exams: Review your menstrual history, symptoms, and perform physical and pelvic exams.

Tests:

Pregnancy test to rule out pregnancy.

Blood tests to check hormone levels (FSH, LH, estrogen, thyroid, prolactin).

Genetic testing for suspected chromosomal issues.

MRI or ultrasound to evaluate pituitary, ovarian, or uterine abnormalities.

Period Tracking: Use an app or journal to note cycle length, last period, medications, diet, exercise, and stress levels. This helps pinpoint causes.

How to Get Your Period Back Naturally

Restoring your period naturally involves addressing the underlying cause, often through lifestyle changes and professional support. Here are eight science-backed strategies, with a focus on hypothalamic amenorrhea, which is highly treatable through lifestyle adjustments.

1. Maintain a Healthy Body Fat Level

Low body fat can halt reproductive hormones, as the body prioritizes survival over reproduction. Hypothalamic amenorrhea often occurs in athletes or those with low body fat due to restrictive eating or eating disorders. Conversely, excessive body fat can increase estrogen production, disrupting cycles.

Action: Work with a dietitian to assess body composition via a DEXA scan or skin fold test. Aim for a healthy weight range that supports menstruation, which varies individually and isn’t determined by BMI alone. Weight gain may be necessary for those with low body fat, while weight loss may help those with obesity.

Evidence: A 2015 study (Seif et al.) linked excessive estrogen from high body fat to amenorrhea, while low body fat is a known HA trigger.

2. Eat Enough, Especially Carbs and Fats

Energy deficits from undereating, particularly carbohydrates and fats, can disrupt the HPO axis, reducing GnRH, LH, and FSH production. This is common in eating disorders or restrictive diets like keto.

Action: Collaborate with a dietitian to create a meal plan with adequate calories, including low-GI, high-fiber carbs (e.g., wholegrain bread, brown rice, quinoa) and healthy fats (e.g., avocados, nuts, olive oil). Avoid extreme low-carb diets, as a 2012 study (Ebbeling et al.) found 45% of teenage girls on a ketogenic diet experienced menstrual issues, including amenorrhea.

Tip: Eat balanced meals and snacks regularly to support hormonal health.

3. Manage Stress

Chronic stress elevates cortisol and adrenaline, which can suppress reproductive hormones, leading to HA. A 2023 study and a 2024 systematic review confirmed a link between stress and menstrual irregularities.

Action: Incorporate relaxation techniques like meditation, mindfulness, yoga, or deep breathing. Prioritize sleep hygiene (e.g., warm showers, bedtime reading) for 7–9 hours of quality sleep. Reduce workload or commitments to create space for self-care.

Tip: Apps like Headspace or Calm offer guided meditation to lower stress.

4. Adjust Exercise Levels

Excessive exercise, especially high-intensity workouts, can create an energy deficit, triggering HA. A 2020 review emphasized that reducing exercise intensity is key to HA recovery.

Action: Scale back or pause high-intensity workouts, opting for gentle activities like walking or restorative yoga. Work with a therapist or dietitian to assess your exercise relationship and develop healthier habits.

Evidence: A 2021 clinical trial showed moderate exercise can reduce menstrual pain but excessive exercise disrupts cycles.

5. Practice Yoga

Yoga can regulate menstrual cycles by reducing stress and improving hormonal balance. A 2017 study found 12 weeks of yoga improved physical function and reduced menstrual pain, while a 2024 study linked specific yoga asanas to cycle regulation.

Action: Try beginner or level 1 yoga videos on YouTube or platforms like Yoga with Adriene. Focus on poses like Child’s Pose or Cat-Cow for relaxation.

Tip: Practice 2–3 times weekly for 20–30 minutes to see benefits.

6. Incorporate Ginger

Ginger may alleviate menstrual pain, though its direct effect on regulating periods is unproven. A 2018 study found 200 mg of ginger every six hours reduced pain in primary dysmenorrhea, and a 2022 study supported up to 2 grams daily.

Action: Add ginger powder to smoothies, teas, or meals, or take ginger supplements after consulting a doctor.

Tip: Start with small doses to avoid digestive upset.

7. Add Cinnamon to Your Diet

Cinnamon may help regulate menstrual cycles, particularly in PCOS. A 2014 study suggested cinnamon improved cycle regularity in PCOS patients, and a 2018 study confirmed its pain-relieving benefits for dysmenorrhea.

Action: Sprinkle cinnamon on oatmeal, yogurt, or coffee, or take supplements under medical guidance.

Tip: Use 1–2 grams daily for potential benefits.

8. Ensure Adequate Vitamin Intake

Low vitamin D and B-6 levels are linked to irregular periods. A 2021 study connected vitamin D deficiency to menstrual issues, while a 2016 study found 40 mg of B-6 and 500 mg of calcium reduced PMS symptoms.

Action: Get vitamin D from fortified foods (milk, cereal), sun exposure (10–30 minutes daily), or supplements. Take B-6 and calcium supplements after consulting a doctor.

