“You’re Gonna Miss Me When I’m Gone!” Signed, Your Period [All about amenorrhea]

by Charlotte on July 29, 2013 · 39 comments

period

Do you remember the day you got your first period? Of course you do! (Unless you’re a dude and then take a hall pass and excuse yourself for the day. You’re welcome.) Because it was like the biggest deal ever when we were kids! I blame that on not being able to drive, date or join Facebook without lying. As far as Big Adult Mysteries go, it was really the only one well within our grasp. So of course there was lots of drama around it.

It started with the day all us girls-on-the-brink were separated from the boys-who-snap-bras and taken into a classroom with no windows to be instructed on the proper care and handling of our plumbing. I even got an illustrated comic book with free coupons for Tampax and Kotex in the back – an item particularly cool because all the boys wanted to steal a copy. (And looking back, I think we should have let them. They needed the education as much as we did. And who doesn’t love a good comic illustration of tampon insertion? I know I do! They should have those Toxic Shock Syndrome warnings delivered by Wolverine – there would never be another forgotten feminine hygiene product issue again!)

Some girls (poor things) already had their period by the time our 5th grade lecture rolled around. Other girls (poor things) didn’t get theirs for years later, proving again that when you’re an adolescent there is no right time to spontaneously eject uterine tissue. Me, I was 16. Definitely one of those “late bloomers.” I got mine during a gymnastics practice. My back had been killing me all evening and I was sure I’d pulled a muscle doing a back handspring or something but when I went into the bathroom, well, all I’ll say is that it wasn’t blue like I’d been promised in so many commercials. At home, we had a party for me. No seriously, we did. My mom was a public health educator and my dad is kind of a hippie (in a good way!) so for my two sisters and I “Period Parties” became a fun ritual of malted milk balls in ice cream and chick flicks.

(Side note: I grew up with a family who let their daughters pierce their ears when they got their first period. In theory I think it’s kind of sweet to mark a girl’s passage into womanhood with a grown-up gesture like puncturing holes in her new womanly body. But in practice what it really meant was that we all knew exactly when each girl got her period and that just seems too intimate for the general public to know, right?)

So after all that hullaballoo surrounding the getting and having of our Red Dot (and we won’t even discuss the shenanigans surrounding the First Tampon Insertion – egads), you’d think we’d all be thrilled to have Red Flo Rida come visit every single month. Um, not.

All that bleeding and cleaning and carrying and hiding and lying about being on it and lying about not being on it and hiding your DNA dipstick in the wastebasket at your best friend’s sleepover and covering it with half a roll of toilet paper so her mom wouldn’t know that Nature was happening in her house right at that very second – it’s exhausting! So if there comes a time, as we grow older, that Ye Olde Rusty Stain wants to take a vacay from ruining our panties and our social lives then you won’t see us crying hormonal tears about it.

Except that maybe losing your period is a bad thing. It turns out there’s a point to not being able to cancel your subscription to the Maculate* of the Month Club. Which leads to the point of this post. Over the past two weeks, I’ve gotten three e-mails from readers asking me about amenorrhea, specifically my own experience with losing my period (and getting it back). And because in my world, two’s a trend and three deserves a Times feature, I’m dedicating an entire post to the question of what to do if you lose your period. Never say I don’t love you guys. I love you at least as much as those people I did the feminine hygiene study for and gave them all my used products – for RESEARCH, people. I got paid. Easiest money I ever made. Plus, you ever wonder how those commercials can say their product is 87% more absorbent? You’re welcome.

ANYHOW. On with the show. (Note: A girl who’s dumb enough to sell her used maxi pads to strangers is clearly not smart enough to dispense medical advice. All that follows is my researched opinion. Always see your doctor if you have medical issues.)

What is amenorrhea?

It simply means the absence of monthly menstruation for three months or longer. It can be “primary” – meaning that your cycles never started – or “secondary” – meaning that they started and have now stopped for some reason. There will be a spelling test on it later. (Seriously I have to look up how to spell amenorrhea every. single. time. Like diarrhea. And hemorrhoids. Why do all the disgusting medical conditions have to be so hard to spell?! Stupid double r’s.)

