Missed or late periods can occur for reasons other than pregnancy. Common causes can range from hormonal imbalances to serious illnesses. In general, menstruation means bleeding due to the loss of the inner layer of the uterus or the endometrium. Blood and endometrial tissue are excreted through the cervix and vagina. Every healthy girl, after entering puberty, undergoes hormonal changes once a month. A normal menstrual cycle lasts between 24 and 38 days. This means that each period should start between 24 and 38 days after the start of the previous period.
In some girls, menstrual cycles fluctuate in the early years of puberty. But usually, after a few years, the menstrual cycle becomes relatively stable, regular, and repetitive. Delayed menstruation means a woman who has an irregular menstrual cycle despite reaching puberty and starting menstruation. More precisely, it refers to a time when a regular menstrual cycle lasts more than 35 days, or a person experiences less than nine menstrual periods in a year. There are several reasons for this, some of which are harmless, and it can also be a sign of a more serious disorder and health condition.
Causes of a late period
There are several reasons for the late period.
1. Stress
The body’s stress system is rooted in a part of the brain called the hypothalamus. When stress levels peak, the brain tells the endocrine system to overwhelm the body with hormones, and switch on fight or flight mode. These hormones suppress functions that are not necessary to escape an imminent danger, including the functioning of the reproductive system.
Long periods of stress can affect a woman’s menstrual cycle, make it longer or shorter, or even cause a missed period. Some women also report more painful menstrual cramps if they are stressed. Avoiding stressful situations, regular exercise, and getting enough sleep can help relieve stress and maintain a regular menstrual cycle.
2. Perimenopause
The average onset of menopause is about 52 years old when a woman has not had a period for at least 12 months. During this time, changes in the menstrual cycle are not uncommon. The number of periods may be more or less, the periods may be shorter or longer, and the amount of bleeding may be lighter or heavier. Hot flashes, night sweats, sleep problems, vaginal dryness, and mood swings may also occur.
Many women experience symptoms from several years before menopause. This is known as Perimenopause and indicates that estrogen levels begin to fluctuate. Irregular estrogen levels can alter a woman’s menstrual cycle, causing women to experience irregular or missed periods.
3. Lost or gained weight
Weight can affect the hypothalamus, a gland in the brain responsible for regulating various body processes, including the menstrual cycle. Significant weight loss can cause a woman to lose her period. Being underweight or having a low body fat ratio can alter the levels of reproductive hormones and reduce them to levels where ovulation and menstruation do not occur.
A woman who has lost one or more periods after losing significant weight should consult her doctor or nutritionist about getting the right number of vitamins, minerals, and nutrients her body needs.
On the other hand, being overweight or gaining too much weight in a short period of time causes the body to produce too much estrogen. Excessive estrogen may stop ovulating within a few months or cause the endometrial lining to overgrow and become unstable, resulting in heavy, irregular, or missed periods.
4. Birth control methods
Some types of contraception, especially hormonal methods, can cause a woman to miss her period. Hormonal pregnancy control typically provides a type of estrogen along with progesterone. Withdrawal of these hormones causes menstruation. Sometimes, these hormones keep the uterus lining so thin that there is not enough lining to make a period. This applies to all forms of hormonal birth control, including pills, patches, shots, implants, and rings.
5. PCOS
PCOS is one of the most common hormonal disorders among women of childbearing age. Polycystic Ovary Syndrome is a set of symptoms caused by reproductive hormone imbalances. People with PCOS do not ovulate regularly.
Although symptoms vary from woman to woman, those with PCOS have abnormal hormone levels that cause small cysts in the ovaries, acne, excess facial and body hair, male pattern baldness, and obesity. Ovarian cyst pain occurs in some women. Irregular menstruation, or even the absence of menstruation, is one of the symptoms of this disease. Women with suspected PCOS should see a gynecologist for evaluation. If left untreated, the absence of different periods during the reproductive years can lead to endometrial cancer.
6. Pregnancy
Women should not rule out pregnancy as a possible cause of late menstruation, even if they use contraception. Women can still get pregnant, even if they use contraception properly. A sexually active woman with a late period should use a home pregnancy test. It is important to note that no contraceptive control is 100% effective. If your period is usually irregular, it is more difficult to find the right time to have a pregnancy test.
The best time to take a pregnancy test
Home pregnancy tests or baby checks are often urine tests, and for most women, the best time to get a pregnancy test is at least one week after the normal time each month to start menstruating. These tests measure the amount of placental gonadotropin, or hCG, in the urine, but only when the hormone has reached a certain level. If this type of test is done too early, the amount of hCG in the urine may not be high enough to test positive.
Another type of pregnancy test measures the amount of hCG in the bloodstream. Blood tests are more sensitive than urine tests. Therefore, they can measure much smaller amounts of the hormone hCG. They can detect pregnancy earlier than urine tests, usually 6 to 8 days after ovulation.
7. Thyroid condition
The thyroid is a butterfly-shaped gland in the neck that produces hormones that help regulate many bodily functions, including the menstrual cycle. There are several common thyroid diseases, including hypothyroidism and hyperthyroidism. Hypothyroidism and hyperthyroidism can affect the menstrual cycle and cause irregularities, but hyperthyroidism is more likely to cause missed or late periods.
