Maybe you haven’t lost your period; you never started getting it in the first place. What should you do?
Dr. Jennifer Guadiani advises that you get a really thoughtful medical workup. She details the questions regarding your history that you should be prepared to answer, and suggests tests that a health practitioner may want to run. RED-S / REDs (Relative Energy Deficiency in Sport) is often the cause of amenorrhea, but as she explains, it’s by no means the only one.
Read the transcript
[Tina] I’ve never had a period. What should I do?
[Jen] Those who have never had a period are advised to go get a really thoughtful workup. So this could be a 14-year-old, a 17-year-old, a 23-year-old or a 30-year-old. If they’ve not yet been worked up, it’s time to go to the doctor and it’s time to give a really honest history. Here’s when I went through puberty.
[Tina] How would someone know that if maybe they didn’t have their period?
[Jen] That’s a great question. You know, here’s when I started to develop body hair, here’s when I started to develop, if somebody was assigned female, breast tissue, if somebody was assigned male, here’s when my voice began to drop, etc. Here’s my family history of when people in my family who are assigned female at birth began to go through puberty. And let’s talk about my history of athletics, my history of nourishment, my history of other physical symptoms.
There are a lot of reasons why somebody might not get a period, and not all of them have to do with RED-S, by any means. There are any number of anatomic, genetic, and other causes that can lead someone not to have gotten a period, so a good, thoughtful, primary care doctor, nurse practitioner, or physician assistant can begin that workup. A gynecologist is really well equipped to begin that work up, as is an endocrinologist, because there’s a lot of tests that we may want to run to just get a better understanding of what’s happening.
[Tina] And would you say one of those in particular? Would it be getting like a feel with, a connection with, that person to really, once you’ve got all those results, which one to continue pushing forward with that journey to get it to come would be?
[Jen] Absolutely. We’ve got blood work to do, and that’s going to include estradiol, LH, FSH, testosterone, sex hormone binding globulin, thyroid… It’s also going to involve possibly an ultrasound. Let’s see, does this person have a uterus? Do they have ovaries? You know, is there some sort of genetic mosaicism or condition in which there actually wasn’t the capacity to have a period? So there’s all sorts of really interesting pathways to walk down without judgment, and just with an open heart, an open mind, to figure out what’s going on.
[Tina] Okay, thank you.
check it out
Recovering from RED-S is hard. It’s even harder if you’re working through it alone. Even if you have professional support, they’re not available 24-7, and that can lead to going down search engine rabbit holes that have the potential to derail everything.
Our online resource, RED-S: Realize. Reflect. Recover, will answer all those questions swimming around in your head about recovery. It will give you the opportunity to connect with the experts you’ve come to know here, and to surround yourself with a community of others who are going through it too. THANK YOU! to Athletic Greens and Tracksmith for supporting this YouTube series and RED-S: Realize. Reflect. Recover.
Go to athleticgreens.com/reds to get five free travel packs of AG1 and a free one year’s supply of vitamin D3+K2 with your subscription!
When you go to https://tracksmith.com/tina and use the code TINA15 at checkout, you’ll get free shipping and Tracksmith will donate 5% of your order to Rising Hearts, the Indigenous-led nonprofit founded by Jordan Marie Daniels.
more about Dr G:
Dr. Jennifer Gaudiani, CEDS-S, FAED, is an internist who specializes in eating disorders. She practices from a deeply anti-diet, weight-inclusive perspective and partners with therapists and dietitians around the country to ameliorate medical roadblocks in patients’ recovery journeys. Her book, “Sick Enough: A Guide to the Medical Complications of Eating Disorders,” is for patients, families, and practitioners. You can find Jen at https://gaudianiclinic.com
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