If You’re Not Thinking About Ovulation, You’re Not Thinking About Health

Benefits of ovulation and ovulatory cycles.

This is my open letter to every clinician, personal trainer, and blogger who offers health advice without thinking about the importance of ovulation and natural ovulatory menstrual cycles.

Dear Sir,

Your restrictive dietary advice may cause young women to stop ovulating which is a problem because ovulation is how women make hormones.

That makes ovulation an essential part of human physiology and not just for making babies. Ovulation is not optional. Thank you.

Please share this message far and wide with every doctor, personal trainer, and health blogger you know. If they need a basic primer on ovulation, direct them here. 

Benefits of ovulation

Yes, ovulation is important. As endocrinology professor Jerilynn Prior puts it,

“Ovulatory cycles are both an indicator and a creator of health.”

By “indicator of health,” Professor Prior means that regular ovulation is a sign that all is well with the body. In particular, it’s a sign that there’s enough food (and enough carbohydrate) and not too much stress.

By “creator of health,” Professor Prior means that ovulation is how we make our much-needed monthly dose of progesterone. Estrogen and progesterone are as important for women as testosterone is for men.

Each and every monthly dose of progesterone is like a deposit into the bank account of long-term health. It builds bone and metabolic reserve to carry us through all the decades after menopause. That’s why it’s so important to ovulate while we can during our reproductive decades, and not shut it down with hormonal birth control.

Why ovulation is important for general health

👉 Tip: Hormonal birth control is not a substitute for regular ovulation for the simple reason that progestins are not progesterone. Read The crucial difference between progesterone and progestins.

It’s true that our ancestors didn’t ovulate as often but they did have more pregnancies, and so built their metabolic reserve that way. Read Do women need periods?

How to detect ovulation

Signs of possible ovulation include:

  • fertile mucus
  • regular period.

Signs of definite ovulation include:

  • A luteal phase rise in temperature, which means two weeks of higher temperatures followed by a bleed.
  • A luteal phase increase in progesterone as measured by a blood test. To get the timing right, read The right way to test progesterone.

A regular period is not a sign of definite ovulation because it’s possible to have an anovulatory cycle

👉 Tip: Cycle-tracking is the original “bio-hacking.”

Three causes of no ovulation

Hormonal birth control

Most types of hormonal contraception work by switching off ovulation and hormones and inducing a drug-withdrawal bleed which is not a real menstrual cycle. 

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal condition of androgen excess and sometimes amenorrhea (lack of periods) or anovulatory cycles. For treatment ideas, read The 4 types of PCOS.

Undereating

Hypothalamic amenorrhea (HA) is the loss of periods due to undereating or undereating carbohydrate. It’s not a dysfunction but is better characterized as a normal, adaptive response to an insufficient food supply. The solution is to eat more.

Other possible causes include thyroid disease, hormonal birth control, high prolactin, gluten sensitivity, zinc deficiency, a vegan diet, and certain medications.

Is it PCOS or hypothalamic amenorrhea?

In many ways, HA and PCOS are quite different (almost opposite), but, unfortunately, HA is routinely misdiagnosed as “lean” PCOS. Which means you might be told to further reduce carbs when you are already in the situation of not eating enough carbs! Read Do you have PCOS or hypothalamic amenorrhea?

Ask me in the comments.

83 thoughts on “If You’re Not Thinking About Ovulation, You’re Not Thinking About Health”

  1. Hi Dr Lara – great article. Do you have any info about late ovulation? I see a lot of helpful information regarding anovulatory cycles, but what about when you’re ovulating on day 30-32, and then having a 44-46 day cycle? Is there info in your book about this subject? I was recently tested for PCOS and was told by my (conventional) Dr that I don’t have it…and up until these past two extra long cycles, I was pretty regular around 33-36 days every month. I am also not on any birth control. Thank you in advance!!

    Reply
  2. I see a lot of research and commentary regarding lack of ovulation, but what about late ovulation? Do you have any articles on that or any bits of advice? I am ovulating but on day 31/32 and having a 46 day cycle. I also have been recently tested for PCOS by my GP and do not have that. Thank you in advance!

