Pregnancy Isn't the Only Cause of Absent Periods

Updated on April 20, 2018
akanga1 profile image

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

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

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.

Important

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

In a typical case of PCOS, the affected woman may find that her periods are unpredictable. She may sometimes go several months without one, or she may bleed every day to the point of anemia. The underlying cause of PCOS is usually an abnormal hormonal environment. In the majority of cases, a successful reduction of body weight to a normal body mass index (BMI) will lead to a resumption of regular periods and ovulation, or it at least may facilitate induction of ovulation with medications.

Ovarian cysts are generally benign, but in some cases, they can cause immense pain, nausea, and late periods.
Ovarian cysts are generally benign, but in some cases, they can cause immense pain, nausea, and late periods.

Functional Ovarian Cysts

During ovulation, small, fluid-filled sacs can form on the ovaries. These are common in all women and are typically benign—you may not even notice the symptoms. However, if the cysts become too large, twist the ovary, or rupture, they can cause pain in the abdomen and lower back, sore breasts, nausea and vomiting, and delayed menses.

If you have a late period and nausea but are not pregnant, your doctor may check for ovarian cysts. They may order ultrasounds and hormone level tests to determine the severity and any underlying hormonal cause.

Ovarian cysts typically go away on their own after a few weeks and up to a few months. In some cases, your doctor may tell you to take birth control pills to reduce the risk of cyst formation by preventing ovulation. In severe cases, surgery is required to remove the cysts.

2. Stress

Mental or emotional stress or anxiety can cause absent periods. Death of a loved one, exams, marital difficulties, and stress at work can cause a woman to miss her periods—sometimes for several months at a stretch.

3. Excessive Exercise

Excessive or intense exercise can also affect menstruation. The female athlete triad—defined as an energy deficit (with or without an eating disorder), decreased bone density, and absent period—is common in young women who participate in competitive sports. Up to half of long-distance runners and around 4 out of 10 professional ballet dancers will experience secondary amenorrhoea. Excessive exercise can lead to the shut down of the hypothalamus, the part of our brain that regulates our hormones through control of the pituitary gland. This is one of the ways that the body deals with the excessive energy expenditure that it is being put through. In the case of ballet dancers, the situation is worsened by the fact that they tend to maintain a restricted calorie intake.

Once the athlete reduces training duration, frequency, or intensity, or increases caloric intake, periods should resume. However, this is not guaranteed and depends on other factors like age and duration and severity of the caloric deficit.

Absent periods are a common occurrence among marathon and other long-distance athletes.
Absent periods are a common occurrence among marathon and other long-distance athletes. | Source

4. Extreme Weight Loss or Weight Gain

Anorexia Nervosa

Anorexia nervosa is a serious psychiatric condition in which the patient is severely underweight and is almost always accompanied by absent periods. The mechanism behind this relationship is similar to how excessive exercise causes missed periods. A caloric deficit puts the body under metabolic stress that can affect the hypothalamus' ability to balance hormones.

Sudden loss of weight not associated with anorexia (e.g. through surgery) can also lead to missed periods, especially if the weight is lost rapidly over a short period of time.

Obesity

Obesity is a metabolic condition that increases systemic inflammation. Excessive weight gain alone does not affect menstruation, but it may indicate other health conditions, most commonly PCOS. The excess adipose tissue and increased inflammation can also lead to changes in levels of estrogen and testosterone, resulting in hormone dysregulation that can delay menses. As little as 5-10% of weight loss may restore ovulation and menses.

5. Medication and Drugs

Drugs that can cause a missed period:

  1. Anti-blood pressure medications like methyldopa
  2. Antidepressants
  3. Antipsychotics (phenothiazines like chlorpromazine, thioridazine, and prochlorperazine)—elevate levels of prolactin, resulting in suppression of estradiol and progesterone
  4. Anti-epilepsy drugs
  5. Chemotherapy

Metoclopramide (Maxolon, Reglan, or Pramin) is another drug that can result in temporary cessation of periods. It is mainly used as an antiemetic (to control nausea and vomiting), making it unusual for it to be taken for a prolonged duration. In general, metoclopramide should not be used for more than 3 months at a time.

6. Stopping Birth Control Pills

Some women, after using birth control pills for a long time, will find that when they come off, their periods do not resume, at least not for a few months. This is known as post-pill amenorrhoea. This can also happen after using other forms of contraception, especially the injection Depo-Provera.

Periods should return within 1-3 months after discontinuing the pill. If menstruation does not return after 3 months, you should consult your doctor and go through the same evaluations as any other woman with amenorrhea. To confirm that you are not pregnant, your doctor may order a hormone profile blood test and a pelvic ultrasound.

The menstrual cycle and hormone balance are largely regulated by the hypothalamus and pituitary gland.
The menstrual cycle and hormone balance are largely regulated by the hypothalamus and pituitary gland. | Source

7. Pituitary Growth

The pituitary is a tiny gland in the brain that is responsible for the production of a variety of vital hormones. One of these hormones, prolactin, stimulates milk production. Pituitary growth or adenoma causes overproduction of prolactin (hyperprolactinemia).

If you notice acne and missed periods, but you're not pregnant, you could have hyperprolactinemia.

Other symptoms include:

  1. Hirsutism (excess body/facial hair growth)
  2. Vaginal dryness
  3. Galactorrhea (milky discharge from breasts but not pregnant or breastfeeding)

Typically, treatment involves medication to suppress prolactin production. Once prolactin levels are back to normal, regular menses should resume.

8. Sheehan's Syndrome

Sheehan's syndrome describes severe blood loss due to postpartum hemorrhaging (bleeding after childbirth). The loss of blood leads to poor oxygenation of the brain, in particular, the pituitary gland, resulting in low levels of pituitary hormones, including luteinizing hormone (LH) and follicle stimulating hormone (FSH) that regulate the menstrual cycle.

Symptoms of Sheehan's Syndrome:

  • No periods
  • Fatigue
  • Difficulty thinking
  • Cold even in warm weather
  • Weight gain
  • Low blood pressure
  • Low blood sugar

Treatment usually involves hormone replacement therapy to make up for the loss of pituitary hormone production.

9. Cushing's Syndrome

Cushing's syndrome is characterized by overproduction of ACTH by the adrenal glands or pituitary glands because of hormone-producing, non-cancerous tumors. This results in prolonged, elevated blood levels of cortisol, the stress hormone. Elevated levels of cortisol can also be caused by taking corticosteroids like prednisone.

Symptoms of Cushing's Syndrome:

  • High blood pressure
  • Weight gain in the upper body and face
  • Loss of bone density
  • Loss of muscle
  • Easily bruised skin
  • Facial hair (in women)

In women, Cushing's disease can also affect menstruation, causing periods to stop.

Treatments involve the patient stopping the use of cortisol-like medication or surgery to remove the tumors producing excess ACTH.

10. Premature Ovarian Failure

Premature ovarian failure is also called primary ovarian insufficiency or premature menopause. It is estimated that up to 1% of women go into menopause before the age of 40. It is not yet known why ovaries can stop functioning before menopause. Premature ovarian failure has been known to happen to girls in their late teens and early twenties.

Symptoms of Premature Ovarian Failure:

  • Absent period
  • Hot flashes
  • Night sweats
  • Irritability
  • Difficulty conceiving
  • Decreased libido

A hormone profile blood test is used to form a diagnosis. Note that once diagnosed, 50% of women can still experience sporadic ovulation, and 1-5% may still conceive. Premature ovarian failure is usually irreversible.