Is it really all that bad not to have a period?

In the social sense, no. If it’s part of treatment for a different medical condition – like taking birth control pills without the period week to treat severe PMS – then no. If the universe were fair and our uteri came with an on-off switch (or at least a sphincter!) then no. But if you lost your period and you’re not sure why, then yes, it’s bad.

Female bodies were designed to grow babies inside them. And if your body feels like for whatever reason it can’t support baby-growing then you may have an underlying health issue that needs to be addressed. Plus, amenorrhea comes with its own health consequences. Infertility, obv. But due to the low levels of estrogen, it can also lead to osteoporosis, which is part of the female athlete triad. In addition, you could have problems from the underlying condition as well. I like to say our menstrual cycles are the canary (cardinal?) in the coal mine when it comes to our bodies. It may seem small and annoying but when it dies, it means there’s trouble below ground.

What is the Female Athlete Triad?

It’s a combination of amenorrhea, osteoporosis (low bone density) and disordered eating. It’s named such because the three are often found together in female athletes that push too hard.

What can cause you to lose your period? 

Short answer: Everything. Longer answer: Everything including stress, medications, eating disorders, illness, hypothyroidism, polycystic ovarian syndrome and even stopping your birth control pills – plus a bunch of other random things. (For a more extensive list, go here.) For me, like a lot of women, I lost my period during the time when I was overexercising and undereating.

How skinny do you have to be to lose your period?

Not very, actually. Every body is different which is why it’s pointless to compare yourself to a teammate, roommate or friend. For myself, I never got emaciated. It seems that for me my body is more concerned about how much body fat I have and less concerned about my weight. I’ve found from experience that any time I drop below about 13% body fat my period is splitsville. It doesn’t matter if my weight is in the healthy range if my body fat is too low.

What do you have to do to get it back?

This one is tricky. If it’s an issue of an underlying illness like hypothyroidism or PCOS then treatment will often return your cycles. For some women, like myself, once I stopped overexercising and undereating it came back on it’s own. It took about 6 months for mine to get back to a regular cycle but it did come back. Other women find however that even when the underlying issues are “fixed”, their ovaries still don’t kick back into gear which necessitates a visit to a doctor, a specialist, hormone therapy or all of the above. Even then, for a few women it never comes back or comes back but stays irregular and/or anovulatory.

Should I see a doctor?

If it’s been several months sans period, yes. At the very least you should be checked to make sure your loss of periods isn’t due to something scary like cancer. At best, your doctor will listen to you about your exercise habits and nutrition and help you see if you are being too extreme. Not everyone is me (lucky ducks!) but I want to add that most women caught in the overexercising/undereating trap really do not have a good grasp on what that looks like, especially in themselves. It’s awfully hard to “cure yourself” when you’re caught up in the middle of it. A doctor can help you see how far out of normal your hormones have gotten and give you a solid reality check. For some women it’s as simple as adding some healthy fats to their diets. For others (like me) it means an entire cessation of ALL exercise for an extended period of time. (I had to go 8 weeks doing nothing but leisurely walking.) And if you don’t think the issue is related to your diet or exercise then seeing an endocrinologist (hormone specialist) can help you look for other issues.

Outside of the realm of traditional medicine there are several alternative therapies that have shown promise in helping bring your cycles back into order. Acupuncture surprisingly has the best track record in the research. Massage therapy or energy therapy can be helpful if your underlying issue is stress. And there are several herbs that can be used although these should be taken under the direction of a qualified doctor or holistic physician as their effects can be quite potent and harmful if misused.

Other resources

There are quite a few books dealing with these issues but two of my favorites are Taking Charge of Your Fertility by Toni Weschler (really just a good read for anyone with a uterus or anyone who loves someone with a uterus) and What Your Doctor May Not Tell You About Premenpause by Dr. John Lee. (Don’t let the title scare you – you don’t have to be anywhere near menopause to find it useful!)

