Treating Missing or Irregular Periods (Amenorrhea) in Bothell, WA

Naturopathic Treatment for Missing or Irregular Periods (Amenorrhea) in Bothell

Diagnosis drives everything here, because the treatments for the common causes are almost opposites — a woman with functional hypothalamic amenorrhea needs more food and less exercise, while a woman with PCOS and insulin resistance often needs the reverse. Dr. Sanika works through a structured differential: pregnancy first, then thyroid function, prolactin, FSH, LH, estradiol, and androgens, with the LH-to-FSH ratio and androgen picture helping to separate PCOS from hypothalamic suppression, where both LH and FSH are typically low. Where prolactin is elevated or ovarian insufficiency is suspected, she refers for imaging and endocrinology input. For functional hypothalamic amenorrhea, treatment is direct and often uncomfortable to hear: energy availability has to increase. That means eating more, frequently substantially more, reducing training volume and intensity, restoring carbohydrate intake, and addressing the psychological stress load and the beliefs about food and body that commonly sit underneath. Clinical nutrition rebuilds intake in a structured way, and recovery of cycles typically takes several months rather than weeks. Where PCOS is the cause, the approach shifts to insulin sensitivity, inositol, and ovulation support. Throughout, Dr. Sanika is explicit that bone density is being lost while estrogen is low, which is why using hormonal contraception to produce a monthly withdrawal bleed is not a solution — it creates the appearance of a cycle without restoring the underlying hormonal signalling or reliably protecting bone. Functional lab testing tracks recovery through repeat hormone panels rather than relying on the return of bleeding alone.