When Your Period Is Missing, But All the Other Signs Are There

Ever had one of those months where all the signs and symptoms of your period are there—the bloating, cramping, breast tenderness, overall achiness, and more—but there’s no bleeding? If so, you’re definitely not alone. This is pretty common and can happen for a number of different reasons, from pregnancy to hormonal birth control to stress. Keep reading to learn about a few different situations where you might experience period symptoms even without your monthly flow.

Asian woman stomachache, feel pain for period conceptAsian woman stomachache, feel pain for period concept

You could be pregnant
In some cases, your period symptoms may not be period symptoms at all. You might actually be pregnant. A lot of the early symptoms of pregnancy are similar to those you experience when you have your period—things like breast tenderness, cramping, fatigue, headaches, and fluctuating mood. You may want to take a birth control test, especially if you’ve had unprotected sex within the last month. But don’t freak out, there are also a whole bunch of other reasons why you may not be experiencing your monthly flow.

You’re experiencing something common called anovulation.
The term anovulation isn’t very well known considering how common the condition is. Women typically ovulate each month, but when anovulation occurs, the ovaries do not release an egg. Despite an egg not being released, the body still  experiences many of the standard changes that come along with a typical monthly period. Meaning, you’ll still feel like you have your period, but you won’t actually be ovulating or experience bleeding. And in some cases that make this matter even more tricky to understand, women may still bleed even when they’re experiencing anovulation.

Your birth control method may be interfering.
If you have an IUD or take birth control pills, these can interfere with your monthly period in a way that makes your period disappear despite other symptoms sticking around. For women taking hormonal birth control, a month or two of missed periods typically isn’t a cause for concern—often the missed period can be attributed to the hormones in the pill. And sometimes the period is still there, it’s just so light you don’t really notice it.

Likewise, IUDs can also contribute to missed periods. Your experience will depend on exactly which type of IUD you have, but hormonal IUDs often contribute to skipped or missed periods.

Your stress levels have been through the roof.
If you’ve been experiencing high levels of stress lately, this could definitely be the reason behind your missed period. When you’re stressed, your body often releases cortisol, which can subsequently affect your menstrual cycle . Stress can cause all sorts of changes, from a longer or shorter period than usual to no period at all.

You’ve recently changed your diet.
Changes in diet can play a big role in affecting your menstrual cycle as well. All sorts of dietary changes can contribute to a missed period, from a recent shift toward consuming less calories to changes in the type of food you eat. Nutrition has a big impact on hormone levels in the body, so to experience changes to ones period after a dietary shift shouldn’t come as a huge surprise.

You’re approaching menopause.
As you move closer to menopause, your period becomes more irregular and may even be skipped. At the same time, hormone imbalances are common and can contribute to cramping and other symptoms that feel similar to those you experience when you have your period.

If you have any concerns about missed periods and period symptoms, speaking with a knowledgeable doctor is a great idea. Arizona OB/GYN Affiliates (AOA) has physicians on staff who are here to help you. To make an appointment,, call  602-343-6174 or visit www.aoafamily.com.

How Perimenopause Affects Your Period

We hear a lot about menopause and the way it impacts the female body, but there’s less talk about what happens beforehand—menopause doesn’t just come out of nowhere, after all. There’s a name for the gradual road towards menopause, and it’s called perimenopause. Perimenopause is essentially a transition into menopause during which the ovaries begin to produce less estrogen. It usually sets in when a women is in her mid-forties, but can start as early as the thirties or even twenties in some cases.

Cropped shot of beautiful smiling middle aged woman sitting outdoor and relaxing in the garden.

Most of the time, perimenopause tends to last around three or four years, but it’s duration can be shorter or longer depending on the individual. One of the most notable symptoms you can expect to experience during this time is a changing menstrual period. For that reason, we’re going to fill you in on all the period-related changes you might encounter during this transitional life phase. To learn more about other changes during this time, we have another blog post on perimenopause has helpful information. Read it here.

Due to changing hormone levels and unpredictable ovulation, you can expect to experience some period irregularity during perimenopause. These changes run the gamut—you might skip a few periods, see spotting between periods, experience menstrual flows that are heavier or lighter than usual, or even those that last longer or shorter than you’re used to. Most of the time, you don’t need to be alarmed by these changes, as they’re common even among women who have experienced extremely regular periods for their whole lives. If two months or more pass by and you haven’t had a period at all, you’re probably in the later phases of perimenopause.