Help a reader(s) out!

Do any of you have any advice or resources for my readers about amenorrhea? Did I get anything wrong? Miss something? Have you ever lost your period? And where were you when you got your Big First??

*Wondering what “maculate” means? Well, you’ve heard of immaculate conception right? Think the opposite of that. Or maybe don’t. Ack.

 

{ 39 comments… read them below or add one }

Swati July 29, 2013 at 5:49 am

I have PCOS and I have never had amenorrhea. But I also think that it’s body fat and not body weight that might cause amenorrhea. Body fat has been shown to be linked to fertility.

Besides ovary, fat cells also secrete estrogen. That’s probably the reason having too much or too less body fat results in messed up hormones.

Interesting read by the way….

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Charlotte July 29, 2013 at 4:17 pm

Good point about the connection between estrogen and fat storing!

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Miz July 29, 2013 at 6:34 am

((sharing with someone who really needs to see this and who is choooooosing not to hear *me* ))

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Charlotte July 29, 2013 at 4:18 pm

:))

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Grace July 29, 2013 at 7:31 am

It’s a good thing we don’t have a sphincter down there. Can you image how hard it would be to squeeze a baby out with a sphincter in the way? It’s hard enough as it is!

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Charlotte July 29, 2013 at 4:24 pm

True!! But at the same time, our butts have a sphincter that is able to open and close with amazing flexibility… (which prob makes me sound like some kind of perv, oops).

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T July 29, 2013 at 7:55 am

If it hadn’t been for losing my period, who knows how long it would have taken me to realise that something was really, actually wrong? Hypothyroidism is sneaky like that.

I tend to envy people who got their period late. I was eleven, very much still a child, and had very little idea what was going on. I was terrified, crying, feeling weird – and had to spend the day at a family gathering with my father who was in a bad mood and refused to understand why I needed to carry a handbag with me. To that lovely start, add terrible PMS and cramps, and losing my period for a while has actually become a very fond memory (medication brought it back).

Oversharing. Sorry. The memories just flooded in and needed to be expulsed.

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Charlotte July 29, 2013 at 4:31 pm

((hugs)) That sounds awful!! As a mom of an 11-year-old myself (albeit a boy) I can’t imagine one so young having to deal with that. Truly 11-year-olds really are still children! And I’m glad you caught your hypoT ! It really is a tricky illness!!

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Megan July 29, 2013 at 9:27 am

I never really “lost” my period, but it would only show up once every few months when I used to run a lot. I wasn’t underweight, I didn’t have low body fat, I just was running a TON so my period was like “Adios!” I didn’t mind, though. My doc said there was no worries. I am not having kids, so I didn’t have that underlying worry about infertility. And honestly, it was fun to not worry about my period! Although the one thing I did miss was having that monthly reminder that I was NOT pregnant. That was always nice…

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Charlotte July 29, 2013 at 4:32 pm

Good point about exercise in general being a possible cause of amenorrhea! And true story about the visible “not pregnant!” confirmation:))

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Amy N. July 29, 2013 at 9:28 am

I didn’t get my period until I was 16 either. I secretly loved it and until my mom threatened to take me to a doctor. The I was terrified that I’d have to admit to a doctor that I didn’t get my period and didn’t want too. I got it the next week. Maybe for me it was all mental.

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Charlotte July 29, 2013 at 4:33 pm

Haha I love it! Maybe it was mental for me too. My best friend hadn’t got her period either and then when she finally did, I got mine a week later. Always been a follower I guess!

