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Pregnancy Isn't the Only Cause of Absent Periods

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I am a consultant obstetrician and gynaecologist at Macclesfield Hospital, in Cheshire, Northern England.

Dr. Mark Trolice, MD, Reproductive Endocrinology and Infertility Specialist, Associate Professor of Ob/Gyn, The IVF Center and UCF College of Medicine


Pregnancy Test Negative After a Missed Period?

You missed your period, but your pregnancy test is negative. There are several possible causes for this that will be discussed later in the article. However, it is extremely important that you first ensure you really aren't pregnant.

Advances in biotechnology have improved the accuracy of home pregnancy tests. Home urine tests for hCG (human chorionic gonadotropin) are now used to confirm or refute blood tests for hCG because, in some women, the blood tests can cross-react with what's called heterophile antibodies (HA) to give a false positive."

However, false negatives in home pregnancy tests can still happen. There are several reasons for a false negative on a home pregnancy test, the most common being that women will take the test too early after a late period. To get accurate results, you should wait to take a pregnancy test two weeks after you miss your period.

If you have ruled out pregnancy, there are 12 other causes of an absent period you should consider.

Can You Miss a Period and Not Be Pregnant?

There are several causes of missed periods other than pregnancy. Amenorrhoea is the medical term for absent periods. There are two types of amenorrhoea:

1. Primary Amenorrhoea

The absence of first menstruation by age 15, or no period more than 3 months after breast development

2. Secondary Amenorrhoea

No period for three cycle intervals, or six months, in women who have been menstruating regularly.

I get a lot of questions from women who report pregnancy-like symptoms, such as a late period and nausea or loss of appetite, even though they are not pregnant. There are several possible reasons for this, ranging from lifestyle changes to drugs/medication and chronic illnesses.


You should rule out pregnancy before considering other causes of an absent period.

Four most common causes of a missed period.

Four most common causes of a missed period.

12 Reasons for a Late Period With No Pregnancy

  1. PCOS (polycystic ovarian syndrome)
  2. Stress
  3. Excessive exercise
  4. Extreme weight loss or weight gain
  5. Medication and drugs
  6. Stopping birth control pills
  7. Pituitary growth
  8. Sheehan's syndrome
  9. Cushing's syndrome
  10. Premature ovarian failure (primary ovarian insufficiency)
  11. Thyroid dysfunction
  12. Asherman's syndrome

1. Polycystic Ovarian Syndrome (PCOS)

According to Dr. Mark Trolice, reproductive endocrinology and infertility specialist at Fertility CARE, "Polycystic ovarian syndrome is the most common hormonal disorder in women, affecting 6-10% of all reproductive-aged women." If you notice you have acne, unwanted body hair, headaches, pelvic pain, extreme fatigue, and no period but are not pregnant, you may have PCOS.

Symptoms of PCOS:

  • Erratic or missed periods
  • Acne
  • Weight gain
  • Fatigue
  • Excess facial/body hair
  • Difficulty conceiving
  • Pelvic pain
  • Headaches
  • Interrupted sleep
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