One thing to understand about how menopause affects the menstrual cycle is that it’s rarely the same from woman to woman. Some women don’t experience any intense symptoms, while others are greatly affected by things like heavy bleeding. Some women will experience inconsistent periods for months or years, whereas others see their menstruation end more suddenly.

During this time of period irregularity, your fertility will likely decrease, but it’s important to remember that as long as you’re still having your period, you can still get pregnant. If you’re using birth control to prevent pregnancy, you’ll want to keep doing so until you haven’t had your period for 12 months in a row. Once you hit this 12 month mark without a period, you’ve likely moved from perimenopause into menopause.

On a similar note, the irregularity of the menstrual cycle during perimenopause can bring changes like extreme hormonal shifts that can be hard to deal with. To regulate the menstrual flow, some women take low-dose hormonal birth control pills up until menopause. It’s smart to keep communication open with your doctor and fill them in on any atypical changes that arise during perimenopause. Things like heavy bleeding and spotting can be normal in perimenopause, but they can also happen when something else is going on in your body, so it’s always a good idea to tell your doctor what’s going on with your body.

If you have any concerns about perimenopause and the changes that happen to your body during that time, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 to set up an appointment with a knowledgeable doctor, or visit www.aoafamily.com.

Menopause and hormones: What you need to know

Menopause may be more openly discussed now than it was in past generations, but for many modern women there is still confusion and a lack of information about Menopause treatments such as hormone therapy.

Menopause marks the end of female reproduction, and although women know that they will experience menopause, they may not understand what hormone therapy is and how it is used to treat menopause symptoms.

Menopause can be a challenging time for women, the American Congress of Obstetricians and Gynecologists (ACOG) reports that three out of four women experience hot flashes during menopause, while other symptoms can include mood swings, sleep disturbances, loss of libido and vaginal dryness.

What Is Hormone Therapy?

Menopause causes imbalances in a women’s hormones, and hormone replacement therapy (HRT) is the most effective treatment for common menopausal symptoms such as hot flashes and vaginal dryness.

In essence, hormone therapy uses female hormones — Estrogen and Progesterone — to treat common symptoms of menopause and aging. Doctors can prescribe it during or after menopause. HRT replaces hormones your body no longer makes after your regular periods have ceased. Hormone therapy can be administered via pills, patches, creams, pellets, sprays or a vaginal ring.

The risks associated with some hormone treatments have been well publicized in reports from the Women’s Health Initiative and other studies. Media coverage about additional benefits, outside of menopause symptom relief, is often contradictory. The topic is a complex one which requires further study.

The type of hormone treatment you use, and the risks and benefits, will depend on your individual circumstances, such as how long it has been since you entered menopause, your history of breast or uterus cancer, and whether you have had a hysterectomy.

A combination therapy of Estrogen/Progesterone/Progestin Hormone Therapy is usually prescribed for women who still have their uterus. This is because taking estrogen without progesterone raises your risk for cancer of the endometrium, the lining of the uterus. Progesterone lowers that risk by thinning the lining.

For women who have had a hysterectomy, the surgery to remove the uterus, a low dose of just Estrogen is often prescribed.

Hormone Therapy Risks:

Like most medications, there is a risk of side effects associated with Hormone Therapy.  The type of drug, the way it’s taken, and when treatment started all play a role in the level of risk, while personal circumstances and health history are also important factors.

  • Like the birth control pill, both estrogen therapy and estrogen with progestogen therapy increase the risk of blood clots in the legs and lungs with oral estrogen. The risk of blood clotting increases with age.
  • Some studies by the Women’s Health Initiative have shown an increased risk of breast cancer after five or more years of continuous estrogen/progestogen therapy. The increased risk decreases after hormone therapy is stopped.
  • There is still a lack of data around the risks of hormone therapy for women who have had breast cancer. Non-hormonal therapies should be the first approach in managing menopausal symptoms in breast cancer survivors.

The level of dosage and length of treatment, along with your personal health circumstances, will determine whether the risks outweigh the benefits of hormone treatment.

Hormone Therapy Alternatives:

  • Alternative approaches to treating menopausal symptoms include certain types of antidepressants, yoga, or dietary supplements.
  • Relizen is another option. It is a safe, effective, and non-hormonal dietary supplement made from a proprietary blend of Swedish flower pollen extract.

More Information About Menopause and Hormone Therapy:

Please discuss the specifics of your situation with your AOA provider. Call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit www.aoafamily.com.