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Alyssa (azusmom) July 29, 2013 at 9:55 am

I lost my period for a few months in grad school, when I was anorexic. I wasn’t massively underweight, but between stress, underneating, lack if sleep and working out 15+ hours a week, my period took a powder.
(OK, yeah, that’s kind if a gross image, sorry!)
I got it back after I started dating Hubby and got happy again :).
I first got it at school, in gym class, when I was 13. I had music class afterwards, and horrible cramps.
The best part was that my dad volunteered to go to the store and pick up my supplies. When he got there, he was completely overwhelmed by the selection. Since this was before cell phones, he ended up buying a bunch of different kinds and bringing them home for me to choose from. :)

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Charlotte July 29, 2013 at 4:34 pm

“My period took a powder” buwhahahahhh! That was an awesome visual. And that is so cute about your dad! I love that he did that for you!!

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Emily July 29, 2013 at 10:01 am

I haven’t had a period in 3 years due to ED behaviors. I’ve never been at a super low weight, so I suspect low body fat to be to blame. My Drs have never seemed too worried because my hormone panels fall within normal range. Ive been actively recovering for 4 months, but still no period. Any suggestions? Drs may not be worried, but I am!

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Charlotte July 29, 2013 at 4:38 pm

Having your hormones in the normal range is good! Recovery is a tricky animal for sure. I’m not a doctor but since you asked for suggestions, I’d try and see if I could get my BF% up by eating more healthy fats. This can be really triggering for EDs, esp since most of us learned to fear fat so maybe do this with the help of a nutritionist? Also, it may just take time. Recovery isn’t a point in time, it’s a process and 4 months isn’t terribly long into it:) Like I said above (I think?) it took me about 6 months to get my cycle back. ((hugs)) And congrats on working hard on actively recovering! That’s a huge accomplishment!!

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Abby July 29, 2013 at 10:08 am

I was 12. It was my first day of junior high so I thought the cramps and general ickiness was normal first day stuff. Wasn’t until that night that I realized! My mom baked a cake for me. When my younger brother asked why she said it was because I was so grown up, lol. And that first tampon? Oh god, the drama! Complete overshare but my mom had to do it for me. After that I figured it out but I swear I thought I was deformed.

I stopped getting my period for a long time in college. When it first stopped I wasn’t even underweight, I just wasn’t eating anything. And I managed to get it back when I was underweight, just by eating more. When I did I was more excited than when I first got it! I’m not ready to have babies quite yet but I worry that when I am I may have managed to screw up my fertility with the anorexia. Fingers crossed.

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Smac-a-roo July 29, 2013 at 10:20 am

Hugs, hopefully not, but if you have problems when yo u are ready, don’t hesitate to see a specialist…

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Charlotte July 29, 2013 at 4:41 pm

Aw, your mom is so sweet! And no such thing as an overshare with me;) I remember talking a roommate through her first tampon insertion through the door and begging her to just let me come in and help her because it’s so much easier to figure out once you know where it goes! (She didn’t let me. Probably a good idea, lol.) As for your fertility, I’d say cross that bridge when you come to it. You’re making healthier choices now and doing your best to recover and I think you’ll be amazed at how resilient the human body is:) And if not, like Smac-a-roo pointed out, you’ve got options!

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Smac-a-roo July 29, 2013 at 10:14 am

Got mine at 11 too, was so naive, I cried, went to my mom and told her I was scared and she was livid that is all I was waking her up for! hey, I didn’t even know how to use a pad (and there was no way she would let me use a tampon, those were for mommies (not virgins) yep, those were the late 80s in my village…!

one note about disordered eating, overexercising, or other that lead to low body fat: you may not lose your periods, but don’t discount issues. I had a hard time “keeping” pregnancies due to low hormones, and had at least 2 chemical pregnacies due to my inability to implant (due to low hormones)… At my lowest body fat (not weight), didn’t lose my periods (9%). So don’t think amenorrhea is the only symptom, so you are “ok” :-(

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Kendra July 29, 2013 at 12:56 pm

Yes to this! I continued getting in the depths of my anorexia and compulsive exercise issues. When I entered treatment at 85 pounds and 2.5% body fat, I thought I was fine because my periods were still regular!