11. Thyroid Dysfunction

Although thyroid dysfunction isn't a direct cause of absent periods, because it controls metabolism and affects so many other organs, it could be the underlying cause. Either underactive or overactive thyroid disease can cause absent or erratic periods.

Underactive Thyroid

If you notice fatigue and late periods, but you are not pregnant, you may have an underactive thyroid.

Symptoms of an Underactive Thyroid:

  1. Fatigue
  2. Late period
  3. Cold even in warm weather
  4. Low mood
  5. Weight gain
  6. Dry, brittle hair and nails

Treatment involves prescription of synthetic thyroid hormone, like levothyroxine, to supplement the body's natural production of thyroid hormone.

Overactive Thyroid

If you feel are hyperactive, sweating excessively, experiencing weight loss, and you have a late period, although it's not very common, you may have an overactive thyroid.

Symptoms of an Overactive Thyroid:

  • Restlessness or hyperactivity
  • Hair loss
  • Absent or erratic periods
  • Heart palpitations
  • Feeling warm and poor tolerability of heat
  • Sweatiness
  • Weight loss, even though there may be increased appetite

Graves' disease is the main cause of excessive thyroid hormone production. Treatment involves taking radioactive iodine or antithyroid medication.

12. Asherman's Syndrome

Asherman's syndrome is a rare condition characterized by the formation of scar tissue, or adhesions, in the uterus, usually after uterine surgery, for example, dilatation and curettage (D&C).

The build-up of scar tissues leads to sparse or absent periods and frequent miscarriages. If you recently had a D&C procedure and notice a missed period, Asherman's syndrome is the most likely cause. Most cases can be treated with surgery to remove the adhesions.

Final Thoughts

As you can see, pregnancy is not the only cause of an absent period. Affected women should know that there are many possible causes and that these conditions are generally easy to treat. However, it is very important that you rule out pregnancy first.

Clinicians should understand the importance of taking a thorough history of the patient. Some of the symptoms are ambiguous and can indicate other possible conditions. Therefore, it is important to understand all the factors that may be contributing to the patient's absent period.

Disclaimer

This article is for informational purposes only and is not intended to diagnose. If you notice any of the symptoms discussed, consult your physician for the proper tests and diagnosis.

References

Corrine K Welt, MD and Robert L Barbieri, MD. (2017). Epidemiology and causes of secondary amenorrhea. UpToDate.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

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    • profile image

      mclegend 

      4 weeks ago

      very helpful

    • akanga1 profile imageAUTHOR

      akanga1 

      7 weeks ago

      @Shreenidhi

      Thank you for the compliment

      Glad to hear you have found it useful

    • Shreenidhi KS profile image

      SHREENIDHI 

      2 months ago from Chennai, Tamilnadu, India

      Quite an informative article for all the young women and even ghe mothers too. Thanku for sharing these information

    • profile image

      sefako 

      3 months ago

      I am 28years so i have no period month

    • profile image

      Lima 

      5 months ago

      Thank you for quick response. The incident happened on September 2018 and after 4 months upon doctors suggestion, I tried to conceive. Because I had 3 regular menstural cycles and my health was perfect then. Totally its been 9months since the incident. So for the past 5months we are trying for a baby.

      Your words are true, still the pain haunts me mentally. But im worried as i didn't get periods for more than 2 months now with negative hpt. Am confused whether am awaiting periods or pregnancy.

    • profile image

      Lima 

      5 months ago

      Thank you for the quick reply. Your words are true, I couldn't bear the loss. The doubt regarding my cycle is that, I had regular periods before and after sexual life, and even after the stillbirth. After stillbirth too I had 3 regular menstural cycles. After that doctors examined me and upon their advise I tried to conceive. Certainly I'm confused by what is happening now. Am I healthy or is this something to worry about seriously?

    • akanga1 profile imageAUTHOR

      akanga1 

      5 months ago

      @Lima

      A stillbirth is incredibly traumatic. It can be difficult to overcome the psychological effects of such an event even if physically you feel relatively well. The psychological effects can also influence the pattern of your cycles. Of course, it is not possible for me to say whether that is what is happening with you but it is one of the possibilities to be considered. Five months is not a long time and the grief of the loss could be affecting your menstrual cycles.

      With five negative urine pregnancy tests, the likelihood is that the results are correct i.e. you are not pregnant. You can get clarity either by doing a blood test to check levels of the pregnancy hormone (beta-hCG) or having a pelvic ultrasound scan. If those happen to confirm that you are not pregnant, you can discuss with your doctor the need for further tests to get to the bottom of the missed periods.

      Best wishes

    • profile image

      Lima 

      5 months ago

      I am married for 2 years now. We are sexually active for the past 5 months, since I experienced stillbirth when I was 6months pregnant. Now am confused by the dramatic change in my cycle. My cycles are always regular always and I never experienced missed periods unless I was pregnant. Coming to the query, my lmp was 13th April I missed by periods on 13th May and 12th June. Its more than two months now. Although hpt turns out negative, I don't have any symptom of periods coming. I feel nauseous and tight breasts that too on and off. But by that, I couldn't conclude that I'm pregnant as five hpt showed negative result. I'm really worried. What should I do? Is it possible for me being pregnant? Please help me with answers.

    • profile image

      Ebot cindy 

      5 months ago

      Does a response come immediately or after like a day?

    • akanga1 profile imageAUTHOR

      akanga1 

      5 months ago

      @Mhm

      Yes, you might still be pregnant but, and it is a big but; this might simply be part of the current variable pattern of your cycles.

      As you might know, the sensitivity of pregnancy test kits varies. With some, if you perform the test too early after conception, you could get a falsely negative result. On the other hand, the symptoms you described (breast engorgement) are pretty common towards the end of the cycle just before the onset of a period.

      Overall, it is unclear whether you have conceived or not. If your period hasn't arrived in one week, I would suggest you repeat the test

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      5 months ago

      @Hai

      I am slightly confused by the part of your statement which says "there was no period till now". Does that mean your period has now arrived or you still have to see a period since the end of January?

      Another thing is if you are having other pregnancy symptoms (other than the missed period), you really ought to repeat the pregnancy test. Your test in March might have been a false negative. I would really take too much notice of what you perceive to be 'movements' in your abdomen as, even if you are indeed pregnant, true fetal movements can only be perceived after 18 weeks gestation and, for most, not until after 20 weeks.

      What you need to do as a priority is to repeat that pregnancy test. If it is negative again, it will be appropriate to move on with tests to investigate other causes of missed periods.

      Best wishes

    • akanga1 profile imageAUTHOR

      akanga1 

      5 months ago

      @Lakeata

      It would appear to me that this was simply a missed or delayed period. You have not given any details whether the 'period' you had on the 1st of June was any different from your norm. If the bleeding was particularly heavier than normal, it could suggest the possibility of having been pregnant and suffering from a very early miscarriage. However, the details you provided are too brief to confidently state whether that might have been the case

    • profile image

      Mhm 

      5 months ago

      My husband and I have an almost 2 year old but would like to have a second. I breastfeed child for 14 months and my period didnt come back until after I had topped completely. Since my cycle stared again it had been short and less regular (18-24 days) than before I was pregnant (28-30 days). I used an OPK test this month and a got a positive result at 6 days. We had unprotect sex 24 hours after. Its now 28 days into my cycle and i haven't gotten my period and my breast feel enlarged, but i took a pregnancy test and it was negative. Could i still be pregnant?

