Low AMH But Regular Periods: What This Actually Means for Fertility

If your AMH is low but your periods are regular, you’re probably getting mixed messages.

You may have been told:

• “Your cycles are normal, so that’s reassuring.”
  
  

• “AMH doesn’t matter unless you’re doing IVF.”
  
  

• “Let’s wait and see.”
  
  

And yet, something doesn’t sit right.

This pattern, low AMH with regular periods, is one of the most misunderstood fertility scenarios. It often leaves people feeling dismissed, confused, and unsure whether they should act or wait.

Let’s clarify what this combination actually means.

What AMH measures vs what your period tells us

At Fab Fertile, we see this pattern often in women over 35 who are still cycling regularly but feel something is off. Understanding what this combination means can help you avoid waiting without a plan.

AMH reflects ovarian reserve, meaning the remaining pool of follicles in the ovaries.

Your period tells us something different:

• that estrogen rose enough to build a uterine lining
  
  

• that the lining shed
  
  

A regular period does not tell us:

• egg quality
  
  

• mitochondrial health of the egg
  
  

• strength of ovulation
  
  

• adequacy of progesterone
  
  

• how resilient the ovaries are to stress
  
  

That’s why low AMH and regular cycles can coexist.

Research shows AMH reflects ovarian reserve rather than egg quality or live birth potential in natural conception scenarios

Why you can still ovulate with low AMH

In the earlier or compensated stages of ovarian decline, the body adapts.

The brain and ovaries may:

• increase signaling to recruit follicles
  
  

• maintain ovulation despite fewer follicles
  
  

• preserve cycles even as reserve declines
  
  

This compensation can mask underlying vulnerability for years.

AMH often declines before cycles change.

What you may be feeling (even if labs look “fine”)

Many women in this category describe:

• worsening PMS
  
  

• spotting before periods
  
  

• subtle cycle changes
  
  

• anxiety around timing and waiting
  
  

• feeling dismissed because cycles are regular
  
  

These experiences are common and meaningful. They’re often early signals that the system is under strain, even if periods continue.

What doctors often say (and what’s missing)

You may hear:

• “If you’re cycling, you’re fertile.”
  
  

• “AMH doesn’t predict natural pregnancy.”
  
  

• “Come back if your cycles change.”
  
  

These statements aren’t entirely wrong, but they’re incomplete.

They don’t address egg quality, stress resilience, inflammation, or the biological cost of waiting without a plan.

The Functional Fertility lens: what matters beyond AMH

When AMH is low, but cycles are regular, we look at how the whole system supports ovulation and implantation, including:

• ovarian signaling (AMH, FSH trends, estradiol, progesterone)
  
  

• thyroid signaling (not just TSH)
  
  

• gut microbiome and hormone clearance
  
  

• vaginal microbiome and immune balance
  
  

• blood sugar stability
  
  

• mineral status (HTMA)
  
  

• nervous system and adrenal signaling
  
  

• sleep and circadian rhythm
  
  

This context matters more than any single lab value.

Gut microbiome: hormone clearance matters

Hormones don’t just need to be produced. They need to be cleared.

The gut plays a key role in:

• estrogen metabolism
  
  

• inflammatory signaling
  
  

• immune balance
  
  

Gut dysbiosis can lead to estrogen recirculation and chronic low-grade inflammation, even when blood hormone levels look normal.

This is especially relevant if you have a history of:

• bloating or constipation
  
  

• IBS or food sensitivities
  
  

• antibiotic use
  
  

• “healthy diet” with poor digestion
  
  

Thyroid signaling: the quiet fertility driver

You can have regular cycles with impaired thyroid signaling.

Thyroid function affects:

• follicle sensitivity to FSH
  
  

• progesterone signaling
  
  

• ovulation strength
  
  

• implantation readiness
  
  

Many women are told their thyroid is “normal” based on TSH alone, without evaluating conversion, antibodies, or stress interference.

With low AMH, even subtle thyroid inefficiency can matter.

Blood sugar stability and egg quality

Blood sugar swings increase:

• oxidative stress
  
  

• inflammatory signaling
  
  

• stress hormone output
  
  

This directly impacts egg quality and progesterone production.

