Periods, Post Pill Amenorrhea & Polycystic Ovarian Syndrome (PCOS)

Since I first wrote about my post pill amenorrhea (no period after coming off the pill) back in May, it has easily become my most visited post. Every week I have women sharing their confusion and fear with me and it breaks my heart to read how afraid, desperate and uninformed a lot of these women are when it comes to the contraceptive pill and its long term effects on fertility and their bodies’ ability to find balance and obtain a healthy cycle once coming off it. You can read my first post here.

So where am I at with it all? Well, here we go. Forewarning: Lengthy post!

Chinese Medicine & Nourishment

For almost 5 months I’ve been focussing on nourishing my body from a Chinese Medicine perspective through the care of Amy O’Brien, a Chinese Medicine Herbalist and Acupuncturist (read more about my experience with acupuncture here) to rebalance and nourish my body.

Amy treats my post-pill ammenorrhea by treating my unique symptoms and looking at the bigger picture; yes I was on the pill for 10 years but I’ve also been under an enormous amount of personal stress this year. So we’ve been treating that as well; stress can be a major contributor to a lack of menstruation. We’ve also focussed on strengthening my digestion, building my blood and improving my general wellbeing.

So what’s Chinese Medicine’s perspective on the contraceptive pill?

Amy says...

Our body is designed to operate in line with full and vibrant, fabulous health.

Every moment each of our cells and organs are receiving intricate feedback, they’re evolving, repairing, and providing the body with precisely what it is asking for in that particular moment.

A fundamental part of whole body health is simply allowing our bodies to be in the driver’s seat. Healthcare can then support our bodies natural ability to function optimally.

Taking The Pill means the body is no longer calling all the shots in the gynae department. And when the body is no longer in the driver’s seat it is unable to direct towards full and vibrant health.

The body adapts, and The Pill actively suppressing normal physiological functioning to control the cycle.The effects of this can be completely unnoticeable in some women, and impossible to ignore in others.

Many women find that when they stop The Pill, especially after years of taking it, their gynaecological functions doesn’t return as smoothly and seamlessly as they had hoped. Some women struggle establishing a normal menstrual cycle.

At this point you’re asking your body to do something that it hasn’t done in years – to ovulate, and to have a natural period.

In Chinese Medicine, this can be for a number of reasons, and needs to be diagnosed on an individual basis. The main priority is always to re-establish and supporting the normal physiological functioning of the body.

In some women, this means building the blood to increase the supply and quality of the blood being delivered to the uterus. In other it means we work to facilitate better circulation of the blood in and around the pelvic cavity, to re-establish the phases of the cycle. Sometimes we just have to work towards slowly rebuilding a depleted body by nourishing and strengthening.It can take time, but the body most often rebuilds, recovers, and slides back into the drivers seat once again.

My program with Amy includes fortnightly acupuncture, prescribed herbs and a nourishing, blood-building diet recommendation which includes lots of green leafy vegetables, goji berries, black beans, organic meats and eggs and limiting alcohol, dairy, refined carbohydrates, soy products and processed foods.

Eating warm, cooked foods is also important to support the digestive system and blood production as cold, raw foods in excess can create dampness and inhibit the ‘digestive fire’ which in turn, can lead to blood deficiency. Blood deficiency = less probability of a period returning anytime soon.

So far, so good. My stress levels have decreased and my digestion is certainly on the mend. It makes sense to me that my body needs to be optimally nourished before my reproductive system can rebalance itself.

So what does Western medicine say?

I’ve had numerous blood tests to suss my hormone levels and they’re all A-OK, besides a potentially under-active thyroid. An ultrasound has revealed however that I have polycystic ovaries. This discovery (combined with the lack of menstruation and a history of problematic acne) led my Doctor to diagnose me with Polycystic Ovarian Syndrome (PCOS).

Polycystic Ovarian Syndrome (PCOS)

PCOS is a syndrome associated with hormonal imbalances that can prevent ovulation and cause a variety of symptoms including period problems, infertility, excessive hair growth, acne and weight gain. Often women with PCOS have an increased risk of developing insulin resistance and diabetes.

It’s important to be clear here however that PCOS is not a disease. Rather, it is a collection of symptoms (which means different women will have different symptoms and to varying degrees) and is one of the most common female endocrine disorders and the most common cause of infertility in women of childbearing age. As it is a relatively “new” syndrome, there is a mountain of new information coming out about PCOS all the time which is great - but can also be conflicting and confusing.

