Delayed Menstruation: Causes and Concerns for Women

Menstrual delay

Hello, doctor.
My menstrual cycle has been quite regular, usually around 28 to 30 days, but my period was originally due on February 18 and still hasn't arrived.
I've been experiencing breast tenderness and abdominal pain, and when I palpate the center of my lower abdomen, it feels painful, somewhat similar to a lipoma.
I have already consulted a gynecologist, and the examination showed no signs of pregnancy.
I have also taken medication to induce menstruation and used a home pregnancy test twice, both of which were negative.
Recently, I have been going to sleep around 2 to 4 AM; could this be affecting my menstrual cycle? Is there still a possibility of pregnancy? If I engage in sexual intercourse while taking medication to induce menstruation, could I become pregnant? Why is my period so delayed this time?

Jun, 20~29 year old female. Ask Date: 2018/02/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My menstrual cycle has been quite regular, around 28 to 30 days.
However, it was originally due on February 18, and it still hasn't arrived.
I've been experiencing breast tenderness and abdominal pain, and when I palpate the center of my lower abdomen, it feels painful, somewhat similar to a lipoma.
I have visited a gynecologist, and the examination showed no signs of pregnancy.
I have also taken medication to induce menstruation and used a home pregnancy test twice, both of which were negative.

1.
I've been going to bed around 2 to 4 AM lately; could this be affecting my menstrual cycle?
Answer: It's possible.

2.
Given that my period was due on February 18 and hasn't come yet, and considering the gynecological examination showed no signs of pregnancy, and I have taken medication to induce menstruation and tested negative twice, is there still a chance of pregnancy?
Answer: The likelihood is very low.

If I engage in sexual intercourse while taking medication to induce menstruation, is there still a chance of becoming pregnant?
Answer: The chances are very small.

Reply Date: 2018/02/25

More Info

Delayed menstruation can be a source of concern for many women, especially when their menstrual cycles have been regular in the past. In your case, you mentioned that your menstrual cycle has typically ranged from 28 to 30 days, but you are now experiencing a delay since your expected period on February 18. You also noted symptoms such as breast tenderness and abdominal pain, which can be common during the menstrual cycle but may also indicate other underlying issues.

There are several potential causes for a delayed period, especially in women who have previously had regular cycles. Stress, significant lifestyle changes, hormonal imbalances, and medical conditions can all contribute to menstrual irregularities. In your situation, you mentioned that your sleep schedule has been disrupted, with you going to bed between 2 to 4 AM. Sleep disturbances can significantly affect hormonal balance, particularly the hormones that regulate the menstrual cycle, such as estrogen and progesterone. This disruption can lead to delayed menstruation or even missed periods.

You also indicated that you have undergone testing with a gynecologist, which did not show any signs of pregnancy, and you have taken medication to induce menstruation. The use of medications like Provera (medroxyprogesterone) can help regulate your cycle, but it is essential to understand that these medications work by mimicking the natural hormonal changes that occur in a typical menstrual cycle. If you engage in sexual activity while taking these medications, there is still a possibility of pregnancy, especially if the medication has not yet induced a period.

In addition to hormonal factors, other medical conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or even conditions like endometriosis can lead to menstrual irregularities. Given your symptoms of abdominal pain, it may be worth discussing these possibilities further with your healthcare provider, especially if the pain persists or worsens.

If your menstrual cycle continues to be delayed, or if you experience any new or worsening symptoms, it is crucial to follow up with your healthcare provider. They may recommend further testing, such as blood tests to check hormone levels or imaging studies to evaluate your reproductive organs.

In summary, while stress and changes in sleep patterns can significantly impact your menstrual cycle, it is essential to consider other potential underlying causes. If you have concerns about your menstrual health or if your symptoms persist, seeking medical advice is the best course of action. Your healthcare provider can help you navigate these changes and determine the appropriate steps to take for your health and well-being.

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