      Thanks.

    • profile image

      Lakeata Williams 

      5 months ago

      Hey I'm ben having normal periods I didn't have one n may at all by on June 1 it came on wat could dat b

    • akanga1 profile imageAUTHOR

      akanga1 

      5 months ago

      @Metothecore

      This isn't as straightforward as it may appear. A prolonged phase of absent periods after coming off the pill is not particularly unusual. It is what is known as 'post-pill amenorrhoea'. This is more common after being on the pill for several years without a break. The advice is usually that if periods don't spontaneously resume after 4-6 months, investigations should be carried out. It is therefore right that you have sought medical help at this point.

      Your doctor is right in advising you that taking a few days of a progestogen hormone preparation would bring about a 'period'. Duphaston is a progestogen. However, strictly speaking, what you get after taking a course of a progestogen is a 'withdrawal bleed' and not what can be described as a true period. It is also false to suggest that taking a progestogen would kick-start a period. That is misunderstanding how it works. Taking a progestogen such as Duphaston has an effect on the lining of the womb. It makes it undergo what is known as decidualisation. When you stop taking the progestogen, the decidualised lining breaks down and therefore you get a bleed. You can do this repeatedly and you will see a bleed but that does not mean your cycles have resumed. Far from it. Cycles are a function of the ovaries and the cyclical hormones produced there. Duphaston and similar progestogens do not influence ovaries. You are therefore getting false reassurance.

      Advice should depend on what your current needs are. If you are not trying to conceive, it is perfectly OK to continue with the current strategy, getting regular progestogen-induced withdrawal bleeds. In fact, a 7-day course would achieve the same thing. You don't have to take them for 14 days. On the other hand, if you are trying to conceive, then appropriate tests as to the underlying cause of your absent periods should be carried out. Normally, if you are not having periods, it is safe to assume, you are unlikely to be ovulating. That may need to be addressed. It is possible you may have an underlying condition such as polycystic ovaries (PCOS) being responsible. Inducing ovulation in such conditions is a relatively simple affair.

      I know this is a long reply but it is important to get the full picture.

      Best wishes

    • profile image

      Metothecore 

      5 months ago

      Hi,

      I have been taking birth control pills before my marriage and i have stopped it since last oct. However, my period has not came till date. I have seen a gynae and she prescribed me duphaston and my period came after taking the pills for 14 days. May I know if the pills will help me to restart my period as my doc told me to wait for 2 mths to see if my period comes if not to take another 14 days of duphaston pills. This is the first month after coming of the pills but my period still has not come. Do you advice whether this is normal? Thanks

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Linnence

      With the quite brief details provided, it is difficult to formulate a meaningful opinion. If you have been having unprotected intercourse frequently, including the fertile phase of the cycle (mid-cycle), yes pregnancy is a probability. I would say this would be more likely to be the case if delayed or missed periods are unusual for you. As it is, details are thin on the ground.

      Best wishes

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Joana,

      The change in the pattern of your periods has nothing to do with your being sexually active. I would be more concerned with the fact that you are having regular sex but have no contraception arrangement in place. That really ought to be your priority. The contraceptive pill is effective but, if you are not comfortable taking this, just have a consultation at a family planning clinic for alternatives. There are several equally effective options.

      An irregular pattern of periods in young women is a fairly common feature. It is certainly nothing to do with your being sexually active.

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Cola

      I genuinely think, as far as the probability of pregnancy is concerned, you can relax. It just is exceedingly unlikely.

      What you ought to actively pursue is the solution to your seemingly wildly irregular and prolonged periods. It is a relatively easy problem to fix and you are likely to address the issue of contraception in the process. You are sexually active and, even though you may be successfully avoiding penetrative intercourse at times, the situation is likely to be a cause of frustration and similar bouts of anxiety as you have now. You need to address that.

      Best wishes.

    • profile image

      Cola 

      6 months ago

      I have very irregular periods that sometimes last for two months. My last period began in mid February and ended at the end of Mar h. On April 7th I fooled around with a guy(manual sex but he might have had precum on his finger when he inserted it). I didn't take plan b because I didn't see a need. So then I start worrying I might have gotten pregnant that way even though most people say it's unlikely. About two weeks later I see brownish blood and then spotting and cramping for the next three weeks. I took a pregnancy tests 17 days from the 7th and it was negative. The latest one I took was 26 days later and it still is negative. I'm sure I took the test right too in the morning. I cramp every day for most of the day but still no period. I've been so panicked that it could be a false negative. I feel like everything I see is about babies and pregnant women. My anxiety is so high my blood sugar has reached a dangerous level. I have a doctors appointment but I am so scared I still might actually be pregnant.

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Tope Funmi

      I believe stress is still at play here. Even though you may feel that you have now settled in since your move a few weeks ago, the effects of psychological and physical stress on the hormonal pattern can persist for a few weeks beyond the overtly stressful period. Your described symptoms are myriad and varied i.e. not specific enough to suggest anything else. I believe your period will arrive sooner rather than later (unless you conceive in the meantime).

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Mamameea

      I am more inclined to believe the 4 consecutive negative pregnancy tests than the first faint i.e equivocal result. It is the case therefore that you are very unlikely to be pregnant. Since it is 4 weeks since that brown blood loss, it will be interesting to see whether a period would arrive. If it does not, you may wish to have the whole situation reviewed by your doctor.

      With sterilisation reversal, you are obviously keen to conceive. That does create its own issues for some as anxiety and stress can set in the longer the time passes without a pregnancy ensuing. Did you have the success of the tubal ligation reversal confirmed? If not, I would suggest that you look into having that done. A hysterosalpingogram (HSG) is a simple XRay test that will bring clarity to that question, something that could be critical in your quest.

      Best wishes

    • profile image

      Tope Funmi 

      6 months ago

      Hi, I had my period last on the 21st of March, then I relocated to another countinent in the beginning of April. The movement was a very stressful exercise for me but I had settled in before my next expected period date. Now, I am yet to see my period, I did pregnancy test twice and both came out negative. Also, I've been having constant headaches, which subsides when I use aspirin (though, that has stopped now) and sometimes, feverish feelings. My sleep pattern has changed too (I don't sleep well) and I have my tummy rumbling evry evening. I don't know what to make out of all these.

    • profile image

      Mamameea 

      6 months ago

      Hi. Last period feb 25th 2019. Its now april 29th 2019. On april 3rd i bled brown blood for 4 days. Took a pregnancy test on the 11th positive faint line. Then took 4x more All negative contacted my doctor blood test negative still no period breast feel full lower right abdominal leg pain. Keep in mind i had my tube reversed so husband and i can try to have a child only one tube though... never missed a period before.... any suggestions

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Aa

      It is quite uncommon but still possible to get pregnant after a tubal ligation. I am not suggesting you are pregnant but it is important to bear that fact in mind. In this particular case, I think pregnancy is very unlikely. That is because there is a combination of pieces of evidence which make that a very unlikely explanation for the absent periods. In fact, I prefer to call this a 'delayed' period because chances are it will arrive, unprompted, sooner rather than later. I am not looking beyond the prime suspect i.e. PCOS. You may not have gone this long before but durations of absent periods are typically variable and unpredictable in PCOS. With a negative pregnancy test, you can justifiably relax for at least a few more weeks. I would suggest if a period hasn't arrived in the next 4 weeks, get a review by a doctor.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Shauna

      Difficult to say. It is, of course, logical that the known potential cause should be effectively ruled out before exploring something else. If you have an underactive thyroid and you are presumably on Levothyroxine replacement, the first thing to do would be to check whether the dose is still adequate. The blood test for this is simple with quick results. If this has already been done and adequate replacement confirmed, a more detailed exploration of what could be causing the absence of periods should be done. A gynaecologist should be able to help you in this regard.