    Reply
  3. I’d love to know this also! I am 38 and in peri menopause. We are done having kids so I don’t need to ovulate for pregnancy but understand ovulation is important. I’m having anovulatory cycles and long cycles (10 days+) with heavy bleeding etc. I’m on Tranexamic acid to help the bleed, but it’s the severe PMS and lack of progesterone that’s still bothering me. I’ve already tried DIM, Cal-D, Vitex and will keep taking magnesium. I’m so tired lol x

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  4. Thank you for your helpful information! I have a mirena coil and I’m told I should still ovulate. I have no periods or bleeds ever and I had a hormone test done twice one a few years ago and again recently all normal fertility but I don’t have the levels etc. I had no sign of ovulation on my recent test but I don’t know my cycle or it could have been the wrong time in month. I don’t think I ovulate ever month as I do at times notice a difference that indicates I am… I feel better more alive more like a woman! I don’t know if I should stay in the coil or not every doc I speak with convinced me otherwise but I feel that my hormones are affecting me. Would you recommend just coming off the coil? 🙏

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  5. Hi Lara,
    I have recently recovered from HA after coming off birth control for 11years. I had no period for 15months and it came after healing sibo, eating more etc. Im grate full to have experience 3 periods since but theyre all been irregular but becoming shorter each time to becoming regular. I have noticed egg white mucus and temp shift but only by about .3 (some days more) i can definitely see a difference in temp from the follicular phase to my luteal phase but the temps go up and down abit. Im not sure if im actually ovulating or not? How long does it usually take to ovulate after HA recovery & post pill? Would you recommend a progesterone cream? Were wanting to start a family but I dont want to do things too soon if my hormones arent in the right place to do so. I would love and appreciate your advice & help.

    Reply
  6. No ovulation for 20 years…..sounds like I’m in trouble. Have used DepoProvera to control Catamenial Epilepsy. Trying to switch to natural Progesterone now.

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  7. Hello Lara, i am very confusing and desesperate about my situattion, and i hope you can give me some advise.
    When i was 15, i had irregular periods and i was diagnosis with PCOS in ultrasound, my doctor sent my the oral contraceptives, i took it for two years and when left them, i was 5 months without periods so my doctor told me to take again the pills, after that i have been 5 years more taking the pills because i started to loss my hair and the doctors told me that it was for PCOS and the pilla were good to avoid the hair loss. Three months ago i left the pill because my mood was horrible, and now i feel better but there is no period again. My LH and FSH are low and alson pregesterone and strogens are.
    I dont know was wrong with my body, i eat well and i have normal weight.
    I hope you can help me, because i am afraid of not having my period again, i really miss to have it, and i feel i need it.
    Thank you so much.

    Reply
  8. Great question! I’m interested in learning more about this topic, too. Addressing my thyroid hormone levels has definitely been critical in restoring my cycle, but it’s still a learning process for me….

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  9. Hi, this might be the wrong place to put this comment, but I would like to ask about it. I’m trying to learn how a normal healthy thyroid changes in response to ovulation and menstruation. Do you know any research that studies the fluctuation of t3 and t4 over the course of a woman’s menstrual cycle?

    Reply
  10. I’ve been having irregular periods for a while now. I’m 39 years old and started with hot flashes a couple months ago. My dr ordered blood work, ultrasound and MRI of my pituitary gland. My hormones are showing that I’m postmenopausal. Thyroid function is normal, as well as my ovaries and uterus.
    It’s being suggested that I Premature Ovarian Failure. Another round of bloodwork including genetic testing…but the dr feels I should be taking the pill as HRT. I don’t want to take the pill…any options I can discuss at my next appointment?

    Reply
  11. Hi Lara,
    I might already be doubling up on something you’ve written before but can you say whether the ovarian reserve screening is really an effective way of understanding our own fertility?

    There was a recent news story and article by ABC about its effectiveness and the the ‘russion Roulette’ that Aussie couple are playing with their fertility.