8. Excessive exercise
Exercise is good for the body. However, when this is done too much, and meals may be limited, the body may not produce enough estrogen to complete the menstrual cycle. Some women, such as ballet dancers, gymnasts, and professional athletes, are at higher risk for amenorrhea. Excessive exercise without getting enough calories can also be disruptive.
9. Early menopause
Early menopause, or premature ovarian failure, occurs when the ovaries stop working before age 40. When the ovaries do not work properly, they do not produce enough estrogen. Symptoms of menopause develop when estrogen levels drop to the lowest level. Missed or late periods may be an early sign. Other symptoms include hot flashes, night sweats, and trouble sleeping.
10. Breastfeeding
The mother may not have a period after the baby is born. It is normal not to menstruate while breastfeeding. This stage, called lactating amenorrhea, is a stage that disrupts the rhythm of the menstrual cycle. After a few months, menstruation begins, and the time of onset varies in different mothers.
11. Change in schedule
Changing jobs, for example, working night shifts instead of a day or traveling, can disrupt the body’s internal clock, which helps regulate hormones. Sometimes this leads to a missed or late period, but when the body changes to new conditions or the program return to normal, the menstrual cycle returns to normal.
12. Uterine fibroids
Uterine fibroids are a non-cancerous growth of uterine cells and can cause severe periods and long periods. This irregularity can cause a late period.
When to see your doctor
Your doctor can correctly diagnose the cause of your delayed or missed period and talk to you about treatment options. Keep track of changes in your cycle as well as other health changes to show your doctor. This helps OBGYN identify the cause. See a doctor right away if you have any of the following symptoms:
- Unusually heavy bleeding
- Fever
- Severe pain
- Bleeding that lasts longer than seven days
- Nausea and vomiting
- Bleeding after entering menopause and had no periods for a year
Natural ways to induce a period
There are several reasons why a woman wants to induce her period. But it is important to note that if a person is pregnant, induction of menstruation can lead to miscarriage. Natural solutions to induce menstruation include:
- Vitamin C: Some people believe that vitamin C, also called ascorbic acid, can cause menstruation. But there is no reliable scientific evidence to support this claim. Vitamin C is thought to increase estrogen levels and decrease progesterone levels. This causes the uterus to contract and the uterus lining to rupture, leading to the onset of menstruation.
- Pineapple: Pineapple is a rich source of bromelain, an enzyme thought to affect estrogen and other hormones.
- Ginger: Ginger is a traditional menstruation treatment believed to cause uterine contractions. Eating raw ginger is unpleasant, so the easiest way to use it is to make ginger tea.
- Relaxation: Stress can sometimes cause delayed or missed periods. When we feel stressed, hormones such as cortisol or adrenaline are produced. These can prevent the production of estrogen and progesterone, which are essential for maintaining a regular menstrual cycle.
- Sex: Sexual activity can stimulate menstruation in several ways. Having an orgasm dilates the cervix. Regular sex can also reduce the effects of stress and help maintain a healthy hormonal balance.
- Reducing exercise: Athletes who exercise hard and for a long time upset their hormonal balance. Decreasing the amount of exercise can cause a regular menstrual cycle.
- Birth control: A longer-term solution to the problem of irregular menstruation is to use hormonal contraception. By controlling the level of hormones in the body, these contraceptives can be somewhat sure of when menstruation begins.
- Hot water bath or hot compress: A warm bath can relieve muscle cramps and emotional stress and may help with menstruation. Use a soothing aromatic oil in the bath for more effect. You can also try using a warm compress, such as a hot water bottle, and placing it on your stomach. The heat is not just soothing; it increases local blood flow and slowly speeds up the menstrual cycle.
The bottom line
Menstruation is one of the basic processes in a woman’s body, and it is the process by which a woman can get pregnant. In general, delayed menstruation occurs when a woman becomes pregnant or when menopause; these are two common cases that cause delayed menstruation and are normal, but apart from these, other cases may cause late periods. To check for late periods, women should see a gynecologist.
Arjang Naim, MD, first diagnoses the cause of the delay in the period and then performs the necessary treatments.
Additional questions
- what is Menometrorrhagia?
Menometrorrhagia is characterized by abnormal, heavy, prolonged, and irregular uterine bleeding. Women with this condition usually bleed more than 80 ml or 3 ounces during the menstrual cycle.
2. How much delay is normal in the period?
If there is no known disease that affects the menstrual cycle, the next period should start within 21 to 35 days of the last period, depending on the natural cycle. Regular periods can vary.
3. What hormones are produced in the hypothalamus?
- Thyrotropin-releasing hormone (TRH)
- Gonadotropin-releasing hormone (GnRH)
- Growth hormone-releasing hormone (GHRH)
- Corticotropin-releasing hormone (CRH)
- Somatostatin
- Dopamine
4. What causes high estrogen in females?
- Fat tissue (adipose tissue)
- Stress
5. What are common thyroid disorders?
- Goiter
- Hyperthyroidism
- Hypothyroidism
- Thyroid cancer
- Thyroid nodules
- Thyroiditis
References
https://www.healthline.com/health/how-late-can-a-period-be
https://www.verywellhealth.com/reasons-you-missed-your-period-2757503
https://www.whattoexpect.com/getting-pregnant/missed-period/
https://www.parents.com/pregnancy/signs/symptoms/7-reasons-for-a-late-period-other-than-pregnancy/