Tip: Buy supplements from reputable sources and follow dosage instructions.

Professional Support for Hypothalamic Amenorrhea Recovery

Hypothalamic amenorrhea (HA) is a common, reversible cause of secondary amenorrhea, often linked to eating disorders, overexercise, or stress. Recovery requires a multidisciplinary team:

Medical Provider: Conducts tests (e.g., hormone levels, ultrasounds) to rule out other causes like PCOS or thyroid disorders.

Dietitian: Develops a nutrition plan to address energy deficits and ensure adequate calorie, carb, and fat intake.

Therapist: Uses cognitive behavioral therapy (CBT) to manage stress, disordered eating thoughts, or gender dysphoria-related challenges. A 2020 study showed CBT can help restore periods.

Endocrinologist: May recommend hormonal treatments for specific imbalances.

Equip’s virtual program, for example, offers a five-person treatment team for HA and eating disorder recovery, including dietitians and therapists experienced in these conditions.

How Long Does It Take for a Period to Regulate?

The time to restore regular periods varies based on the cause and treatment:

Hypothalamic Amenorrhea: With lifestyle changes (e.g., increased food intake, reduced exercise), periods may return in 3–6 months. Full weight restoration is often necessary for consistent cycles, per a 2020 review.

PCOS or Hormonal Imbalances: Medications or lifestyle changes may regulate cycles within a few months, though ongoing management may be needed.

Post-Birth Control: Periods may take 3–12 months to normalize after stopping hormonal contraception.

Chronic Conditions: Treating underlying issues like thyroid disorders can take months, with periods returning as health improves.

Patience is key, as hormonal balance takes time. Regular follow-ups with your healthcare provider can track progress.

Can You Get Pregnant with Irregular Periods?

Yes, pregnancy is possible with irregular periods, but it’s more challenging due to unpredictable ovulation. Conditions like HA or PCOS reduce ovulation frequency, lowering fertility. However, restoring regular cycles through lifestyle changes or medical treatment can improve fertility. If pregnancy is a goal, discuss options like ovulation induction with your doctor.

What Underlying Conditions Might Cause Irregular Periods?

Irregular periods, including amenorrhea, can stem from:

Pregnancy or Breastfeeding: Natural causes of missed periods.

PCOS: Hormonal imbalances cause irregular or absent periods.

Thyroid Disorders: Hypothyroidism or hyperthyroidism disrupts hormone production.

Eating Disorders: Anorexia or bulimia can lead to HA due to energy deficits.

Stress: High cortisol levels suppress reproductive hormones.

Primary Ovarian Insufficiency: Early ovarian failure reduces estrogen.

Pituitary Tumors: Can disrupt hormone regulation.

Chronic Illness: Conditions like kidney disease or diabetes affect cycles.

A healthcare provider can diagnose these through tests and tailor treatment accordingly.

When to See a Doctor

Consult a healthcare provider if you:

Are over 15 and haven’t had your first period.

Miss three consecutive periods (secondary amenorrhea).

Experience symptoms like severe pain, fever, abnormal discharge, nipple discharge, excessive hair growth, or unexplained weight changes.

Suspect an eating disorder or HA, especially with symptoms like low heart rate, poor sleep, or bone health concerns.

Seek immediate care for:

Bleeding between periods, after sex, or post-menopause.

Heavy periods requiring pad/tampon changes every hour.

Severe pelvic pain or fever.

Prevention and Long-Term Health

Preventing secondary amenorrhea involves maintaining overall health:

Balanced Diet: Include carbs, fats, and proteins to support hormonal health.

Moderate Exercise: Avoid overtraining; aim for balanced activity levels.

Stress Management: Practice relaxation techniques regularly.

Regular Checkups: Schedule gynecological exams and Pap tests to monitor reproductive health.

Track Periods: Use an app to monitor cycle regularity and identify changes early.

Living with Amenorrhea

While waiting for your period to return, ask your healthcare provider:

What’s causing my amenorrhea?

What are my treatment options, including risks and benefits?

Do I need an endocrinologist?

Can I get pregnant with amenorrhea?

How can I prevent recurrence?

For those with HA or eating disorders, recovery is a journey. As an eating disorder dietitian, I’ve seen clients transform their health by addressing energy deficits, stress, and exercise habits. Support from a team can make this process empowering.

Conclusion

Getting your period back naturally is achievable with the right strategies and support. By addressing lifestyle factors like nutrition, stress, and exercise, and seeking professional guidance, you can restore your menstrual cycle and overall health. Whether you’re dealing with hypothalamic amenorrhea, PCOS, or another cause, patience and a multidisciplinary approach are key. Don’t let a missing period define your health—take proactive steps, like those offered by Equip’s virtual program or local providers like Cleveland Clinic, to reclaim your cycle. As I learned through my own recovery, a regular period is a sign of vitality and balance, and it’s within your reach.