    Thanks in advance, I know your time is valuable.
    Rachael

    https://mobile.abc.net.au/news/2019-01-08/study-finds-australians-are-misunderstanding-fertility/10694372

    Reply
  12. Hello Dr. Lara Briden! I have a question for you. I am 34 years old. I have PCOS. I want to get pregnant. I take Metformin at 1000mgs daily. It does not work for me. I want to produce a cycle. I was prescribed Tri Lo Sprintec birth control. Can I induce a menstral cycle by taking the placebo pills? If so, usually hiw long does it take? Thank you 🙂

    Reply
  13. Hi Lara
    I am currently reading your repair manual book and it says if your bleeding is prolonged longer than 7 days you certainly have an anovulatory cycle. I have the copper IUD (chosen so it doesn’t affect my hormones) and have had really heavy and long periods since getting it in. Does this still mean I don’t ovulate? Or could it just mean it’s because of the IUD.

    Reply
  14. What is your opinion on ovulation stimulation medications (letrozole) for when you have tried dietary and lifestyle changes mentioned above religiously, are still not ovulating regularly and want a baby yesterday?

    Thanks!

    Reply
  15. Hi Lara, i love reading your posts and they have become super important to me since being diagnosed with hasimotos, coeliac disease and finally PCOS within the past 2 years. I recently started seeing an endo who told me that simply based on my period tracker i probably havent been ovulating and when i want to get pregnant (my partner and i want to start trying next year) she’ll put me on clomid. How can i ovulate without resorting to taking drugs?
    Thank you

    Reply
  16. Hi Lara. I have HA and have had for many years. I got my thyroid tested…are these normal? FreeT4:15, TSH: 0.78, free T3, 4.3. And negative thyroid antibodies. I’m going to buy your book to see what work on getting my period back 🙂

    Reply
    • As a general comment, yes those look normal. But please speak to your doctor. It’s possible that you still need to eat more, and maybe more carbohydrate. As women, we need a lot more food than we’ve been led to believe!

      Reply
  17. Hello! In cases of lack of ovulation due to breastfeeding, how are changes in our hormonal cycle in the absence of progesterone.

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  18. First of all, I want to thank you for all your work on women’s hormonal health. This seems to be a vastly understudied arena and it reflects the broader gender bias in medicine. I recently bought your book and have learned so much!!! I think every woman should read it and have been encouraging my friends to buy it.

    That said, I was wondering if you could offer some advice. Last week, I quit a low dose combination pill (ortho tri cyclen lo) after about 15 years of continuous use. I started the pill after an unplanned pregnancy at age 15, so my reasons for going on the pill in the first place were not positive. In the last 10 or so years, i have developed horrible side effects. After another 72 hour migraine, intense depression, and a 12-13 day pill bleed this past pill cycle, i finally decided i have had enough.

    My worries now revolve around the potential “post-pill syndrome” – It has been a while, but I don’t remember having irregular cycles or particularly bad acne – i had what you might call “normal teenage skin”/very mild acne at worst. But, my skin has been pretty consistently clear on the pill and I am afraid of losing that!

    I eat a hormone-balancing diet full of plants + whole foods, no dairy (i used to eat dairy yogurt but recently eliminated it) and very little sugar (pretty much only from whole fruit with the skin). I exercise frequently, get enough sleep, rarely drink alcohol, and I have been taking milk thistle, zinc, turmeric, and a b vitamin complex for over a year now (recently added in magnesium). My naturopath recommended adding DIM + vitex as I transition off hormonal birth control, but my question is: should I incorporate these two additional supplements into my regimen now? I am a PhD student with somewhat limited funds, and I also don’t want to overdo it with supplementation if i don’t absolutely *need* to.

    What do you think? Should I start taking one or both, or see how my body does on its own before deciding?

    Thanks so much,

    Sara

    Reply
    • Hi Sara, thanks for your feedback.
      With my patients in a similar situation, I start with the diet plus zinc, as you’ve done. Chances are, that will be enough. But we queue up the DIM capsules to start IF and when the skin starts to get bad. I don’t give Vitex so soon after the pill.

      Reply
  19. Hi Lara,

    I’m stopped taking birth control a year ago in hopes of getting pregnant (I was on it for two years in order to not getting pregnant, no other reason) but I haven’t gotten my period back. Ive gone to the doctor and they say all my hormones are normal and I bleed on provera, so it is probably stress related. Can stress stop your period for a year? Do you have any ideas on what else it could be? Or any ideas on what I can do to get it back?

