Why Is My Period Late Despite a Regular Cycle? Possible Causes

My menstrual cycle has been very regular, but this month it hasn't come at all?

Hello, my menstrual cycle has always been very regular, although it doesn't have a fixed number of days, it arrives every month between 28 to 35 days.
My last menstrual period started on November 15, and now it is December 24, yet I still haven't gotten my period.
I have had sexual intercourse with my boyfriend, and we used condoms for contraception, but I know there is still a risk.
Since I haven't gotten my period since December 15, I have been taking pregnancy tests and ovulation tests (I thought that since ovulation tests measure luteinizing hormone, which increases during pregnancy due to high progesterone levels, it could help me determine if I am pregnant).
However, until this morning, all tests have shown negative for pregnancy, and the progesterone levels are low (not at ovulation levels).
Should I see a doctor? I'm worried that the doctor might just tell me it's due to stress (I am currently preparing for a retake exam, but I didn't experience this last year during the same situation).
Also, if I were pregnant, would the progesterone levels be as high as or higher than during ovulation? Thank you.

Nín hǎo., 10~19 year old female. Ask Date: 2015/12/24

Dr. Lin Wenbin reply Obstetrics and Gynecology

You need to seek guidance from a physician regarding your condition, including the proper usage of various reagents.
If you are considering retaking the exam, focus your energy on your studies; other matters, such as romantic relationships, should be avoided in order to achieve better results than last year.
Value yourself and live in the moment.
The opportunity to retake the exam may only come once or twice in a few years; if your boyfriend cannot wait that long, it is unrealistic to expect him to be with you for a lifetime.
You must take the greatest responsibility for your own stress.
The pressure of fearing pregnancy while monitoring ovulation is greater than anything else.

Reply Date: 2015/12/24

More Info

It's understandable to feel concerned when your menstrual cycle, which has been regular, suddenly becomes late. There are several potential reasons for a missed period, even in the context of a stable cycle. Let's explore some of these possibilities.

1. Pregnancy: The most common reason for a missed period is pregnancy, especially if you've had unprotected sex or if the condom failed. While you mentioned using condoms, no contraceptive method is 100% effective. If you have been testing for pregnancy and the results are negative, it could still be too early to detect pregnancy hormones, particularly if you tested too soon after your missed period. The hormone responsible for maintaining pregnancy, progesterone, is indeed elevated during pregnancy, often higher than during the luteal phase of a regular cycle.

2. Hormonal Imbalances: Even with a regular cycle, hormonal fluctuations can occur. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other endocrine issues can lead to irregularities in your menstrual cycle. Stress, which you mentioned is a factor in your life right now, can also significantly impact hormone levels and disrupt your cycle.

3. Stress and Lifestyle Factors: High levels of stress, whether from studying for exams or other life changes, can affect your hypothalamus, the part of your brain that regulates hormones. This can lead to changes in your menstrual cycle. Additionally, significant changes in weight, exercise habits, or diet can also impact your cycle.

4. Medical Conditions: There are various medical conditions that can cause missed periods, including uterine fibroids, endometriosis, or other reproductive health issues. If your period remains absent for an extended period, it may be worth investigating these possibilities.

5. Testing and Monitoring: Since you have been monitoring your ovulation and progesterone levels, it's good to keep track of these results. If your progesterone levels are low, it may indicate that ovulation did not occur, which can lead to a missed period.
Given your situation, it would be advisable to consult with a healthcare provider. They can perform a thorough evaluation, including blood tests to check hormone levels, and possibly an ultrasound to rule out any underlying conditions. While it’s common to feel anxious about what a doctor might say, getting a professional opinion can provide clarity and peace of mind.

In conclusion, while stress and lifestyle factors are often the culprits behind a missed period, it’s essential to rule out pregnancy and any underlying health issues. If your period does not arrive soon or if you experience any unusual symptoms, seeking medical advice is the best course of action. Remember, your health is important, and addressing these concerns early can help you manage your reproductive health effectively.

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