Safe, Effective and Non-Hormonal Options for Dealing with PMS & Menopause: Dr. Melanie Bone

How to deal with hot flashes during menopause

Menopause is a time of life few women are excited to experience. Most women dread the big “M.” It signals the end of our reproductive life, and it doesn’t help that magazines, movies, and mainstream media portray this transition as a time of suffering. The American Congress of Obstetricians and Gynecologists (ACOG) reports that three out of four women experience hot flashes during menopause. Many women start having these “vasomotor symptoms,” or “VMS,” in perimenopause, a term used for the years leading up to your final menstrual period, when the amount of estrogen produced by your ovaries begins to decline. A recent study showed that women who begin to have VMS in perimenopause tend to have them for almost twelve years, while those women who start getting VMS at the time of menopause can have them for over seven years. Either way, that is a long time to be “hot and bothered” by them!

What options exist to treat vasomotor symptoms? Hormone therapy with estrogen can be effective, but it has risks and potential side effects. Additionally, ACOG recommends no more than two to five years of hormone therapy for menopausal symptoms.

There are options for women who do not want to use hormones or who cannot use them because of medical contraindications, such as breast cancer or a history of blood clots. Some healthcare professionals prescribe antidepressants that are approved by the FDA to treat VMS. These drugs can have side effects and can interfere with other medications. Some alternative treatments for VMS include acupuncture and herbs. There is no one-size-fits-all answer where menopause is concerned.

Another option for women who do not want or cannot take hormone therapy is Relizen. Introduced to the United States in 2014, yet available in Europe for over fifteen years, where it has been used by over one million women, Relizen is for women who want to or need to avoid hormones. Relizen is a safe, effective, and non-hormonal dietary supplement made from a proprietary blend of Swedish flower pollen extract. In a well-controlled study, Relizen showed a significant reduction in frequency of hot flashes, with side effects no different from a sugar pill and no observed drug interactions or contraindications.* In a separate open-label study with over 400 women, Relizen showed reductions in intensity of hot flashes and night sweats, and improvements in fatigue, irritability, quality of sleep, and overall quality of life.*

How to deal with symptoms of PMS

For those of you who are still in the midst of your reproductive years, the struggle with Premenstrual Syndrome (PMS) may be all too familiar. Many women struggle with irritability, mood swings, and a general feeling of unease called dysphoria in the days leading up to their menstrual period. When these symptoms happen month after month and are bothersome or disruptive, the condition is called PMS. Millions of women from teenagers to women in their early forties suffer from PMS.

What treatment options exist for PMS? Some healthcare professionals prescribe birth control pills, antidepressants, or anti-anxiety medications, but these have side effects and can be habit-forming. Similar to treatments for menopausal symptoms, there is no one-size-fits-all answer for those suffering from PMS symptoms.

Introduced in August 2015 to the United States, Serenol is a clinically effective dietary supplement that has been shown to be safe. Serenol consists of a flower pollen extract, Chromax® chromium picolinate and a low dose of Royal Jelly. In several well-designed studies, the ingredients in Serenol have been shown to help with irritability, mood fluctuations, water retention, sleep disturbances, food cravings, and premenstrual weight gain, with side effects no different from a sugar pill and no observed drug interactions.* Royal Jelly is a bee product, however, and those that are allergic to bees should avoid taking Serenol.

Speak to your AOA healthcare professional today to learn more about Relizen & Serenol, or go online, to either www.Relizen.com or www.Serenol.com. If you use the discount code 5002962 when ordering†, you can save significantly on your first three months of therapy. For best results with both Relizen and Serenol, it is advised that you stay on active therapy for at least three full months, taking two tablets once per day.

† For use towards patient purchase of Relizen or Serenol. Valid for one use per customer. If coupon code is applied to purchase Relizen Together Program or Serenol Simplicity Program, discount will be $15 off each of the first three months’ supply (total of $45 discount). If coupon code is applied to a single box (1-month supply), discount will be $15 off one-time only.

Dr. Melanie Bone is a board-certified OBGYN with the American Board of Obstetrics and Gynecology. She received her medical degree from Albany Medical College, and completed her residency at George Washington University Hospital. Dr. Bone resides in south Florida, where she actively practices gynecology, frequently speaks on gynecological issues around the nation, and writes a column for the Palm Beach Post Heath.

Dr. Bone was compensated for her time in preparing this article.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.