    Reply
  20. I have not ovulated regularly for 8-10 years, but my doctors always told me not to worry about it. How do I find someone who will help me get to the bottom of this and help me through a treatment plan without charging me my first born child??

    Reply
    • My book Period Repair Manual is a good place to start. Chapter 7 explores all the different reasons for lack of ovulation.

      Reply
  21. Thank you for this blog and interesting posts. I really have a lot of valuable information here. I started to treat my PCOS differently. Greetings from Poland

    Reply
  22. Hi Lara, what would cause late ovulation (day 18+) with a short luteal phase of 9 days? I have read your book but it doesn’t seem to touch on short luteal phases.

    Reply
  23. Can I get take a glucose tolerance test although I’ve already been taking myo-inositol for a few months? If not, how many days/weeks before should I stop taking it?

    Reply
  24. Sorry for the lengthy comment ive watched your website for almost a year and really would be ecstatic to hear from you on ANY of this. I am so thankful for your committment to ovulation and hormone harmony by spreading the word about “small men’s” health. 😂

    I have taken notes on everything however I cant find any information on my one big question. My first birth control method ever was the mirena (4 years) which caused many symptoms for me my acne being the most identifiable. I removed it. I got a copper iud. My acne did not subside. I had that removed as well its been 5 months since that and I do have periods. MY QUESTION:
    IF IT HAS BEEN A FULL YEAR SINCE MIRENA REMOVAL (OR ANY SYNTHETIC HORMONES) AND IM STILL SUFFERING FROM SEVERE ACNE, IS THIS MORE SERIOUS )PCOS/ANOTHER DIAGNOSABLE PROBLEM) TYPE OF SITUATION

    OR

    IS IT POSSIBLE THE AFTER EFFECTS FROM MIRENA COULD STILL BE HAPPENING?

    IS ALL HORMONAL ACNE ABLE TO BE HELPED BY THE KEY SUPPLEMENTS AND DIETS YOU SUGGEST?

    unfortunately I have switched doctors twice now and they disagree with every word I say or convince me not to get a blood test and encourage more hormones or spironolactone so i have been left in the dark .

    COULD VITEX BE THE BEST FIRST STEP FOR ME EVEN THOUGH IM LONG PAST “POST-PILL?”

    DO YOU THINK BECAUSE OF HOW THE LEVEROGNESTREL IS ADMINISTERED IN THE IUD THAT THE EFFECTS MESSES ME UP WORSE/FOR LONGER?

    Reply
  25. I am 22 and have HA, I haven’t had a natural period since I was 16, having struggled with an eating disorder. Both my estrogen and progesterone are on the floor and I am working on rebuilding them by managing my stress and anxiety and nourishing my body. I wanted to know if my lack of ovulation for such a long period of time may have done some long term damage to my body- I worry about increased risk of osteoporosis etc. Thanks in advance 🙂

    Reply
  26. I was diagnosed with POF when I was 18 and put on birth control to give me hormones. I am now 29. I read up on stuff myself and took myself off it 3 years ago. I don’t have any period and have suffered with depression and anxiety for years. I think methylation is an issue for me too. Hoping to do a Dutch test and GI Map test soon to shed some light. Your opinion would be much appreciated. I know I’m not healthy but it’s very hard to get to the root of this sort of thing. Lucy x

    Reply
    • Do you truly have POF? What is your FSH reading? If your FSH is high (menopausal), you are going to need hormone replacement. But it can be body identical or bioidentical estradiol and progesterone. I don’t see how a Dutch test can give any insight into POF.

      Reply
  27. I was diagnosed with lean PCOS three years ago and have been trying to figure out how to get a regular cycle back. Thanks to you, I realized that the very low carb diet my doctor and nutritionist had me on only made my cycles worse! I now get periods on my own, but have long cycles so it only happens 8-9 times a year.When we are talking about progesterone stores, do we need monthly periods? Is 8 or 9 good enough for someone with PCOS? Another question, when it comes to “over-exercising” I have never gotten a straight answer to what this means. Is it mostly a too much cardio issue? Are there ways to know if over-exercising is a problem?I was told no carbs and lots of exercise by so many health professionals, but I think it is bad advise for me.

