Decoded: Not Getting Your Period While on Birth Control

Periods are messy. And while I realize (and yes, quite intended) the pun, the statement is wholeheartedly true. After all, our periods are *somewhat* unpredictable, sometimes painful, and oftentimes, they're easily misunderstood and they can even be viewed as a hindrance or a diabolical curse. (This coming from someone who used to experience such debilitating pain each month that I'd miss a day of school like clockwork.)

However, what I had no way of knowing back then is that it would take roughly eight years and a nasty experience with anorexia before I would want to understand my period and give it the respect and attention it deserved. Sure, blame it on the fact I haven't gotten a period (or at least a regular one) since high school, but now I miss it, and truthfully, I don't feel like a woman. Something I used to rebuff has now become something intangible—a missing piece of a puzzle that is starting to feel increasingly complete, thanks to an amazing career, a stellar support system, and a stronger comprehension of my self-identity. And just as the quest for a missing puzzle piece the size of a postage stamp may seem daunting or even impossible, so can the quest for a healthy menstrual cycle. And here's the kicker: I know I'm not alone.

After going a few years without my period thanks to the hormonal ups and downs that come with eating disorder recovery, I kind of felt like Humpty Dumpty (bear with me here). I had taken a very hard fall battling anorexia, and after a time of feeling slightly cracked and bruised, I expected to be put back together again by all the king's horses and all the king's men. Aka: my physician and Western medicine. Which, to my surprise, involved the suggestion to go on birth control. Despite the fact that medically speaking my body was "recovered" (i.e. my heart was no longer beating dangerously slowly and my weight was in a healthy BMI range), my hormones were lagging behind. Namely, my estrogen levels, which were causing a pre-menopause-esque situation in which I wasn't menstruating. I was frustrated, and birth control, my doctor said, would be a good substitute. A solution? Well, in the most literal sense of the word—possibly. But a healing, legitimate fix? Well, not really. So I abstained.

A couple of months ago, when I was writing this article (oh, and this one too), I had the chance to interview and chat numerous times with Lara Briden, ND, who specializes in women's health and is the author of two very helpful books (I refer to them often) Period Repair Manual ($10) and Period Repair Manual Second Edition ($10). One of the biggest takeaways I learned from Briden: Our period is like a report card, serving as one of the body's most useful and inherently accurate indicators of overall health.

So, that being said, what happens when we're on birth control that incurs monthly pill bleeds while simultaneously hibernating our natural menstrual cycles? How are we to know if our reproductive system is working the way it should be, and without those automated bleeds, if we'd otherwise have a regular and healthy cycle? Interestingly, it was a poignant excerpt from Briden's second book that, while inarguably opinionated, also struck a cord.

“We're in a strange time for women's health. A time when we think it's okay to routinely give a drug to switch off the hormones of millions of women and girls. What are we doing?" Briden asks. "Why should we have to shut down a woman's entire hormonal system just to accomplish the simple job of preventing pregnancy? Fertility is an expression of health and not a disease to be treated with a drug.

"Imagine if hormonal birth control were proposed today for the first time. Quite likely, most women, doctors, and scientists would be appalled. But that's seeing it from a modern perspective, which values women and women's hormones. The pill is far from modern. It's a relic from the 1950s when people had different ideas about things. For example, they thought DDT was fine and normal. They thought smoking was fine and normal. And of course, they thought contraception should be illegal.”

So whether you agree or disagree, where does an analysis like this leave us in 2018? And, in consideration of the fact that Western medicine and our doctors do, indeed, have our best interests in mind (each and every expert I talked to wanted to iterate that), how are we supposed to understand what is and isn't normal and what is and isn't healthy?

Overwhelmed? Confused? Questions? I warned you. Periods are messy. Hopefully, however, this story can serve as a springboard and will inspire you to investigate an approach to your period that feels healthy and safe for you.

That being said, after consulting a variety of experts on the topic, we have some information and thoughts. "Thoughts" (versus "answers") because any discussion on reproductive health is just that—a discussion. Sharing knowledge, encouraging education, and imparting zero judgment or prescriptive demands. Also worth pointing out? This is only the tip of the iceberg where our menstrual health is concerned, and questions surrounding our periods, are in a word: complicated. Ahead we're decoding the somewhat murky and somewhat unwieldy topic of a suppressed or absent period while on the pill. Let's dive in.