The Hypothalamic-Pituitary-Ovarian Axis (HPO)
by Dr Peta Wright
The HPO axis stands for the hypothalamic-pituitary-ovarian axis. It’s a mouthful and basically describes the messages from the brain to the ovary and back again that continue throughout your reproductive life.
Periods in the years after the first menstrual period can be irregular and I see so many young women being put on the pill at this time and told that it will ‘regulate’ their cycles. The reproductive system takes around 2 years on average to mature and up to 8 years to reach full maturity.
It’s like having your reproductive training wheels on.
It takes practice for the brain to successfully coordinate ovulation with the ovaries, and while ovulation is a bit hit and miss periods can be irregular too. There are lots of things we can do to support healthy ovulation and maturation of the HPO.
Time is the biggest thing followed by giving young women an awareness of factors which effect ovulation – diet, sleep, stress, exercise, etc and also supporting girls with heavy periods using supplements, non-hormonal medications, or progesterone, while their bodies are still on their training wheels, but the pill simply turns the messages between the brain and ovary off.
The HPO axis has been unable to practice and master ovulation so it’s not surprising that periods can still be irregular when women in their late 20s or 30s do eventually go off the pill. Then they can be misdiagnosed with PCOS or be sent down the rabbit hole of fertility treatment. Some young women who start the pill for irregular cycles may also develop other problems which may impact ovulation over time, but because they have been getting a regular ‘period’, their issues are masked and by the time they do address them they are racing the ovarian clock.
The pill is also linked to a higher incidence of anxiety and depression particularly in adolescents. It does not come without side effects and risks and often there is no need to ‘correct’ a normal part of development by literally turning off the reproductive system.
It is imperative that the decision to go on the pill at this time is properly informed and all the potential risks have been discussed.