      Best wishes

    • profile image

      Aa 

      6 months ago

      Hi , I had tubal ligation done 3 yrs back.

      I have PCOS but periods come regularly, the longest it’s delayed would be 45 days .

      But not it’s 50 days and still no period . I do have pains n aches n negative pregnancy test .

      Please advice

    • profile image

      Shauna 

      6 months ago

      Last period 23rd of Feb & it lasted two days.

      I have missed two periods now.

      X3 pregnancy tests negative.

      Underactive thyroid but treated.

      Unsure of what to do next?

    • akanga1 profile imageAUTHOR

      akanga1 

      6 months ago

      @Chigozie

      If a urine pregnancy test is showing "faintly positive" and this has been the case more than once, that needs to be investigated further. You need to be seen by a gynaecologist. They will offer to do a blood test to check levels of the pregnancy hormone (beta-hCG). When there is no pregnancy, that hormone should be undetectable. If that is found to be the case, it will imply that your faintly positive urine test is caused by cross-reactivity with other hormones. This does happen with some test kits. From that point on, the gynaecologist can then embark upon investigating why you have not seen your periods for a few months.

      There is another possible scenario. The blood test may actually show a low level of the pregnancy hormone beta-hCG. That will imply that you may have conceived but the pregnancy failed at a very early stage and some of the pregnancy tissue is still retained. That tissue, therefore, continues to produce low levels of the hormone.

      All in all, you ought to be seen by a specialist

      Best wishes

    • profile image

      chigozie 

      6 months ago

      please I have not seen my period for four months and pregnancy test is showing me faintly positive Scan is saying am not pregnant please I need help I don't know what to do

    • profile image

      Yesse23 

      7 months ago

      Really? It’s very unusual to me, since the smells changed as well and it’s incredibly light. Would it change again to a more heavy flow?

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Daxa

      Your period is late by a few days. Since this is a departure from your normal experience and you have had unprotected intercourse, suspecting pregnancy is logical. I would suggest that you repeat the pregnancy test 48-72 hours from the last one. Ideally, use a different brand test kit (sensitivities vary). If that too is negative, you are most probably not pregnant and the period is simply delayed. That can happen from time to time for many women. That is why I put up this hub.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Yesse23

      The character of your periods has changed. That is by no means unusual. It is unclear from the details provided what age you are. Change in the character of periods in the teens is quite common. If your periods are regular and the only change is a reduction in the amount of menstrual blood loss, that should not be a cause for worry at all. By the way, a 3-4 day duration of a menstrual period is the norm for many women.

      You seem to have conflated the change in the character of your periods with losing your virginity and becoming sexually active. The two are not related. The timing is simply coincidental.

    • profile image

      Yesse23 

      7 months ago

      Hello,

      I am sexually active but ever since my periods have grown lighter (like to the point where it only lasts 3-4 days of light period and no heavy bleeding). I know that I am not pregnant since I use protection, and this has happened ever since I lost my virginity which was almost a year ago. I’d like to know why?

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Laxgirl45

      I think you should take the pregnancy test and here is why. Nothing I can advise you here will confirm or rule out anything with finality. As such, you are inevitably going to remain anxious unless and until your period arrives.

      Sustained regular strenuous exercises can certainly cause periods to cease albeit temporarily. You are the person who knows how strenuous your lacrosse exertions are and any view I take will be pure guesswork. Yes, over 2 hours of daily physically demanding sport seems considerable but can I be certain that is the cause of your missed/delayed period? No, I can't. The sensible thing for peace of mind is therefore to perform the urine pregnancy test.

      Best wishes.

    • profile image

      Laxgirl45 

      7 months ago

      Hi my period is currently 3-4 days late. I had a surgery last year and have just gotten back to playing sports. Now I’m playing lacrosse everyday except sundays for 2-2.5 hours. I haven’t worked out or played a sport like this in over a year. I am also currently sexually active with my boyfriend. I was wondering if this excersise could be the cause of my late period? I don’t want to take a pregnancy test because I’m only 3 days late but I have never been late for my period before so I’m nervous. When should I start worrying or do you think the exercise has something to do with this?

      Thank you!

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Msdale28

      These additional details are quite useful. You didn't have a period for 3 months until late February and that was clearly because of the Depo Provera injection you had. It would appear you did not have any additional injections. Since Depo Provera is supposed to be administered every 12 weeks, the fact that you did not have the subsequent injections means your periods resumed. When you stop Depo injections, the cycles can be rather irregular before they settle into a regular pattern and I feel that is what is going on with you.

      I am not sure whether you have decided that you want to get pregnant after all. Reading between the lines, you have stopped Depo, you are not using any other contraception and you are sexually active. Even with current irregular cycles, you could sooner or later find yourself pregnant again.

    • profile image

      Msdale28 

      7 months ago

      @akanga1 before I had the d&c I had my period s regularly and wen it didn't show I took a test I found out I was pregnant.. i had a d&c 6 months cause I wasn't prepared for a 3 child i also had the depo shot after the d&c and never took after that one time so when I didn't get a period I thought it was still in my system then it came and still haven't came since that month and am having white vaginal discharge and period like cramping with no period the fatigue naseua mood swings dizziness hope this help

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Noor

      Since you have not been sexually active, pregnancy is clearly not the cause of your delayed period. The whole purpose of my writing this hub was to help girls and women like you who miss a period (or periods) when they are not pregnant. It is to help you have an understanding of the many other causes of absent or missed periods.

      Of course I can't answer why your period has not arrived yet. However, by carefully reading this hub, you might be able to work out whether any of the suggested causes is applicable to you. Plus, it is also the case that sometimes there is no obvious explanation for delayed periods and the situation eventually resolves spontaneously

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Msdale28

      You have not said why you had a D&C 6 months ago The delayed period this time around may be for the same reasons you went through almost 3 months after the D&C without one. Was that normal for you? You mention a 'milky white discharge' but you haven't specified whether this is a vaginal discharge or a breast discharge. I really don't have enough information here to be in a position to advise you with confidence. What is clear is that you are almost certainly not pregnant. You may therefore wish to re-read this hub and see whether any of the mentioned potential causes of absent periods comes closest to what you are experiencing.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Veronica

      It may be tempting for me to give a straight answer to a seemingly straight question but life is rarely that straight forward, is it. There are a number of issues you have mentioned that could be relevant in your current state. You describe yourself as 'overweight' but it is not clear to what degree. Is your BMI over 30 or even 35? A rapid weight gain can in itself cause a disruption of menstruation. However, it is also important to be certain whether that weight gain is a direct result of the change in lifestyle (less exercise and/or increased calorie intake) or whether there is an underlying hormonal reason. You may find that if you sit back and take stock, you may be able to answer many of these questions. If by being brutally honest with yourself you conclude that a change in lifestyle has not been significant enough to explain the weight gain and consequently the absent periods, a visit to your doctor would be advised sooner rather than later. However, if you feel that a reset to your lifestyle is what needs to happen, then go ahead and do that. Losing weight is never easy but when it is the primary issue, nothing else will do.

