One of themes common comments we hear is; “I went off the contraceptive pill, but I still don’t have my period”. Whether it’s a missing period 1 month post-pill or 10 months – it is an all too common issue.
TCM Dr. Lauren Curtain explains the intricacies of why this is such a common problem and delves into some potential solutions.

Have you ever taken the oral contraceptive pill to regulate your cycle? Have you struggled to stop the pill and regain a regular cycle? Well, you’re in the right place to understand what’s really going on here- read on!

Whilst the oral contraceptive pill is very commonly prescribed for many menstrual irregularities, a common one being irregular cycles (long or short), many women find that they can become dependent on the pill in order to have a regular bleed, because for some women when they stop the pill, their cycles goes out of whack and they may not get a bleed bang on every four weeks. It may be every two weeks, or every 6-8 weeks, or every few months!

So what is happening here?

The key is to really understand what constitutes a normal menstrual cycle is, and then understand what happens to the cycle when on the pill.

The menstrual cycle is a flow of events that happen in response to hormonal stimulation. The menstrual cycle is comprised of two main phases, each lasting two weeks. The follicular phase (from the first day of the period until ovulation), and the luteal phase (from ovulation until the day before the first day of the next period). These two phases are governed by the hormones follicle stimulating hormone (FSH), luteinizing hormone (LH), oestrogen and progesterone. 

The main event of the menstrual cycle is really ovulation, this is how as women we make our main sources of oestrogen (estradiol) and progesterone. These hormones are not only vital for fertility and healthy cycles, but also affect every other cell, organ and tissue in the body and help mood, sleep, skin, energy, libido, digestion and so much more!

The timing of our ovulation, periods and menstrual cycles give us so much insight into our overall health and where any imbalances may lie. Paying attention to our cycles cues can help us to identify areas of our health that need extra support and get to work on easing the body back into balance before more imbalances pop up.

The period can be viewed as the fifth vital sign of the body.

When the menstrual cycle is irregular it is a sign that something is out of balance internally. If you are experiencing consistently long cycles (eg. 35 days and over) it means that there is a delay to ovulation, or the cycles may be anovulatory altogether which means no ovulation takes place. There is always a reason for delays to ovulation or long/short cycles. From a Chinese medicine perspective factors such as heat, cold, damp and stagnation can all interfere with ovulation and affect the length of our cycles. From a western perspective things like insulin resistance, inflammation, elevated androgens, low progesterone and low oestrogen can all affect ovulation and cycle regularity. 

So now what happens if we take the pill to regulate our period?

The bleed that is experienced whilst taking the oral contraceptive pill isn’t a ‘period’, it’s a withdrawal bleed from medication, a ‘pill bleed.’

The pill shuts down brain and ovarian communication. On the pill there is no FSH, LH, oestrogen or progesterone. There is no dance of hormones. There is no ovulation, and no period. There is no menstrual cycle. The bleed experienced whilst on the pill is a withdrawal bleed from pausing the synthetic hormones during the sugar pills. The pill bleeds are only regular due to the timing of sugar pills happening regularly. 

This is a process that is mimicking a healthy regular cycle to give an impression of a balanced cycle. 

So if a woman is taking the pill in order to regulate her cycles and then stops the pill, it is likely her cycles will return to being irregular as the underlying cause of why her cycles were irregular in the first place have not been addressed. 

It is shutting down the HPO axis (hypothalamic-pituitary-ovarian axis), the reproductive system, depriving the body of essential hormones and giving a chemically induced bleed each month.⠀

A period, on the other hand, this is a vital indicator and sign from the body our health is balanced and thriving. A monthly period is the end result of a delicate dance our hormones and body has played throughout the cycle, ebbing and flowing and maturing an egg to be released with ovulation. ⠀

Understanding the qualities of our periods gives us insight into our overall health and wellbeing.

If you feel like you have been caught in the repetitive cycle of only being able to have a regular period whilst taking the pill, it’s time to dig deeper. Seek out individualised support from a health practitioner focused on women’s health to uncover a root cause solution. 

Yours in health,
Your Tea

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