Reasons for a Delayed Menstruation: Pregnancy, Pressure, Hormonal Changes, among others
Missing a period can be a cause for concern, but it's important to remember that there are several reasons why this might happen, beyond pregnancy and polycystic ovary syndrome (PCOS).
PCOS, a hormonal disorder common among people of childbearing age, can cause irregular or absent periods, among other symptoms. However, hormonal imbalances beyond PCOS can also disrupt the menstrual cycle. These include thyroid dysfunction, pituitary disorders, and early ovarian failure[1].
High stress levels can inhibit the brain signals that regulate your menstrual cycle, leading to missed periods[1][3]. Significant weight changes or poor nutrition, whether through extreme weight loss, insufficient body fat, or rapid weight gain, can affect estrogen production, potentially stopping ovulation or preventing the uterine lining from shedding[1][2][3].
Excessive or strenuous exercise can cause amenorrhea (absence of menstruation), especially in athletes[1][2][4]. Some types of birth control, particularly hormonal methods, can also cause a person to miss a period[2][3][4].
Lifestyle and environmental changes, such as traveling across time zones, shift work, changes in sleep routines, or weather alterations, can disrupt the body’s internal clock and hormonal balance, resulting in late or missed periods[1][2]. Breastfeeding increases the hormone prolactin, which suppresses estrogen and can delay menstruation postpartum[3].
Acute illness or bodily stress can temporarily halt menstruation[5]. A pituitary tumor or prolactinoma can interfere with the menstrual cycle by raising levels of the hormone prolactin[6]. Being underweight or having a low body-fat ratio can alter reproductive hormone levels, leading to missed periods[7].
Perimenopause, the period before menopause, can cause irregular or missed periods due to fluctuating estrogen levels. Hormonal birth control methods, including pills, patches, shots, implants, and rings, can sometimes cause a person to miss their period due to hormones thinning the lining of the uterus[6].
If you are experiencing irregular or missed periods, it's essential to keep a written record of the start and end dates, as well as a list of other symptoms. This information can help a doctor determine the cause. A sexually active person with a late period can take a home pregnancy test.
Thyroid hormones play an important role in menstruation, so having an underactive or overactive thyroid can disrupt the menstrual cycle[1]. Prolonged stress can affect the menstrual cycle, making it longer or shorter, or causing a missed period[8].
Avoiding stressful situations, regular exercise, and getting enough sleep can help maintain a regular menstrual cycle. If you are concerned about missed periods or any other symptoms, it's always a good idea to consult with a healthcare professional. They can determine the cause of any hormone imbalances and may recommend a blood test to see whether certain hormone levels are high or low.
[1] Mayo Clinic. (2021). Missed period. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/missed-period/art-20048087 [2] American College of Obstetricians and Gynecologists. (2021). Birth control methods. Retrieved from https://www.acog.org/womens-health/faqs/birth-control-methods [3] American Pregnancy Association. (2021). Missed period. Retrieved from https://americanpregnancy.org/getting-pregnant/missed-period/ [4] National Eating Disorders Association. (2021). Eating disorders and your period. Retrieved from https://www.nationaleatingdisorders.org/learn/about-eating-disorders/health-implications/your-period [5] Cleveland Clinic. (2021). Missed period. Retrieved from https://my.clevelandclinic.org/health/symptoms/10604-missed-period [6] Johns Hopkins Medicine. (2021). Polycystic ovary syndrome (PCOS). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos [7] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. [8] American Psychological Association. (2018). Stress and your menstrual cycle. Retrieved from https://www.apa.org/topics/stress/menstrual-cycle
- Outside of pregnancy and PCOS, hormonal imbalances such as thyroid dysfunction, pituitary disorders, and early ovarian failure can disrupt menstruation.
- Hormonal birth control methods can sometimes cause a person to miss their period due to hormones thinning the lining of the uterus.
- Stress, whether chronic or acute, can affect the menstrual cycle, leading to missed periods or irregular cycles.
- Science has shown that poor nutrition, excessive exercise, and lifestyle changes can also affect estrogen production and menstruation.
- Perimenopause, the phase before menopause, is characterized by fluctuating estrogen levels which can cause irregular or missed periods.
- If a person is experiencing irregular or missed periods, keeping track of start and end dates, as well as other symptoms, can help a doctor make a diagnosis.
- In conditions like COPD, menstruation may be affected, highlighting the importance of women's health and health-and-wellness in general.
