Missed Period Concerns: When to See a Doctor?

Menstruation has not yet arrived?

Hello doctor, I had sexual intercourse on October 17, and my period started on October 21.
My usual cycle is between 28 to 31 days, but this month it still hasn't arrived (I haven't had any sexual intercourse since then).
Is this normal? I've been feeling bloated and uncomfortable in my abdomen for the past few days, and occasionally I feel a bit nauseous.
I also have a sensation of something flowing down there.
I’ve been quite stressed due to exams and competitions.
If my period still doesn't come, should I see a doctor?

Xiao Zhu, 10~19 year old female. Ask Date: 2018/11/22

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors affecting the menstrual cycle are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, and breastfeeding, among others.
It is recommended that if your symptoms persist or worsen, you should consult a gynecologist to check for hormonal imbalances or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/11/22

More Info

It's understandable to feel concerned about a missed period, especially when your menstrual cycle is typically regular. Based on the information you've provided, you had sexual intercourse on October 17, and your period started on October 21. Since you mentioned that your menstrual cycle usually ranges from 28 to 31 days, it seems that your period was on time for that month. However, if your period has not arrived this month and you are experiencing symptoms such as bloating and occasional nausea, it is reasonable to consider a few factors.

Firstly, stress can significantly impact your menstrual cycle. You mentioned that you have been under pressure due to exams and competitions, which can lead to hormonal fluctuations. Stress can cause your body to produce higher levels of cortisol, which may interfere with the hormones that regulate your menstrual cycle, potentially leading to a delayed or missed period.

Secondly, while you indicated that you have not had sexual intercourse since your last period, it is still important to consider the possibility of pregnancy, especially if you are sexually active. If you are concerned about this, taking a home pregnancy test can provide clarity. These tests are generally accurate if taken after a missed period, but some tests can detect pregnancy a few days before your expected period.

If your period does not arrive within a week or two, or if you continue to experience discomfort or other concerning symptoms, it would be wise to consult a healthcare provider. They can perform a thorough evaluation, which may include a physical examination and possibly blood tests or imaging studies, to determine the underlying cause of your missed period and any associated symptoms.

In addition to stress, other factors that can lead to a missed period include significant weight loss or gain, excessive exercise, hormonal imbalances, and certain medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders. Therefore, it is essential to discuss your medical history and any lifestyle changes with your doctor.

In summary, while occasional missed periods can be normal, especially in the context of stress, it is important to monitor your symptoms. If your period does not come soon, or if you have any concerns about your health, seeking medical advice is the best course of action. Your healthcare provider can help you understand what might be happening and guide you on the next steps to take. Remember, your health and peace of mind are paramount, and it's always better to err on the side of caution when it comes to your well-being.

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