    Reply
    • Thanks for sharing your story about getting your period back with carbs. If you’re certain you’re ovulating, then 9 periods per year is reasonably ok. You might just still need to eat more. Do you have high androgens?

      Reply
      • I have tested high for testosterone (the number dropped after I started eating low carb but were still on the very highest end of normal). I have never displayed any of the physical manifestations of high androgens (no acne, hair growth, etc…) I have also never tested positive for any time of insulin resistance (in fact my last test for fasting insulin was 3 mg/dL). I’m a healthy weight (5’3” 120 lbs). I had irregular periods since puberty until I went on the pill at 18. Several doctors have told me this is just the way I am, but I find that frustrating.

        Reply
    • Hi Jessica – I really recommend the book ‘How to Heal Your Metabolism’ by Kate Deering if you’d like some more insight into the amount and kind of carbs and exercise that are good for you but won’t stress your body out! It’s a life changer. But basically, small amounts of weight training are best if you haven’t been healthy and have stressed your body out (i.e. lowered your metabolism) with a low-carb diet.

      Reply
  28. Thank you for all you do Dr. Briden! I am almost done with your book and have learned so much already!

    I am not 100% sure what I had\have going on. I went abroad for 6 months in college and lost my period for 6 months–i was a normal weight and didn’t really diet or over exercise. When I got home to America I was restrictive and started doing an hour of cardio a few days a week, continuing to add more and more. I counted all my calories. Eventually that year I got concerned and went to my OB and she didn’t do any tests, just gave me the mini pill and I had a fake period. My period never start-up on its own and she wasn’t concerned, I was 19.

    Years went by and I had one or two random periods. I started running half marathons and lifting weights. After three years I went back to my OB and time she ordered an ultrasound and hormone testing. I had polycystic ovaries but normal androgens. She gave me birth control to give me cycles. Nothing further! She told me I had PCOS like symptoms and that birth control would kick start my body into having cycles. I have done HBC a few times but only lasted a few months as I quickly gained weight, became depressed and bloated in matter of days. Today I n married and regained cycles by eating more and exercising less. I have had cycles now since late 2016 but I have ovarian pain 10-5 days before the end of my cycle, bad enough I just lay in bed with a heating pad and I have days of nausea.Do you think this was truly PCOS or HPA axis dysregulation? I have cycles now at about 34 days. I track my temperatures, CM and Cerivx to try to make sure I am ovulating. While ovulation at hone tests and my cervix confirm ovulation but my temps don’t confirm it every month. Can I go by my CM and Cervix height to confirm it?

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  29. I am 15 months postpartum and 1 month since my daughter has been completely weaned from breastfeeding. Prior to pregnancy I was diagnosed with PCOS after coming off of the pill (was on for over 10 years) as blood test showed high testosterone and 3:1 lh:fsh ratio. I never had a natural cycle prior to my pregnancy (1.5 years off of the pill) and took clomid and progesterone support to acheive pregnancy.
    Postpartum I have had a total of 4 periods and the last two have been about a month apart but with at least a week of spotting prior to my period. Blood tests showed the high testosterone still but lh:fsh ratio was 1:1.
    Is there anything I can do to naturally lower the testosterone? I have been taking zinc and have taken vitamin d for many years as I was very deficient.

    Reply
  30. Thank you for all your helpful blog posts, Dr. Briden. I was diagnosed with PCOS within the past few months, which was confirmed by two health care providers. I believe I have had PCOS since puberty because I have never had a regular period, and I wasn’t overweight when I was younger. I am currently slightly overweight but exercise regularly and strive to eat a healthy diet.

    I went off hormonal birth control for about 6 months to see what my body would do in its natural state, and with a few exceptions, my symptoms definitely worsened. I gained weight, grew more hair on my face and arms, got a lot more acne, and didn’t have a regular period. After confirming the PCOS diagnosis, my OB/GYN strongly recommended I go back on hormonal birth control to “turn off the PCOS” essentially. She seems knowledgeable about my condition and I generally trust her advice, but given the information you provide in this post, I am still questioning whether being on hormonal birth control is best for me. I am 30 years old and have been using hormonal birth control almost constantly for the past 12 years. I am not ready to have a child yet, but I’m married and will want to start trying in the next couple years. I really just want to do what’s best for my overall health, so any personalized advice you can offer is much appreciated!

