When I see a new female client, I ask for lots of information about her menstrual cycle: Is it regular? Does she track it? Is the bleeding heavy with painful cramps? Does she experience PMS symptoms or migraines? Irregular cycles are common, but that’s not always normal.
Your period can give you clues about your overall health, stress level, fertility status, and hormone balance. If yours is missing, irregular, or is too heavy or frequent, there are steps you can take to restore balance and harmony and regulate your period.
How to Regulate Your Period Naturally
A normal menstrual cycle varies in length from 21 to 35 days. Count from day 1 as the first day of bleeding. While the gold standard is considered a 28 day cycle with ovulation around day 14, as long as your cycle spans the same relative number of days within the 21-35 day norm each cycle, give or take a day or 2, you’re considered regular.
Skipping a period every now and again is normal, too (assuming you’re not pregnant). But when there are wide variations between periods or differences in the number of days of bleeding each month, your period is considered irregular. This is known as oligomenorrhea, which refers to infrequent periods with intervals of more than 35 days.
Symptom: Light, Irregular, or Absent Periods
Amenorrhea is the absence of your period, usually characterized by missing three or more periods in a row (the most obvious cause is pregnancy or lactation, both of which we’ll rule out for this article). A common cause of missing periods is hypothalamic amenorrhea, caused by psychological or physical stress, excessive exercise, disordered eating or a combination of these factors resulting in suppression of the hypothalamic–pituitary–ovarian axis.
The conventional “cure” most often recommended to restore a normal cycle is hormonal birth control, but this method does not address or heal the root cause.
Causes of Irregular or Absent Cycles
- Insufficient hormone levels, typically low estrogen and/or progesterone. Most often due to stress, the hypothalamus doesn’t signal the ovaries to properly produce and release hormones. Low hormone levels prevent the uterus from building up a lining, so there’s nothing to shed. This is typically known as hypothalamic amenorrhea or oligomenorrhea. Chronic stress raises cortisol levels and burns out the feedback loop between the brain, adrenals, and ovaries (the HPA axis). Stress can be in the form of emotional stress, dietary stress (food allergies, hypoglycemia), or inflammation. If you’re in a chronic fight-or-flight phase, the body prioritizes survival over reproduction.
- Overexercising can overly decrease body fat and cause low hormone levels, leading to absent or irregular cycles because of insufficient lining. Your body perceives there are not enough stores to support a pregnancy, so fertility comes to a halt.
- Losing too much weight. Similar to low body fat, losing too much weight can cause low hormone levels, overall nutrient deficiencies, and anovulation (absence of ovulation).
- Deficiencies. Anemia (low iron) can cause infrequent or scanty periods or amenorrhea. Deficiencies in B vitamins and zinc may also be culprits. Insufficient nourishment or overly restricting calories can cause irregular cycles. Eating too low carb can contribute to low thyroid and female hormone levels in some women.
- Transitioning off hormonal birth control can leave a woman with low progesterone levels, which can cause absent or irregular periods. Click here to read how to stop taking the pill.
- Address adrenal fatigue/HPA axis dysfunction and stressors in your life, whether it be too much work, not enough sleep, chugging coffee or alcohol, or unhealthy relationships.
- Get enough sleep. Here are my sleep hygiene tips.
- Rebalance hormones to combat estrogen dominance, especially coming off birth control. Bio-identical progesterone can help boost low progesterone levels. My article on estrogen dominance explains more.
- Eat enough food! Eat the right diet for your body, and include plenty of healthy fats, the precursors to your hormones. Make sure you’re getting enough calories to support your bodyweight and activity level. I always have my clients log everything they eat in an app like FitDay for 3-5 days, and many are shocked to see they’re actually undereating.
- Normalize body weight.
- Vitex can help restore the HPA (hypothalamic-pituitary) axis, along with addressing adrenal fatigue.
- Get bloodwork done to determine if you have deficiencies or anemia. You can order your own blood work without a doctor here (I recommend the first test on the list, but the second test is a great start. I do recommend reviewing your results with a health professional!). I also recommend the DUTCH hormone test which is an excellent sex and stress hormone assessment.
