Missed Period for Over a Month: What Should You Do Next?

Menstruation has not occurred for over a month?

Hello Doctor: I forgot when my last sexual intercourse was, but my menstrual period has been absent for over a month.
A few days ago, I used a pregnancy test, and the result showed only one line, but my period still hasn't arrived.
Could this mean the pregnancy test was incorrect? Should I continue to wait for my period to come on its own?

Niming, 20~29 year old female. Ask Date: 2016/04/25

Dr. Lin Manying reply Obstetrics and Gynecology

For such issues, it is recommended to refer to the National Health Agency's "Sexual Health e-Learning" or the Obstetrics and Gynecology Society's "Consultation Guide for Adolescent Contraception" at http://goo.gl/dc6PfW.
If menstruation is delayed, it is advised to take another test after three days.
If the result is still negative, you may visit a healthcare facility for menstrual induction.

Reply Date: 2016/04/25

More Info

If you have missed your period for over a month and have taken a pregnancy test that returned negative, there are several important considerations to keep in mind. First and foremost, it is essential to understand that a missed period can occur for various reasons, and not all of them are related to pregnancy.
The first step is to confirm the accuracy of the pregnancy test. Home pregnancy tests are generally reliable, especially when used correctly and after a missed period. However, false negatives can occur, particularly if the test is taken too early or if the urine is diluted. If you suspect that you might be pregnant despite the negative result, it may be worthwhile to wait a few days and take another test, preferably with the first morning urine, which tends to have the highest concentration of the pregnancy hormone hCG.

If your period does not arrive and subsequent tests remain negative, it is advisable to consult a healthcare provider. There are several potential causes for a missed period, including:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) can disrupt the regularity of your menstrual cycle. Hormonal fluctuations can also occur due to stress, significant weight loss or gain, or changes in exercise habits.

2. Thyroid Issues: Both hyperthyroidism and hypothyroidism can affect menstrual cycles. Thyroid hormones play a crucial role in regulating your menstrual cycle, and any imbalance can lead to missed periods.

3. Stress and Lifestyle Factors: High levels of stress, changes in routine, or significant life events can impact your menstrual cycle. Additionally, excessive exercise or dietary changes can also lead to missed periods.

4. Medical Conditions: Certain medical conditions, such as diabetes or other endocrine disorders, can affect your menstrual cycle.
5. Perimenopause: If you are approaching your late 30s or early 40s, you may be experiencing perimenopause, which can cause irregular periods.

Given these possibilities, it is essential to seek medical advice if your period does not return within a reasonable timeframe. A healthcare provider can conduct a thorough evaluation, which may include a physical examination, blood tests to check hormone levels, and possibly an ultrasound to assess your reproductive organs.

In summary, while a missed period can be concerning, it is not always indicative of pregnancy, especially if home tests are negative. It is crucial to monitor your symptoms and consult with a healthcare professional for a comprehensive evaluation. They can provide guidance tailored to your specific situation and help determine the underlying cause of your missed period. Remember, your health is paramount, and seeking professional advice is always a wise choice when it comes to reproductive health.

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