Can you restart your menstrual cycle if it's disrupted by underweight, over-exercise, and stress?
Your Story: I'm a 28-year-old woman. Four years ago, I achieved healthy weight loss through diet and exercise. But I lost balance, maintaining the strict regimen with 5-6 workouts weekly and fearing normal eating. I sought help at an eating disorder clinic and, after a tough battle, regained control. Sports and food no longer dominate my life—true freedom!
Two years ago, I stopped the contraceptive pill to test my natural cycle. It never returned, likely from prior underweight, physical demands, and stress. Today, I'm balanced and at a healthy weight (1.60 m, 54 kg), yet my periods remain absent. Is this a sign I'm not at my ideal weight? Should I wait patiently, or can I actively help restart it? Does it impact fertility? Am I still fertile without menstruating? —H. van D., Amsterdam
Expert Answer from GP Ingrid Kuiper: Amenorrhea, the medical term for absent periods, is commonly triggered by a mix of stress, low body weight, and intense exercise—as in your case. Other potential causes include hormonal conditions like polycystic ovary syndrome (PCOS) or early menopause, plus issues such as diabetes or thyroid disorders.
Missing periods doesn't automatically mean infertility. If you're planning pregnancy, track ovulation (essential for conception) using methods like basal body temperature charting. For amenorrhea lasting two years when trying to conceive, consult a gynecologist; hormone therapy can often induce ovulation. The outlook is excellent for cases linked to sports, underweight, or stress, with cycles typically resuming once balance is restored.