- Certain herbal formulas help normalize estrogen and progesterone levels. I like this one that contains vitex, dong quai, motherwort (and more).
Symptom: Heavy Bleeding, or Periods too Close Together
If your periods starts occurring more frequently (closer together), or if the bleeding is heavier, or you experience an increase in the number of days of bleeding, hormone imbalance is typically the cause. Heavy bleeding can lead to deficiencies in iron (anemia) and other minerals.
- Luteal phase deficiency. This means your body isn’t producing enough progesterone to balance estrogen, so the luteal phase (second half of your cycle) shortens in length. Typically menstruation should start a full 2 weeks after ovulation, but with a low progesterone/luteal phase deficiency, the second half of the cycle may only be 7- 10 days, and ovulation may not have occurred. Most often the cause is chronic stress, which means an increase in the stress hormone cortisol. Your senses that survival is more important than reproduction, and a stressed body isn’t in reproduction mode. This causes low progesterone, leaving a woman estrogen dominant and usually with irregular, absent, or heavier periods.
- Hypothyroidism: underfunctioning thyroid can cause painful, heavy periods and/or irregular cycles. Have your TSH, T3, and T4 levels checked, or even better request a full thyroid panel, especially if you experience other signs of hypothyroid: fatigue, weight gain, constipation, thinning hair. You can order your own thyroid panel here.
- Polycystic ovarian syndrome (PCOS) is a hormonal imbalance associated with insulin resistance and irregular cycles. Other symptoms include being overweight/increase in belly fat, hair growth on face, heavy bleeding, high DHEA and/or testosterone levels. With PCOS, egg follicles form but aren’t released, so cysts form on the ovaries. This can cause low progesterone and heavy bleeding.
- Increased body fat can contribute to estrogen dominance, which is a factor in irregular cycles and heavy bleeding.
- Endometriosis is a structural issue that occurs when the tissue that lines the uterus grows outside the uterus; it causes heavy, painful bleeding.
- Fibroids can cause prolonged bleeding (7 or more days) and heavy periods.
- Reduce body fat and avoid refined sugar and carbohydrates. PCOS in particular responds well to a lower carb type paleo plan to reduce insulin levels. Exercise helps too.
- Liver detox helps normalize estrogen and testosterone levels. Try my easy and fun 21 day detox!
- Support the thyroid. Taking your basal body temperature (BBT) every morning can give you a good indication of thyroid function, and charting your cycles via BBT can let you know when/if you’re ovulating. This book gives you all the info you need to chart your cycles.
- Manage stress and support the adrenals to normalize cortisol. This is hugely important.
- Vitex and bio-identical progesterone will help luteal phase deficiency (periods too close together).
- Avoid excessive red meat (more than twice weekly) and absolutely avoid all conventional meats and dairy, which contain estrogenic compounds and antibiotics.
- Avoid processed soy, which is highly estrogenic.
- Acupuncture can help move stagnant blood and normalize cycles.
Regulating your cycles naturally is a combination of the right diet for your body, stress management, getting enough sleep, appropriate levels of exercise, good lifestyle habits, and using herbs and nutrients to supplement if needed. I always recommend charting your cycles by taking basal body temperature so you can learn when and if you’re ovulating by detecting shifts in body temperature. I often also recommend saliva testing (like the DUTCH test, which you can find on this test menu) to assess cortisol and female hormone levels to get an idea of how your adrenals are functioning. It may take a few months to get back on track, but regulating your periods is possible without the use of hormonal birth control. Check out Taking Charge of Your Fertility for more help.
4 Tips to Balance Your Hormones Right Now
All about Estrogen Dominance
Top Tips for Hormone Balance
Healing Adrenal Fatigue
Natural Solutions to Cut the Cramps
How to Get Pregnant (or Avoid Pregnancy)
How to Make Your Period Pleasant
10 Foods to Heal Hypothyroidism
Hormones & Women’s Health Podcast
How & Why to Stop Taking the Pill
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.