But do I really have PCOS? I’m not so sure.

While I don’t have the excessive hair growth and am not overweight, I have battled with hormonal acne since the age of 13 and do gain weight easily. My Doctor has taken the position that I have always had PCOS and the pill masked the symptoms by regulating my periods and clearing up my acne. The pill certainly helped to clear up my acne as well as lose weight, so perhaps this is the case, however I didn't have irregular periods before commencing the pill.

The only option I was given by my GP upon her diagnosis was to recommence taking the pill. She explained to me that the risk of uteran cancer increased significantly when menstruation does not occur at least 4 times a year (although failed to mention the proven link between the contraceptive pill and breast cancer) and without a period now for 10 months, she felt I was better to go back on the pill until such time that I wanted to fall pregnant. She assured me that there was no connection between the contraceptive pill, PCOS and infertility.

Again, I’m not so sure.

The pill has been proven to significantly deplete levels of essential vitamins and antioxidants. It inhibits ovulation and true menstruation (no, that is not your real period on the pill, it is a withdrawal bleed) so effectively I did not ovulate for 10 years. Is it possible that this could contribute to polycystic ovaries? And what was I saying earlier about the essential nourishment required to prevent blood deficiency? After a decade of pill-induced malnourishment (a contributing factor to PCOS), I kind of don’t really feel like going back on the pill. Strangely enough.

So what’s a girl to do?

Well let's take a trip down memory lane shall we?

I remember sitting in a Dr’s office 10 years ago and being told that I had acute liver inflammation and potentially auto-immune hepatitis (which later revealed to be caused by long term antibiotic use - again, for my acne) and that my only option was a course of steroids. The same little voice inside my head that said no, thank you back then has grown much louder in the last decade as I have explored the power of natural health, nutrition and holistic healing therapies and so it was an easy decision for me to say no, thank you once again and walk out of her office without a prescription.

I am sure for other women in my position though, this decision is not so easy.

So. How am I?

I truly cannot wait for my period to return. I lamented to my best friend the other day that I don’t feel like a woman (as Shania would say) without my monthly 'lady time'.

Sure I’m saving cashola on organic tampons, but it’s not really a trade off. A period is a time of release, renewal and reflection. I want to connect with my body through my cycle, to understand when I am ovulating and to personally appreciate the miracle that is the female reproductive system.

Heck, I wanna have kids. I want to know that I CAN have kids. I want to know that my long term use of the contraceptive pill doesn’t necessarily equal chemical castration. (Sorry - that last bit was graphic. Here is a picture of Ryan Gosling to lighten the mood!)

From here, I’m just going to keep trucking. While I am not 100% convinced I have PCOS (perhaps just polycystic ovaries as opposed to the syndrome) the best way I can see to treat my symptoms is by eating nourishing whole foods paleo-style diet (I have had SO many people suggest this style of eating to me to improve PCOS symptoms) based around green leafy vegetables, fruits, organic meats, eggs, nuts and seeds and continue to avoid sugar, alcohol (more than 2 glasses a week can inhibit ovulation), dairy, soy milk (yep - signing off my weekly soy lattes), gluten and processed foods.I’ll be getting plenty of exercise, sleep, acupuncture (read this article on the encouraging studies being done that link acupuncture to an improvement in ovulation in women with PCOS) and focussing on stress management and supporting my digestive system. Just all round general nourishment to get my body back into balance. 

I’m incredibly grateful I have embarked on this journey before wanting to start a family, because I imagine the stress of trying to fall pregnant while experiencing imbalances such as post-pill ammonorrhea and PCOS could be devastating. I continue to urge anyone who is taking the contraceptive pill or considering taking the contraceptive pill to do your research. Listen to your body. Ask questions. Don’t take everything you read to be truth (including what I have written here) and make your own decisions.

Where to from here?

If you're looking at making positive health and lifestyle changes, I have loads of recipes, personal anecdotes and insights in my She Is Radiant eRange. Check it out here. I also recommend this eBook Healing Hypothalamic Amenorrhea by nutritionist Kate Callaghan.

Finally, if it's PCOS specific information you're looking for, I'd love to point you in the direction of Dr. Nat Kringoudis' eCourse Debunking PCOS.

Please remember to speak to your own health professional team before making any significant changes to your lifestyle. 

Phew! Glad I got that out. Let's get a discussion going here. Have you experienced any of the issues I've mentioned? What are your thought and experiences when it comes to the contraceptive pill and/or PCOS?