Delayed Menstruation: Symptoms, Causes, and Next Steps

Menstrual delay

Hello, doctor.
I am the one who asked about my period being 14 days late.
My last menstrual period was from September 24 to September 30.
Recently, I have been experiencing increasing breast tenderness and discomfort.
Last night, I started feeling dizzy, and today I have continued to feel dizzy, have a headache, and feel very sleepy.
I also have persistent sharp pain on both sides of my abdomen, or a dull ache, and I have noticed an increase in discharge.
This afternoon, I visited a gynecology clinic where they performed a urine test, but it came back negative.
An ultrasound was done, and the doctor said that there were no abnormalities in my uterus, indicating that everything is normal.
The doctor suggested that it might be due to stress or irregular lifestyle.
I usually exercise four times a week for an hour, do not drink sugary beverages, eat fruits regularly, consume light meals, and do not stay up late; I usually go to bed by 11 PM.
I was quite shocked that my period has not arrived this late for the first time, and with these symptoms, I am feeling very anxious.
Could my stress be related to constantly thinking about why my period hasn’t come yet? Should I take the medication prescribed by the doctor to induce my period, or should I go to a larger hospital for further evaluation?

Yúyú, 20~29 year old female. Ask Date: 2017/11/07

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My last menstrual period was from September 24 to September 30.
Recently, I've been experiencing increasing breast tenderness and discomfort.
Last night, I started feeling dizzy, and today the dizziness has persisted along with a headache and a strong desire to sleep.
I also have sharp pains on both sides of my abdomen or a feeling of heaviness, and I've noticed an increase in discharge.
This afternoon, I visited a gynecologist at a clinic.
During a urine test, nothing was detected, and an ultrasound was performed.
The doctor said that my uterus showed no abnormalities and that everything appeared normal.
It might be due to stress or irregular lifestyle.
I usually exercise four times a week for an hour, don’t drink sugary beverages, eat fruits regularly, consume light meals, and avoid staying up late, although I do go to bed by 11 PM.
I was quite shocked that my period is so late this time and with these symptoms, it makes me very anxious.
Could my stress be related to constantly thinking about why my period hasn’t arrived yet? Should I take the medication prescribed by the doctor to induce my period, or should I go to a larger hospital for further evaluation? Answer: My last menstrual period was from September 24 to September 30.
This afternoon, I visited a gynecologist at a clinic.
During a urine test, nothing was detected, and an ultrasound showed no abnormalities in the uterus.
It is advisable to start taking the medication prescribed by the doctor to induce menstruation.

Reply Date: 2017/11/07

More Info

Understanding delayed menstruation can be a complex issue, especially when accompanied by various symptoms such as breast tenderness, dizziness, abdominal pain, and changes in discharge. It’s important to approach this situation with a comprehensive understanding of potential causes and next steps.

Firstly, it’s crucial to recognize that a delay in menstruation can occur for a variety of reasons. Common causes include hormonal imbalances, stress, significant weight changes, excessive exercise, and underlying medical conditions. In your case, you mentioned experiencing increased stress and changes in your routine, which can significantly impact your menstrual cycle. Stress can lead to the release of cortisol, a hormone that may interfere with the normal hormonal signals that regulate menstruation.

Your symptoms, including breast tenderness, dizziness, and abdominal discomfort, can also be indicative of hormonal fluctuations. These symptoms are not uncommon in the context of premenstrual syndrome (PMS) or other hormonal changes. However, since you have not had your period for 14 days and are experiencing these symptoms, it is understandable that you are concerned.

You mentioned that you visited a gynecologist who performed a urine test and an ultrasound, both of which returned normal results. This is a positive sign, as it suggests that there are no immediate concerns such as pregnancy or significant abnormalities in the reproductive organs. The doctor’s suggestion that stress or irregular sleep patterns could be contributing factors aligns with common medical understanding. Even if you maintain a generally healthy lifestyle, factors such as stress and anxiety about your menstrual cycle can create a feedback loop that exacerbates the situation.

Regarding your question about taking medication to induce menstruation, it is essential to consult with your healthcare provider before starting any medication. While some doctors may prescribe medication to help regulate the menstrual cycle, it is typically recommended to first explore lifestyle modifications and stress management techniques. If your symptoms persist or worsen, or if you continue to experience significant anxiety about your menstrual health, it may be beneficial to seek a second opinion or consult a specialist at a larger medical facility.

In the meantime, consider implementing stress-reduction techniques such as mindfulness, yoga, or meditation. Regular physical activity, which you already engage in, can also help alleviate stress and improve overall well-being. Additionally, maintaining a consistent sleep schedule is vital; while you mentioned going to bed at 11 PM, ensure that you are getting adequate rest and managing any factors that may disrupt your sleep.

If your symptoms of dizziness and abdominal pain continue, or if you experience any new symptoms, do not hesitate to seek further medical evaluation. It’s important to prioritize your health and well-being, and being proactive in addressing your concerns is a positive step.

In summary, while delayed menstruation can be concerning, it is often manageable with lifestyle adjustments and proper medical guidance. Keep an open line of communication with your healthcare provider, and do not hesitate to advocate for your health if you feel your concerns are not being adequately addressed.

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