    Thank you again for your expert and supportive advice!

    Reply
    • I know you are looking for Dr. Briden’s advice but I can’t help but chime in – if you want to start trying to have kids in the next couple of years, I would definitely start working on coming off of the pill now, it could take years to get to the point where you can conceive. You will need time to figure out your body and restore regular ovulation. I know so many people who waited and stayed on the pill only to then battle infertility for years and have age working against them. Buy her book the Period Repair Manual, read the whole thing, make changes and don’t look back! In the meantime you can still use a natural birth control method, they are outlined in her book.

      Reply
  31. Thanks for your very helpful blog, especially this post. What are your thoughts about lack of ovulation during perimenopause? A natural part of the process so wait it out, or something to be addressed? Specifically, I’m 50. All indications are that ovulation is at best irregular or at worst absent, but I continue to have long-duration, irregular, at times heavy bleeding. The doctors I’ve seen lean toward Door #1 (wait it out), but I can’t help but think that’s not good for me.

    Reply
  32. I am 38 year old breastfeeding mama. I am 14 months postpartum, and I still haven’t gotten my period back. My daughter still nurses frequently, but I don’t think she nurses more frequently than either of my boys did and I had my period back by the time I was 9 months postpartum with each of them. Of course, I was in my early thirties back then. Does this seem abnormal to you? (I eat a healthy, mostly AIP diet, and am a healthy weight.)

    Reply
  33. Hi Lara. Great post! My doctor has me on 250mg a day of bio identical transdermal Progesterone! I’m 43, and had bleeding 3 weeks a month for a few years after coming off the Pill, but not worryingly heavy, just annoying. No cause was found, but I have Hashimoto’s that was under-treated for a decade, till recently. But still, 250mg a day of Progesterone when other people do 20 or 40? Is this crazy? Thanks.

    Reply
  34. Hi Lara,
    I loved this post!! I have been diagnosed with lean pcos since I was a teen.I am 24 now and went on diane 35 for 7 months which I regret now.I thiyhht since I was on it for a short period of time it wouldn’t affect me hah!II couldn’t have been more wrong.Its been almost 9 months since I have gone off it and I still haven’t had my periods since 2 months.I am qoreied because I am doing everything I can.But apparently it’s not just enough.

    Currently I am taking zinc,magnesium,omega 3 ,NAC and after reading your post about vitex I decided to try vitex too.Even then I don’t notice any changes.

    My question is am I taking too many supplements?How long will it take for me to restore my cycles.It was irregular before but after Diane I think I just made it worse.It would really help me if you cpuld give your insights on this!!

    Thank you!

    Reply
  35. I really appreciate your post! I’ve seen several doctors about issues with infertility but they’ve just wanted to throw drugs at it rather than find the root cause of things. Currently my diagnosis is unexplained infertility. I have very strong ovulation symptoms: cervical mucus, breast pain, ovulation pain, positive opk kit and temperature rise. My ovulation tends to be pretty early (day 8-12) and I tend to have spotting during the last week of my luteal phase. Do you have any ideas of what would be contributing to the early ovulation and do you think it’s something I should push explore to see if underlying issues are affecting my fertility?

    Reply
    • Day 9-12 ovulation should be okay. How old are you? You could think about some natural progesterone support in the luteal phase.
      Also, are you 100% sure it’s a female issue? My experience is that the male side of things doesn’t get the attention it deserves. For example, sperm morphology is very important. I’ve got a guest blog coming out about that.
      Also, thyroid and immune issues can play a role in implantation.
      Ovulation is just one relatively small part of the fertility picture.

      Reply
      • Thanks for your reply! Husband checked out fine on all his tests but I will have to look back and verify they addressed morphology. I am hypothyroid and am on 50mcg levothyroxine. My gyno did put me on natural progesterone (capsules) during the luteal phase and while it has helped me sleep a lot better it hasn’t addressed the spotting.