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Charlotte July 29, 2013 at 4:45 pm

This is a REALLY good point. The damage to your health can begin long before your periods stop or be independent of your cycle all together. Will not having your period is often a sign that something is amiss, simply having one does not equate to health. Thank you so much for adding your experience!

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Charlotte July 29, 2013 at 4:45 pm

PS. And the “virgin” thing… ay yi yi…

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Jane July 29, 2013 at 10:28 am

Chemo took ” my friend Flo” away for 9 months then I was surprised to have her return like a first timer again, needing pad and tampon to control her. Wouldn’t you know it was a weekend with a houseful of company/ entertaining and lots of people. Worst part was that I had to send my older brother to the store for Midol, which I hadn’t needed in decades. Those cramps were terrible….something I rarely experienced before. Doctors said later “oh, that can happen” . Thanks for the warning doc! To think I had been wearing white crops the evening before with a ton of people… so glad she waited until morning to appear!

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Charlotte July 29, 2013 at 4:47 pm

Oy! So glad it worked out all right and the white capris were saved;) I’m also happy that you (seem to?) have recovered from your cancer!

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Leslie Goldman July 29, 2013 at 11:13 am

I just got it for the first time on my own since I was 19! I had it regularly, every month, for over a decade, but only because of the Pill. When I went off the Pill, it never came back. Then I needed fertility meds to induce it. Had the baby in Feb 2012 and never got it again…until this month! I feel very proud of my body – a bizarre sense of accomplishment. I even called my mom to tell her! Anyhow, I just had my annual exam a few days ago and my ob told me that if I go another 3 months without it coming back, we’ll need to induce it with meds. Apparently it can be a rish for uterine cancer if you go too long without it, and she said I need to be getting it at least once every 3 months. Maybe that’s why Seasonale has users take a break four times a year? So they still bleed once every three months? Anyway, you should be getting an invite to me Red Tent party in the mail soon. xo

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Charlotte July 29, 2013 at 4:49 pm

Wooohooo! Congratulations! I wish we could have a Red Tent party for you:) And so interesting about the risk of uterine cancer rising with cessation of periods – I hadn’t heard that before! And seeing as I was on (the generic of) Seasonale, that makes sense…

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Casey Kay July 29, 2013 at 12:20 pm

I got mine when I was 15. My mother was actually on the verge of taking me to a doctor for bloodwork just to be sure I was anemic or something. The weird thing for me is, rather than losing my period when I get under a certain weight, it happens when I go over a certain weight. Seriously, in tracking both my weight and my periods together, I found out that as I gain weight the cycle gets longer and as I lose it again it gets shorter and more regular. The only time I’ve ever really had regular periods was when I was down at the lower end of the “healthy” weight range for my height. Then again, maybe that is due to me being more active and in general more “healthy” to get to and stay at that range than just the weight itself.

I had always heard the “If you get too skinny, you get amenorrhea,” thing, so I was really confused when losing weight actually helped regulate things for me. Just goes to show that there is no one “solution” to things when it comes to individual health.

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Charlotte July 29, 2013 at 4:53 pm

So interesting about the link for you between gaining weight and amenorrhea! I hadn’t heard that before but I totally believe you. Since the hormones that regulate our cycles are so fine tuned I can see how any fluctuations in weight could throw it off. Thanks for adding your experience!!

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Mary July 29, 2013 at 12:22 pm

You keep using Immaculate Conception. I do not think it means what you think it means. Actually I know it doesn’t because I’m a good little Catholic. The Immaculate Conception refers to the conception of the Virgin Mary. She was conceived the normal old way by her loving parents but unlike the rest of us she was free from the stain of original sin–one might even say *immaculate*–from the moment of her, wait for it, *conception*. The rest of us had to be redeemed by Christ and baptized but she got a free pass with early admission. What you’re thinking of, conception without sex, is the Virgin Birth (and I’m pretty sure that was a one-off event.)

