Menstrual Irregularities: What to Do When Periods Are Delayed

Q: Menstrual Irregularities: What to Do When Periods Are Delayed

Hello： There are many reasons for the absence of menstruation, and the first step is to rule out pregnancy. <br>If pregnancy is not the cause, we then look for other reasons. <br>Common factors include stress and anxiety, which can suppress the release of hypothalamic gonadotropi

Menstrual issues

My girlfriend hasn't had her period for about one or two months, and she has taken a pregnancy test that came back negative.
What could be the issue? Her period has not come, and the pregnancy test was negative, leaving me unsure of what to do.

Lin, 10~19 year old female. Ask Date: 2015/07/14

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: There are many reasons for the absence of menstruation, and the first step is to rule out pregnancy.
If pregnancy is not the cause, we then look for other reasons.
Common factors include stress and anxiety, which can suppress the release of hypothalamic gonadotropin-releasing hormone and the secretion of pituitary luteinizing hormone and follicle-stimulating hormone.
Additionally, certain medications used in psychiatry and cardiology may also have this side effect.
Next, it is important to check for any endocrine abnormalities, including hyperthyroidism, hypothyroidism, elevated prolactin levels, elevated androgens, polycystic ovary syndrome, and certain ovarian tumors, all of which can lead to amenorrhea.
Typically, if initial examinations do not reveal any pathological changes, progesterone can be administered to induce menstruation.
Thank you for your message!

Reply Date: 2015/07/14

More Info

Menstrual irregularities can be concerning, and it's important to understand the potential causes and appropriate steps to take when periods are delayed. In your girlfriend's case, experiencing a delay of one to two months without a positive pregnancy test can be attributed to various factors, and it is essential to approach this situation with care and understanding.

Firstly, it is crucial to recognize that menstrual cycles can vary significantly among individuals. A typical menstrual cycle ranges from 21 to 35 days, and variations can occur due to numerous reasons. Common causes of delayed periods include hormonal imbalances, stress, significant weight changes (either gain or loss), excessive exercise, and underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders.

1. Hormonal Imbalances: The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. Any disruption in this hormonal balance can lead to irregularities. Conditions such as PCOS, which is characterized by the presence of multiple cysts on the ovaries, can cause irregular or absent periods due to elevated levels of androgens (male hormones).

2. Stress: Psychological stress can significantly impact menstrual cycles. Stress triggers the release of cortisol, which can interfere with the hormones responsible for regulating the menstrual cycle. If your girlfriend has been experiencing increased stress, it may be a contributing factor to her delayed periods.

3. Weight Changes: Both significant weight loss and weight gain can affect menstrual regularity. Low body weight can lead to a decrease in estrogen production, resulting in missed periods. Conversely, obesity can lead to hormonal imbalances that may also cause irregularities.

4. Excessive Exercise: Intense physical activity, especially in athletes, can lead to a condition known as exercise-induced amenorrhea, where periods are absent due to low body fat and energy availability.

5. Medical Conditions: Conditions such as thyroid disorders (hypothyroidism or hyperthyroidism) can affect menstrual cycles. An underactive thyroid can lead to heavier and more prolonged periods, while an overactive thyroid may cause lighter or missed periods.

Given that your girlfriend has already taken a pregnancy test that returned negative, it is advisable for her to consult a healthcare provider for further evaluation. A healthcare professional can conduct a thorough assessment, which may include:
- A detailed medical history and physical examination.

- Blood tests to check hormone levels, including thyroid function tests and hormone panels.

- An ultrasound to evaluate the ovaries and uterus for any abnormalities.

In the meantime, encourage your girlfriend to maintain a healthy lifestyle, including a balanced diet, regular exercise (without excessive strain), and stress management techniques such as mindfulness or yoga. Keeping a menstrual diary to track her cycles, symptoms, and any lifestyle changes can also be beneficial for her healthcare provider to understand her situation better.

In conclusion, while occasional menstrual irregularities can be normal, a delay of one to two months warrants further investigation, especially if it is accompanied by other symptoms. Support her in seeking medical advice, as this is the best way to determine the underlying cause and receive appropriate treatment.

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