      Your inability to conceive despite not using contraception may be associated with erratic ovulation. If you are not having periods, you are almost certainly not ovulating regularly.

      You mention vaginal itchiness, redness and whitish discharge. That sounds suspiciously like thrush (yeast) infection to me. The medical term is 'vaginal candidiasis'. Again, that is a condition that is generally more common in women who are significantly overweight. It is also common in those who have diabetes. The information provided here isn't sufficient for me to declare that possibility in your case but a combination of a high body mass index, possible vaginal thrush and feeling unexplained fatigue means such a suspicion is not a far-fetched leap. I would suggest that you look at a possible medical review.

      Best wishes.

    • profile image

      Msdale28 

      7 months ago

      @akanga1 I have a question for you I recently had a d&c done end of October bleed for 7 days didn't have a period for Dec Jan till Feb 22 it came lasted 9 days it's was light now am 18 days late on my 49day cycle having dizziness fatigue sever low back legs an shoulder pain with cramping having a lot of milky white discharges took 3 pregnancy test 5 days apart all negative what is the problem can you please help me .

    • profile image

      Veronica 

      7 months ago

      @akanga1, you have been so helpful for so many people!

      And because of that, I wanted to ask your advice as well.

      I haven't had my period for almost nine months now and I'm really worried that there's something wrong. I am 24 yo, extremely tired all the time and I am overweight (I gained quite some weight due to a sudden lack of exercise and healthy nutrition about a year ago).

      All this time I thought that it was my weight that is preventing me from having periods, but lately I started getting other symptoms as well. I'm troubled by sore breasts, vaginal itches and redness, white discharge (that has been there every month instead of the period, but has now increased), abdominal pain (mostly after intercourse/orgasm), and I'm very tensed in general and have become over-emotional.

      My boyfriend and I have been together for a long time and we don't really use condoms, as they tend to cause temporary vaginal dryness and discomfort afterwards. However, I have taken several pregnancy tests and I'm not pregnant. Nor have I ever been in my life. I've never had any STD's (not even a yeast infection) or any problems with my period before this. Though, since I haven't had my period, I've had a yeast infection twice.

      Other then that, I have been really stressed the last six months or so due to some personal problems. I have in mind to start exercising asap and eating healthier again. However, I wanted to ask you if I should be seriously worried. Should there be a serious concern regarding my health? Or could a healthier lifestyle resolve (some of) my issues?

      Thank you so much!

    • profile image

      Noor 

      7 months ago

      Can any 1 help me plz i m really worrird for my periods this month period not came and i m un married girl no sex no intercourse no sexual activity but still periods late plz some1 help me

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Cluadine

      I understand why your situation would cause distress but realistically there is no possibility that I could give you any useful answer. This is because I really don't know anything about you or, indeed, your husband.

      Inability or delayed conception has got so many causes, some male and some female and sometimes a combination of both. In addition to that, in up to a third of couples, tests fail to identify any cause. That is a category termed as 'unexplained sub-fertility'.

      For something like this, you should really arrange to see a gynaecologist. Ideally, both you and your husband should be seen together. The specialist will need to take a detailed history, perform an examination and then arrange tests that would be deemed appropriate. These usually involve vaginal swabs, hormone profile blood tests and ultrasound scan. Often times an x ray test to check the state of your fallopian tubes is required. On the part of your husband, a semen analysis is usually necessary.

      My best wishes

    • profile image

      @ Cluadine 

      7 months ago

      I want 2 knw bout it so l am married for 3 year yes but l dont get 4 pregnany why?

      My hubby want 2 make baby..

      Please help me Doc

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Nikita

      For many women, tender breasts in the lead up to a period is normal and to be expected. Also, three days is arguably a relatively short 'delay'.

      Having said all that, you can really make an assessment of the possibility of pregnancy based on your own personal experience. If your periods tend to be clockwork regular and marked breast tenderness does not usually precede your periods, this apparent delay may well be significant. If that is the case, you may wish to do a urine pregnancy test to get clarity sooner rather than later.

      Best wishes.

    • profile image

      Nikita 

      7 months ago

      My last period was on 3.3.19

      My breasts are tender & my period is 3 days late for April

      Should i be worried

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Nagma

      I am sorry I am unable to give you an answer to your question. I understand your anxiety but with such little information about you, it is not possible for me or indeed for any doctor to be able to explain why you haven't seen a period for over 6 weeks.

      You say you are "unmarried" which I take to mean that you are not sexually active. That would mean you are definitely not pregnant.

      I would suggest you read this hub (article) again carefully and assess whether any of the described possible causes would apply to you. If none seem likely then your next logical step would be to see a doctor so you can have an examination and appropriate tests.

      Best wishes

    • profile image

      Hi I m nagma 

      7 months ago

      My periods is missing 45 days...due to i m feelling so uncomfortable for that

      I m unmarried

      What's reason to my periods missed

      Plzz help me doctor.......i m from India

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Hi, I am 30yrs old and I haven't see my period for 6 month now. I have donever the pregnancy test it was negative.Test where conducted on me some where negative....

      Unfortunately, because you did not put a name or username, I am having to address you using a section of your query.

      You describe microbiology test results, presumably from vaginal swabs that were taken. The results show a variety of bacteria. These are unlikely to be significant or relevant. A vagina always carries bacteria. That is normal.

      In any case, vaginal swabs can never give you an explanation as to why you are missing your periods. Those results are therefore not relevant as far as your issue is concerned. Please read this article again on the various causes of absent periods and assess whether any of those mentioned may apply to you.

      Investigating the cause of absent periods usually involves blood tests (hormone profile) and imaging, usually using ultrasound scans.

      I hope you will have the appropriate assistance and resolution to this soon.

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @Bibiche tresor81

      You are describing features strongly suggestive of a threatened miscarriage. It would appear that you are/were about 7 weeks pregnant and the progressive spotting which is evolving into a frank bleed would be a cause for concern about the status of the pregnancy. Your doctor should be able to arrange a pelvic ultrasound scan to establish what is going on.

      My best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      7 months ago

      @kayla

      Since I'm writing this reply more than a week since you posted your query, it is possible that your period has already arrived and the issue is no longer there.

      All in all pregnancy test results are quite reliable. However, a negative pregnancy test is not foolproof. You can still be pregnant if you have used a low quality, substandard or expired test kit which can give you falsely negative results. Now that it is more than two weeks since your period was due, if you haven't done so, I would suggest that you repeat the test. If it is still negative, you can either wait another couple of weeks to see if a period arrives or, if you are anxious to be certain, see a doctor to arrange a blood test for the pregnancy hormone (beta-hCG). The results of that test will give you certainty on whether you are pregnant or not

    • profile image

      Bibiche tresor81 

      7 months ago

      Hi im 38years old.i have been 19days late on my period did have unprotected sex last moth and this mont 19 days late that i find is too much for me as my period has never been late.so i took a at home pregnancy test on Friday wich was positive so I called the surgery to have another test went in Saturday they did another test and again positive. As i was having some discharge and pain on my lower abdomen they recommended me to see a genealogist the same day .i went there and has been given an appointment this morning and im on my way.i just want to mention that i don't have no symptoms except for breast tender for about 2 weeks now.but as i woke up this morning i have noticed that the spotting has changed colour completely from pink brown to red and the tenderness on my breast has reduced suddenly. So im very confused please help.

