Where has my period gone?

🌙 Where Has My Period Gone?

If your period has disappeared, you’re not alone and you’re definitely not “broken.”

But it is something worth understanding.

🌱 A quick note before we start

This is a brief overview to help you make sense of what might be going on.

There are a few key patterns we look for when periods stop, and understanding which one applies to you helps guide what to do next.

If you’ve been offered a progestogen challenge test, you can read more about that here 

🧭 Why do periods stop?

Your menstrual cycle depends on a delicate conversation between your brain, ovaries, and hormones ( Dr Nicky Keay compares it to the orchestra working together)

When that conversation is disrupted, periods can become irregular or stop altogether (called amenorrhoea).

The most common reasons include:

🔄 1. Not ovulating regularly

This is one of the most common causes.

Your body may still be making estrogen, but:

• Ovulation isn’t happening consistently
• Periods become irregular or stop
• Common examples include PCOS and coming off contraception.

🧠 2. The brain pressing pause (hypothalamic causes)

Sometimes your body decides it’s not the right time to ovulate.

This can happen with:

• Stress (even if you feel like you're coping)
• Not eating enough for your needs
• High levels of exercise
• Weight changes

This is your body being protective , not dysfunctional.

🔄 3. Hormonal transitions

• As hormones shift across life stages, cycles can change.
• This includes perimenopause (often in your 40s, sometimes earlier) and post-pill hormone readjustment.

⚖️ 4. Lower hormone levels

In some cases, estrogen levels are lower than expected, meaning:

The uterine lining doesn’t build up -> There’s nothing to shed

🛡️ Why does it matter?

It’s tempting to think:

“If I’m not getting a period, that’s one less thing to worry about…”

But  your cycle is more than just bleeding.

It reflects:

• Hormone balance
• Bone health
• Metabolic health
• Fertility (now or in the future)
• Future health risks

And in some cases, the uterine lining may build up without shedding, which isn’t ideal long term.

🔍 So what happens next?

The next step is usually about understanding which pattern you’re in.

That might include:

• A clinical history
• Blood tests
• An ultrasound scan
• Or a simple test like a progestogen challenge

This helps us work out:

• Are you making enough estrogen?
• Is ovulation the issue?
• Or is your body in a low hormone state?

❤️ The bottom line

Missing periods are common, but they’re also meaningful.

They’re your body’s way of saying:

“Something in the system has shifted.”

Our job is to understand what that shift is and support your body accordingly.

As a GP I often see my role as starting the journey of investigating with you, but often I would refer you to a gynaecologist, or endocrinologist if periods are still not coming.