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Charlotte July 29, 2013 at 4:56 pm

Ohmygoodness you are so RIGHT. I truly did not know that was what it meant! Thanks for setting me straight. And I should probably stop misappropriating terms from religions I don’t belong too… Oops. Thanks for the correction and I’ll take that out of my post! I’m sorry if I offended…

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Mary July 29, 2013 at 5:05 pm

Oh Charlotte, you didn’t offend! Most Catholics don’t even get that one right! But that’s the 3rd time I’ve noticed you saying that recently-ish (totally a word!) so, as you say, time for a Times feature. Or dogma spouting blog comment, same dif.

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Aurora July 29, 2013 at 1:23 pm

To be honest, the idea of being so low-fat you don’t get periods seems sort of like a win-win to me. No gouting blood for 1/6 of each month plus looking carved out of stone? Hell yes.

Is it really so bad?

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Charlotte July 29, 2013 at 4:59 pm

Erm, yes. See my answer to question #2. Women need a certain amount of body fat to be healthy. That’s one of the great contradictions of calling women who are ultra-lean, ultra-healthy. There are health repercussions from staying at a too-low body fat % including bone loss, mood disorders, thyroid dysfunction and hormone imbalances:) But I hear you – I wish we didn’t have to deal with it every month either!

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Gaby @ first steps fitness July 29, 2013 at 5:15 pm

I have irregular menstrual cycle too. When I was teen, I didn’t have my period for six months and recently three months. Like you, the culprit is increased physical activity. Glad to know that I am not the only one having this issue. This will surely save me from having paranoia when my period decides to take a leave for months. :D

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MNMama July 29, 2013 at 8:24 pm

I got my “Big First” as Charlotte put it, on a Sunday in November. It triggered a heated argument between my parents (like everything else) and I remember being curled up in the fetal position on my bed overwhelmed by cramps and listening to my parents scream at each other for what seemed like the entire afternoon about me getting my period. That was followed by trips to the Pediatrician as my mother was routinely convinced that I had gotten myself pregnant. For the record, I was a virgin until my wedding day.

Periods are embarrassing for any teen. I felt especially ashamed. As an adult, I confided in my fiancé how I would never check out at the store with a male cashier if I had feminine hygiene products. He decided to cure me of that and took me to the store and HE bought a plethora of Kotex products, checking out with a male cashier. We went to the car and he rolled down the window, put a tampon in his mouth like a cigar, and we drove away. It worked. I was cured. Except for the time I bought KY Jelly, Redi-whip and birthday candles in the same trip and the guy behind me in line at the cash register said he wished he was invited to that party.

“Puberty” conversations with my own daughter have actually been some of our best times together. Our favorite is when I told her the story of when she was two and she got into my panty liners. By the time I found her, she had decorated all the bathroom walls and shower door. We laughed ourselves into tears and paralysis when I told her the story. As lousy as it is every month, I have to thank Aunt Flo for being part of the process that got my daughter here in the first place and for being the butt of our jokes for years to come.

For the record, I, too, have been mixing up “immaculate conception” and “virgin birth” for as long as I can remember. Thanks, Mary! :)

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CarrieB July 31, 2013 at 2:50 am

MNMama, your fiance (hubby now I guess?) is The. Best.
Seriously, that is one of the coolest and sweetest things I’ve read in months.
He’s a keeper! :)

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Kate August 14, 2013 at 5:47 am

Hi,
Im 15 and a half and I have missed my periods for nearly 7 months now. Last year I was in recovery from anorexia, yet in Feb 2013 I had my first for about a year. I got back my periods, I think, by eating a lot. I still exercised a lot, though I got them back (only once, though). I have a healthy BMI, exercise every day, am slim (though not thin) and eat extremely healthily. Although, I am missing my periods. My mum keeps threatening me about osteoporosis and infertility, and I eat well, around 2500 calories each day, but still I am missing my periods. She also won’t take me to the doctor, as the doctor didn’t help much last time.
Can anyone help me and advise me about getting them back? Do I need more fats in my diet (I don’t eat full fat dairy, meat or oils). I really want to have children when Im older and Im worried about my health. Thank you

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