    • profile image

      Hi, I am 30yrs old and I haven't see my period for 6 month now. I have donever the pregnancy test it was negative.Test where conducted on me some where negative. Order test show that I have gram cocci 

      7 months ago

      Hi iam 30yrs old and i haven't see my period for 6 month now. The pregnancy test have been conducted it was negative. Order test where conducted some where negatives while orders shows that i have gram cocci +,gram bacilli+and pus cells++. Some antibiotics where been prescribed to me by the doctor. I have taken all the medication but still yet l haven't see my period.please i need help

    • profile image

      kayla 

      8 months ago

      hi doc me and my boy have sex with a condom however after we have sex we check to see if the condom burst an it didn't we have sex on the march the 8 my period normally regular but today am four days late .. i took a pregnancy test but it comes back negative .. am so worry about if am prgenant?

    • profile image

      Adekunle Sammy 

      8 months ago

      My wife was going through beedling and the blood was comeing fast what's do I do and she said she need a pill

    • profile image

      chizzy 

      8 months ago

      l am nineteen years old I started my period since 2012 october last year i stopped seeing my period till now plsss what do i do

    • profile image

      Anoha deva 

      10 months ago

      I got married 1 yr 4 months back.but still not pregnant,periods is regular monthly monthly 25 to 27 days.i dont know what is the problem of not getting pregnant.we checked with doctor.no problem with both them.pls give some ideas.

    • akanga1 profile imageAUTHOR

      akanga1 

      16 months ago

      @Vanity

      I feel for you. When you don't get answers to this kind of situation, it can be quite distressing. There is, however, a silver lining in all this. You said your test results were all normal. That can only be a good thing. However, it wouldn't be possible for me, or anybody else for that matter, to give a more specific advice since you haven't given details of the actual tests that were carried out and the subsequent results.

      All I can advise is for you to go through this hub again to see if any of the described conditions might apply to you. If none fits, that would be described as idiopathic (unexplained) absent periods. A spontaneous resolution of that can be reasonably expected.

      Best wishes.

    • profile image

      vanity 

      16 months ago

      iam 64 days late I went to doctors in April an i wasn't pregnant then I had every test done in the world by blood to make sure my reproductive system was fine results came back that I was perfect but no baby.It is now July 1 i was supposed to get AF may 25th no show or symptoms please help.

    • janshares profile image

      Janis Leslie Evans 

      18 months ago from Washington, DC

      Informative and imporant article, well done. Women don’t think of their periods as a “vital sign” indicative of good reproductive health and not just a pregnancy marker. I wrote an article on POI and used to run a support group. Thank you for providing another resource for women dealing with infertility and other medical issues that affect reproductive health.

    • akanga1 profile imageAUTHOR

      akanga1 

      19 months ago

      @ajayioluwatoyin0@gmail.com

      There is not much information here to go by. Are your periods usually regular, is this the first time you have had a late period, how old are you, what is your body weight (i.e. are you over- or underweight? All these are important pieces of information for a doctor to form an opinion on what might be going on.

      Regarding the possibility of polycystic ovaries, I would suggest that you read this hub again to get more information on that. Similarly, Asherman's syndrome is described in the hub. You can then be in a better position to know whether either of these conditions may be applicable in your particular case.

      Best wishes.

    • profile image

      ajayioluwatoyin0@gmail.com 

      19 months ago

      I am 5 days late, i did pregnancy test using the home kit and also went for pelvic scan which came out negative but with some syndrome which was detected but am still trying to believe since I just missed my period this month. The impression the gynecologist got was : no gravid, polycystic syndrome, asherman syndrome and cervical OS closed. Plso what does this mean because am yet to visit a doctor. Thanks

    • akanga1 profile imageAUTHOR

      akanga1 

      19 months ago

      @cyntia

      I cannot comment on the advice given by your doctor because I do not know the basis upon which it was given. However, erratic and prolonged absence of periods out of the blue like what you describe here almost always require specific tests to try to understand the cause. Taking a contraceptive pill will always lead to a 'period' at the end. However, that is not a true period. It is what is called a withdrawal bleed. It does not address the underlying issue which, in your case, has not been established yet.

      I would suggest that you see a specialist who will need to take a careful history, examine you and then decide on which tests will be appropriate for you. I think a hormone profile blood test is likely to be needed at the very least.

      My best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      21 months ago

      Hi Hb27

      Thank you for stopping by. I am surprised at your doctors' reaction to your issue. When periods stop out of the blue, there is usually an explanation which ought to be sought. It is true that some of those causes would resolve spontaneously without any need for active intervention. However, that prospect does not negate the need to investigate the cause.

      From your brief details, it would appear that the underlying cause in your case could be hormonal. I would suggest that you see your specialist again and politely but firmly insist on a hormone profile blood test. As explained in the hub, checking for levels of hormones including LH, FSH and Prolactin will go a long way in bringing about clarity to your situation. It is a simple test.

      Best wishes.

    • profile image

      Hb27 

      21 months ago

      Hi! I'm 27 yrs old I have had regular periods my whole life until July 2017 my periods have vanished I went to my OB and had a negative hcg test. Ob acts like this is a normal thing and gave me a prescription of progesterone and said that my periods should return to normal. Well when I do take progesterone I do have a period afterwards but she only gave me 3 refills of that so I haven't had a period for 5 months. I'm getting concerned of why I'm not having a period? I'm worried that when I decide to have a 2nd child that I will not be able to conceive. I havent been back to my ob bc they acted like I was crazy for being seen for a missed period. Any advice??

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Rachel

      It would appear you are not pregnant. You had unprotected sex but this was arguably in the least fertile phase of the cycle. More crucially, you have had multiple negative pregnancy tests. Whilst it is still possible to get falsely negative pregnancy test results, the modern test kits are so sensitive and accurate that this is becoming a rare occurrence. I am inclined to believe that, while not impossible, it is very unlikely that you are pregnant.

      My advice is for you to keep the doctor's appointment which is due in less than 2 weeks. The proper period might well arrive in the interim. Missed periods are really not that uncommon but, for obvious reasons, I am not able to tell you what the cause is in your particular case. If you get symptoms like pelvic pain, especially if localised, you will need to be seen promptly. I think that is highly unlikely.

      Best wishes

    • profile image

      Rachel 

      2 years ago

      My last period was july 2nd. I usually have regular periods. In August just a day or 2 before my period, my bf and I had unprotected sex and he did not pull out. Well I missed that period and now I have missed September. I have taken 3 pregnancy tests and all negative. I don't have sore breasts, however just last week 9/4 through maybe thursday or friday. I was spotting super light pink and only a few hours a day. I have taken another test today and negative. which the time i was spotting was around the time i would have gotten my period. I have a doc appointment but isn't until the 25th. I am asking for advice/help. Also I was getting really light cramps. some days a little more like period cramps but most of the time just really light cramps.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Julie

      I am very surprised that your doctors have not offered you tests to find out why you are not getting your periods. If this has been the case for as long as you say, hormone and imaging (scans) investigations have got to be done.

      Polycystic ovarian syndrome (PCOS) is by far the commonest cause of prolonged absence of periods which can last many months at a time. However, I do not have anywhere near enough details about you to advise you whether that is the case here.

      You should arrange to see your doctor and insist that you want to get to the bottom of this.

    • profile image

      Julie 

      2 years ago

      Hi I haven't seen my period for months and years now I don't know what wrong with me every time I go to the doctor they always say nothing wrong with me but I can't see my period or get parganant what to do

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Lisajm

      As you would have seen in this Hub, there are many causes of missed periods and premature menopause is only one of them. It is also the case that only roughly 1% of women go into menopause before the age of 40. It should, therefore, be low down on the list of possible causes. Also, you have not mentioned any of the other symptoms associated with evolving menopause.