        Reply
        • Dr. Briden, I have also had more problems with sleeping the longer I’ve been off the pill. Every few weeks I’ll experience a period of waking up at 3 or 4am and not being able to fall back asleep. Is this due to low progesterone? Is there anything I can do to promote better sleep until I get my cycle back? I also feel that I’m catching more colds. I’m wondering if this is also related to not getting enough rest. Thanks again!

          Reply
          • I can’t say that it’s associated with PMS as I have not had a period/pill bleed for more than a year. Thank you for sharing this post -very informative and super helpful! Would you recommend avoiding melatonin if I’m not ovulating yet? I’m currently trying to see if taking Synthroid to improve my T3 levels will trigger ovulation. Any thoughts on also taking N-acetyl cysteine to promote ovulation? Thanks again!

  36. Hi Lara,

    Thanks for writing this great piece!

    I am recovering from disordered eating behaviours that were going on for 2.5 years. I lost my period in July of 2016. I’ve put on some weight since last year (although still in low range BMI) and I have slowed down the intensive exercise and am sticking to mostly cardio.

    It’s been almost a year since making a conscious decision to begin recovery but no signs of menstruation as yet and I’m feeling a bit dejected. I hoped that my body would coin onto the fact that it’s getting the right amount of food now and I’d have some symptoms at least, but nothing.

    Do you have any advice on how to continue being patient? It’s a very stressful time especially when the ED voice inside my head is urging me to fall back into old ways to find comfort and control.

    Would love to hear your advice – thanks!

    Sarah

    Reply
  37. I love your post about ‘PCOS or hypothalamic amemorrhea – or both?’! I’m actually not sure which of them I have. I’m 33 and have been off the pill for three years. Two years ago on a day 3 menstrual cycle blood test my LH was 13.3 and FSH was 7.5. Last month, the same test showed LH was 3.8 and FSH was 7.9. Progesterone was low and my doctor thought I wasn’t ovulating. I have signs of androgen excess (acne and hirsutism) and a short synacthen test showed my adrenals are making too many androgens. I eat plenty, including carbs. TSH was 2.5 in January.

    Do you think I should try peony and licorice to restore ovulation?

    Reply
  38. Thank you for all your great work. What would you advise for women who want to save their eggs in case they will want to have children later in life (e.g. in their early 40s)? Would you still advise to ovulate every month, or would, in this case, it would make sense to pause ovulations hormonally, as less ovulations = more eggs saved?

    Reply
  39. For anovulatory cycles post depo provera (1 shit, 1 year ago), how many months is vitex a good choice? Going on 3 cycles and still no ovulation.

    Reply
  40. Hi! Loved this post! Just wanted to know, are all these topics included in your book? I’m not good at jumpong from a post to another…but love books better. Thank you!!!

    Reply
  41. Great post! However, this makes me sad/worried as it’s been nearly a year and a half since I went off birth control pills and I still have not ovulated/had a period.

    I eat a well rounded, higher-carb, gluten-free diet and over the past year have gained almost 10lbs as I’ve taken some time off of running and have included more fats in my diet; I take a zinc supplement; and my prolactin and insulin levels are normal. My TSH has been high and my T3 has been low, so one month ago I started to take Synthroid to see if a thyroid disease is the root cause.

    Thoughts on synthetic versus natural thyroid hormone? How quickly would I expect to have a period if low T3 has been the cause of my anovulation?

    Also, any thoughts on taking N-acetyl cysteine to promote ovulation?

    Thanks for all that you do!

    Reply
    • thanks for your comment. Sadly, it’s not unusual for it to take 1-2 years to reestablish ovulation post-pill. Especially if it was started at a young age. (how old were you?)

      It sounds like you’re doing everything right, except maybe you need even more carbs that you thought! (low T3 is a classic sign of too little carbohydrate). Or, you may just need a bit more time. You’ll get a clue that something is coming if you notice other hormonal signs like breast swelling and vaginal discharge.

      And re: synthroid versus natural thyroid hormone, they can both be helpful.

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      • Thank you for your quick response! Sorta encouraging to hear that I’m within a normal timeframe for re-establishing ovulation. I was about 15 years old when I was put on the pill for irregular periods. Though the root cause of my irregular periods were never investigated. Will continue to give Synthroid some time to work…

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