emotional stress-induced amenorrhea
February 4, 2016 5:32 AM   Subscribe

If you have dealt with emotional stress-induced hypothalamic amenorrhea, with emphasis on the emotional sort of stress (as opposed to physical / excessive exercise-induced), what did you do to ensure that you regularly got your period?

I'm a twenty-something, otherwise-healthy woman who hasn't had a period for over a year. I'm in medical school, which is this chronic, low-level stress, and my periods gradually spaced out and sputtered to a halt after med school began. My toenails and hair actually stopped growing for a while, even though I was "doing everything right" in terms of diet and exercise-- my feeling is that I had difficulty creating real space to process my thoughts and emotions for a long time, and medical school exacerbated that.

I had a four-month long break/vacation from medical school, and it feels like things are juuust starting to get back on track in terms of my blood tests and how I feel in general. My endocrinologist said that I must have been extremely stressed when I first visited him last year, though I look much better now. He encouraged me to do a trial of going off my medications now to see if my body can regulate hormones on its own. In fact, I've never felt this well and in touch with my body in my life before, ever! I am blown away at how much chronic stress I must have grown up with. I can see now that even when I previously felt "relaxed," my standard of relaxed must have been still, at baseline, quite stressed. Obviously, it is a lot easier to relax when on vacation. Help me keep moving in the right direction as my schedule shifts to a more stressful routine: in a few weeks, I'm going to have to return to my clinical rotations soon, which means returning to cramming for shelf exams, not having time to myself, being on overnight call, interacting with many supervisors and evaluators that change every few days as each service rotates on and off, and so on. I am kind of worried, because I don't have any more breaks in my medical training (maybe a bit in my fourth year, but residency won't be any easier, that's for sure), so any reassurance in that regard would also be appreciated.

I'm looking for ways to approach things in a less stressed out way; to take everything less seriously, despite my busy schedule and stressful, sometimes competitive environment. I started therapy and have been working on it for the past half year already. It seems so nebulous, to "reduce emotional stress," but my body won't menstruate unless I take a more balanced approach to everything, and I feel it is an important barometer of my health. If it matters, my BMI is normal, has always been, and I have not been exercising excessively-- just yoga 3-4x a week and some walking.
posted by anonymous to Health & Fitness (4 answers total) 3 users marked this as a favorite
YMMV, it's junk science, whatever: acupuncture (listed partway down) has really helped me. (You'd need a few successive weeks.)

Also, how's your sleep? Poor sleep can exacerbate physical and emotional stress.
posted by listen, lady at 6:01 AM on February 4, 2016

Do you meditate? It can be very helpful for stress.

Also, you might want to consider if this is what you really want. The price of getting a medical degree and then being a doctor sounds very high for you. I don't mean this to be flip. I wish I had re-aligned my life goals at your age instead of trying to deal with and cope with the stress. It takes a real toll. If your quality of life continues to suffer this much, it really might be beneficial to consider other fulfilling careers that don't demand as much from your mind and body. I know I wish I had.

In any case: sleep, hydrate, eat enough and well, exercise, and try meditating.

Best of luck.
posted by sockermom at 6:27 AM on February 4, 2016 [2 favorites]

Is there any way you could take a year off? I imagine you've been driving yourself non-stop for many years.

If you can't take time off there are several things you could try, like those mentioned above. Can you afford to get a massage every week? I have no idea if they actually help, but they sure feel good. Do you go to a class for yoga? Or do you do it alone? If you go to a class maybe some of your classmates could recommend a massage therapist.

Dancing, especially dancing to music you really like, can help to de-stress. As would playing an instrument if you have that skillset. And don't forget sex. If you don't have a partner be good to yourself.
posted by mareli at 7:23 AM on February 4, 2016 [1 favorite]

"He encouraged me to do a trial of going off my medications now to see if my body can regulate hormones on its own." Just what are you being treated for? Thyroid dysfunction? PCOS? Any of those as well as a myriad of other things might throw off your cycle. But the important question is why you feel like you *need* to have a regular cycle? As long as you have a withdrawl bleed every few months to stave off your risk of hyperplasia you don't *need* to have a cycle assuming all alarming causes of amenorrhea/oligomenorrhea have been ruled out.

Second Mareli here, as an OB/Gyn resident here, it's not gonna get LESS stressful as you go further. If this is freaking you out so much perhaps you should bail while you still can....

Not being flippant at all, BTW, just observing that the earlier you are in the road to attending-hood the easier it is to get out, no matter how insurmountable it looks now.
posted by eglenner at 4:50 PM on February 4, 2016 [3 favorites]

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