      Whilst it is not possible for me to tell you what might have caused your periods to behave this way, on balance of probability, premature menopause is unlikely. Should this persist, you will need to see your doctor for examination and tests.

      Best wishes

    • profile image

      Lisajm 

      2 years ago

      8 weeks now with no period, but daily only at night spotting which varys in old and new blood. Tubal litigation done in 08 and regular 21 day cycle. no pain or swelling. 35 years old. could this be early menopause?

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Rehan

      Your wife used the oestrogen hormone tablet Gynaecosid when she missed her period. This tablet will normally provoke a withdrawal bleed when used and that is what it is marketed for. Unsurprising, the period has once again failed to arrive. Unsurprisingly because Gynaecosid does not address the cause.

      It is of course not possible for me to advise you on what the cause is as I do not have your wife's details. If missing periods is unusual for her, I would suggest that she is seen by a doctor to take a detailed history, an examination and determine whether and which tests are required to get to the bottom of this.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Romoke

      It remains my view that your current period and the accompanying symptoms are to do with the fact that you have come off the pill. The contraceptive pill is really quite effective in both regulating menstruation and masking any symptoms that would otherwise accompany the menstrual bleed. When you come off, especially if you have been on it for a long time, this can happen.

      I would expect all this to settle in no more than 3 or 4 days. However, if that does not happen, you should definitely see your doctor.

      Best wishes.

    • profile image

      rehan 

      2 years ago

      Hi...I just want to know my wife has missed her second period. after sex and before her period she used gynecosid tablets then she got her period of that month while now the next is absent and three days are on the due date?? can you guide me what will be a problem??

    • profile image

      Romoke 

      2 years ago

      Thank you so much for your quick response, the bleeding I had was small compare to my normal flow ,my mestral flow is always heavy coupled with clothing but this was little compare to my normal flow without clothing. As am speaking the leg pain,waist pain and headache has not ceased.sharp pain in my abdomen that comes and go,also with little cramp.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Wunmi

      It is actually unusual for a woman in their late 40s to continue having regular periods. At that stage, periods tend to be irregular and less predictable. This is because, in most cycles, ovulation does not take place. If you have been having regular periods, that will be because you have been on contraception, presumably a type of combined pill. Now that you have stopped using this, you are likely to see a much more erratic pattern to your periods. What you have seen this month does not necessarily mean your periods have 'stopped'. It is more likely that you will still get them but they will be much less predictable.

      However, it is also possible, even if less likely, that the menopause transition has already started and this was being masked by your use of hormonal contraception.

    • profile image

      Wunmi 

      2 years ago

      I'm 48yrs old and last month I had my period for 7days and didn't continue using my contraceptives. This month I was to see my period 4days ago and till now no show. My question is. Is it normal for a woman my age to stop seeing her period abruptly.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Romoke

      It is difficult to say. You have had a vaginal bleed 4 days after it was due by your dates. This could simply be a delayed period. This is a fairly common occurrence even if that has not been the case with you so far. In cycles where ovulation does not take place, a subsequent period can be delayed for several days. It is also possible that you may have been pregnant and you have had an early miscarriage. You have not said whether the bleeding was heavier than your normal period but that tends to be the case with miscarriage.

      There is also a possibility, albeit small, that you are pregnant still and the bleeding and cramps you have experienced are features of a 'threatened miscarriage'. That is unlikely but not impossible.

      If you have a strong feeling that you may have been or are still pregnant, the only sure way to know for certain is to perform a pregnancy test.

      Best wishes

    • profile image

      Romoke 

      2 years ago

      Had unprotected sex and supposed to see my period on the 1st but the period ceased, although I had several cramps as if it was coming with slight headache ,tiredness,tendel breast and more crave for sex, on the 4th I started having severe cramps again with some brownish discharge coupled with slight headache and dizzleness, on the 5th which is yesterday I started bleeding with serious cramps and leg pains but reduced today and the way it is the bleeding will stop by tomorrow am I really pregnant.though last month I was on typhoid medication wish lasted for just 5days.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @liza

      I am afraid I did not understand your question. You have not had a period for over 3 months. Do you think you might be pregnant? If that is not possible for whatever reason then you need tests to find out why your period is that late.

      You have mentioned "a little lump on the left uterus". I am assuming you mean the left side of the uterus since you have only one uterus. How was that lump identified? Did you have an ultrasound scan? A 'lump' on the uterus is almost always a fibroid. A fibroid would not make you miss a period so that finding is unlikely to be clinically significant.

      I am sorry that I am unable to give you meaningful advice because the details provided are too brief

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Saraa

      I'm not sure I understand the basis on which the doctors advised you. Did you have a pregnancy test or an ultrasound scan done? If these were done and were negative then you are clearly not pregnant.

      If you have not had a bleed for two months and a pregnancy test is negative that to me suggests that you were never pregnant in the first place and any advice that you "could have lost it" would be misleading. A pregnancy test remains positive even if the embryo or fetus ceases to be viable. That is until the pregnancy tissue has been expelled.

      You are clearly still in the dark as to what has caused you to miss your period and I think your doctors should be doing more in trying to give you an explanation by doing appropriate tests.

    • profile image

      liza 

      2 years ago

      hi..I missed again my period,my last cycle was last May26.but untill now no menstruation again.and i found out that on my left uterus has a little lump compared in the right and sometimes it is painful.also having headache always.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @KellyA

      You have been on Clomid (Clomifene) which would indicate you are actively trying to conceive. Even though you have not given a lot of details, I would hazard a guess that you were started on this because tests showed that you are not ovulating regularly. That being the case, you may have experienced irregular periods also. That tends to be a fairly common feature in people with erratic ovulation. Polycystic ovaries (PCOS) is the commonest but not the only cause of this. I am therefore guessing that what you are seeing currently is a continuation of this.

      The other possibility is of course that you have successfully conceived. The vaginal spotting you have experienced would, therefore, be regarded as a threatened miscarriage. I would strongly suggest that you do a pregnancy test. If positive, an early ultrasound scan would be advised to establish status and location of the pregnancy

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @SadeF

      Thank you for the additional information. Indeed, Mononessa is a type of combined pill which, besides being an effective contraceptive, should give you regular periods. This is not happening with you so this particular preparation appears unsuitable for you.

      I really don't think you are pregnant. My considered opinion is that pursuit of this line of inquiry can now be abandoned. As per my original advice, I would suggest you attend your local family planning facility to get your birth control arrangements reviewed with the aim of switching you onto a more suitable preparation.

      Best wishes.

    • profile image

      SadeF 

      2 years ago

      Thank you for your response. The pills I take are called Mononessa which is a combination pill. Even on this birthcontrol I've had the same things happen. Today is now day 11 and I have 3 negative pregnancy test. I just really need answers.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @DIvin

      Even though not foolproof, the emergency contraceptive or morning after pill is very effective. That is provided it is taken correctly. It would appear you are under considerable stress and this seems to be the most likely cause of your missed/delayed period. However, your avoiding to take the pregnancy test is clearly not helping and, if the period continues to be absent, this is the next logical step to take. I would suggest that you do the test even before seeing your doctor. It will clarify the picture a great deal.

      Personally, I am not a big fan of repeated reliance on the morning after pill. It is inherently anxiety inducing because you cannot be sure it has worked until the next period has arrived. There is more info here: http://www.pregnancy-bliss.co.uk/emergencycontrace...