This pattern is common in:

• high achievers
  
  

• under-eating
  
  

• intermittent fasting
  
  

• long gaps between meals
  
  

• over-exercising
  
  

Even with normal A1C, unstable daily blood sugar can strain already vulnerable ovaries.

Nervous system and adrenal signaling

Chronic stress doesn’t usually stop periods right away.

Instead, it:

• flattens LH signaling
  
  

• reduces progesterone output
  
  

• alters ovarian blood flow
  
  

• prioritizes survival over reproduction
  
  

Low AMH ovaries are less forgiving of prolonged stress.

This is physiology, not mindset.

HTMA: mineral patterns that don’t show up on bloodwork

Hair Tissue Mineral Analysis often reveals:

• low magnesium (mitochondrial stress)
  
  

• zinc and copper imbalance (egg development)
  
  

• calcium dominance (stress adaptation)
  
  

• slow oxidation patterns
  
  

These patterns are common when cycles look normal, but fertility feels fragile.

Vaginal microbiome and implantation readiness

Even with regular periods, vaginal microbiome imbalance can:

• impair implantation
  
  

• disrupt immune tolerance
  
  

• increase local inflammation
  
  

This is rarely assessed unless there are recurrent losses or IVF failure, yet it plays a meaningful role in early pregnancy success.

Inflammation: the common thread

Chronic low-grade inflammation:

• doesn’t stop cycles
  
  

• doesn’t always show on basic labs
  
  

• quietly degrades egg competence
  
  

It’s often driven by a combination of gut imbalance, stress, blood sugar instability, sleep disruption, and immune signaling.

Sleep and circadian rhythm

Sleep is not optional for fertility signaling.

Poor sleep:

• increases cortisol
  
  

• disrupts melatonin (a key egg antioxidant)
  
  

• worsens insulin sensitivity
  
  

• impairs progesterone output
  
  

With low AMH, sleep debt has a bigger impact.

Action items if you have low AMH but regular periods

• Don’t rely on AMH alone to guide decisions
  
  

• Avoid “wait and see” without a clear plan
  
  

• Assess ovulation quality, not just ovulation
  
  

• Evaluate thyroid, gut, and stress physiology
  
  

• Stabilize blood sugar and prioritize sleep
  
  

• Consider vaginal microbiome assessment if trying >6–12 months
  

If you want a deeper breakdown, you may find this helpful: [How to improve egg quality with low AMH]

Frequently Asked Questions

Can you get pregnant naturally with low AMH and regular periods?

Yes, pregnancy is possible. Regular periods suggest ovulation is still occurring. The key question is not if ovulation happens, but how strong and resilient it is.

Does a regular period mean ovulation is strong?

No. A regular period does not mean ovulation is strong.

A period only confirms that estrogen rose and the uterine lining shed. It does not show egg quality, ovulation strength, progesterone adequacy, or how resilient the cycle is to stress.

With low AMH, ovulation can still occur due to compensation, but it may be weaker and less supportive of implantation, even when cycles appear normal.

Does low AMH mean I should rush into IVF?

Not automatically. Low AMH indicates fewer follicles, but outcomes depend heavily on egg quality, preparation, and overall physiology. Rushing without addressing underlying imbalances can reduce success.

Why do doctors say my fertility is fine if my periods are regular?

Because regular cycles are often used as a proxy for fertility. However, cycles don’t reflect egg quality, stress resilience, or implantation readiness.

Can stress really affect fertility if I’m still cycling?

Yes. Stress often impacts progesterone, egg quality, and implantation before it affects cycle regularity.

Should you wait if your AMH is low but cycles are regular?

Waiting for cycles to change can mean missing an important preparation window. AMH often declines years before cycles become irregular.

Key takeaway

Low AMH with regular periods is not reassurance. It’s information.

For many, this pattern represents a window where targeted preparation can meaningfully influence outcomes, before fertility becomes more fragile.

If you’re navigating low AMH with regular periods and unsure whether to act or wait, having your full picture reviewed can help bring clarity before decisions feel urgent. Send a message to hello@fabfertile.ca, subject line FERTILE or book your call here.