      Best wishes

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Elizabeth Kennedy

      I am unsure what the definitive diagnosis of your pregnancy loss was. You were pregnant but there was no fetal pole on the scan. Was there an empty gestational sac inside the uterus or was this absent too? The distinction here is important. If there was adefinite gestational sac but without a fetal pole, that makes it an 'anembryonic pregnancy', also known by the older term 'blighted ovum'. It would be OK to manage this expectantly as you did and eventual miscarriage is inevitable even though the interval to this varies. If there was no gestation sac, that will make the diagnosis 'Pregnancy of Unknown Location' or PUL. That is an entirely different diagnosis where expectant management would be deemed risky. This is because of the possibility of an ectopic pregnancy.

      Either way, it would appear the point at which the whole process concluded is unclear. With PUL, you could have persisting trophoblastic tissue in the body and this would continue to produce the pregnancy hormone hCG. This hormone would have the effect of stopping the normal cyclical hormonal pattern which can manifest in the form of completely absent periods or erratic bleeding, usually light.

      Of course, I am making a few assumptions here because I don't have all the details I would need. All in all, I would suggest that you arrange to see your doctor and a blood test for levels of the hCG hormone may be appropriate. If this is negative, at the very least this would eliminate the possibility of persisting trophoblastic tissue as being the cause of your symptoms.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @SadeF

      It sounds like you have what is termed as 'dysfunctional uterine bleeding' or 'DUB'. Your periods are irregular and unpredictable. There is a crucial piece of information missing from the details you have provided. You say you are on 'birth control' but you have not specified which type. You should really not have irregular periods if you are on the combined pill. Your periods should be clockwork regular on that. However, if you are on the mini-pill or the Progestogen-only Pill, to give it its proper name, you can suffer from this type of unpredictable pattern.

      I think the answer to your issue may lie in reviewing your contraceptive choice to get one which suits you better.

      Best wishes.

    • profile image

      Divin 

      2 years ago

      Hi

      I took the morning after pill on the 2nd of July which was two weeks before my period

      I have experienced chronic fatigue and cravings for salty and sweet things and rapidly gained weight especially my tummy got swollen within a week after the morning after pill. I have been very stressed due to so many problems. I experienced red blood spotting which lasted only for few minutes if not seconds after wiping. I have been so scared to even take a pregnancy test or go to the doctor but definitely this coming week I will take the courage and go see a doctor however the chronic fatigue has stopped and am getting much better but still no sign of period and I am really worried! I have used the morning after pill before and nothing like this has happened before but this time is just different.

      Please help

    • profile image

      Elizabeth Kennedy 

      2 years ago

      I'm 29 years of age. I have 3 children already and had my first at 17. For the last 6years I had the mirena IUD and had it removed in October. I had a normal period in December from the 24-31. In February I found out in was pregnant but at my 10 week ultrasound the Dr couldn't find a fetal pole although all the tests were positive. I wasn't expecting to be pregnant just wanted to remove the IUD and find another birth control. I opted for a natural miscarriage instead of the d&c. The bleeding began on April 14and ended on may 21. I then bled for 7days in early June. My last day of my period post miscarriage was june 9,2017. I waited for my periods to become normal again. July 3rd blood occurred and then it was gone by the 4th. And then everytime we had sex I bled or spotted for 2 days. We only have sex once a week now because of what's going on with my body and its no longer fun. I haven't bled yet and its September 1st. I called my Dr and he kept saying just wait. But I just want to know nothing else is wrong with me and if I can still get pregnant at all. What should I do? How long does it take for a period to get back to normal post miscarriage? And can I demand my Dr run more tests on me?

    • profile image

      SadeF 

      2 years ago

      Hello, my last period was 7/23 and I had unprotected intercourse 3 days after it ended. I am on birth control and my period is now 9 days late. I have taken two test that come back negative. I am feeling all the symptoms of my period but I am not bleeding. I do have one child and since I've given birth my period has been doing it's own thing. Even before I started having sex again I was late 11 days before. I'm confused my period would come 4 days early or it would be 7-11 days late. I'm starting to get a little worried and I don't know what to do. I hope I explained my situation to where you could understand. Thanks in advance for your response.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Confused

      With you having just missed a period by a handful of days, pregnancy is still possible despite the negative test. Condoms are of course not the most reliable form of contraception and there are a number of ways conception can still ensue even if the condom has not broken.

      Whilst on a balance of probability this is simply a delayed period, something every woman will experience at some point or another, pregnancy is still possible even if unlikely.

      Much as this may seem unacceptably long to live with uncertainty, I would advise that you wait for another week at least. If the period has not arrived in that time, repeat the test. If still negative, see your doctor for appropriate tests to establish what is going on.

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Raquel

      It is unusual (though not impossible) for modern pregnancy test kits to give a falsely negative result for a pregnancy that may be as advanced as 8 weeks (2 months). The likelihood is therefore that you are not pregnant.

      I'm having to make a lot of assumptions here since the information given is brief. I take it that your periods are usually regular and you are not on any contraception. If that is the case, look through the article again and see whether any of the mentioned causes of missed periods might apply to you. If not, the logical thing to do will be to consult your doctor.

      Best wishes

    • profile image

      Confused 

      2 years ago

      Hello, my last period was on July 31st, it was longer than usual lasting about 8 days. This month my period is late, it's been 32 days since my last period. I took a pregnancy test yesterday and it was negative. My boyfriend and I always use condoms and it never broke. I've always been regular and never missed a period and my periods have always come between 24-28 days. I've been feeling extremely nauseous these last few days as if I'm about to throw up. Could I still be pregnant? Or what could be causing my late period?

    • profile image

      Raquel 

      2 years ago

      HI

      I have not had my period in 2 months. Took a pregnancy test and it is negative. I feel so hormonal and tired and moody. I don't feel like myself, its like Im pms everyday. Please help!

      ..

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Kelly,

      Yes, you could be pregnant. I am assuming you are not on any contraception and if so, yes, the symptoms are quite suggestive.

      Modern pregnancy test kits are quite sensitive and having a false negative test is quite uncommon. However, they are not infallible and occasionally you get a poor batch. You may, therefore, be pregnant despite the negative tests. It is obviously not a foregone conclusion and your period might still arrive. However, if this hasn't happened when you see your doctors next week, they will repeat the test and, if negative, they may arrange a blood test. This is foolproof as it measures the quantity of the pregnancy hormone hCG. Alternatively, they may arrange an ultrasound scan (or both).

      Best wishes.

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Komal

      I doubt you are pregnant. If you have used protection and a urine pregnancy test has been negative, not once but twice, the likelihood of pregnancy is very low. Your period is delayed and you have had light bleeding so it may be one of those often difficult to explain menstrual changes which tend to be transient. However, if you have significant pain and especially if this is localised in just one part of your lower abdomen, it may be advisable to seek medical attention.

      Best wishes

    • akanga1 profile imageAUTHOR

      akanga1 

      2 years ago

      @Lina

      If you had unprotected intercourse in the background of a delayed period (by almost six weeks), it would not be possible to know whether that was a fertile phase of a cycle. As such, with it being almost 8 weeks since you had sex, the only way you are going to have clarity on whether you may have conceived or not is to perform a pregnancy test. If the test is negative, it will be time to take the next logical step which will be to see your doctor for tests to establish why you have not had a period for over 3 months now.

      Best wishes.

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