Delayed Menstruation: Common Causes and Concerns - Obstetrics and Gynecology

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Delayed menstruation can be a source of concern for many individuals, and understanding the common causes can help alleviate anxiety. In your case, several factors may contribute to your delayed period.
1. Stress and Lifestyle Changes: You mentioned that you have been busy with exams and have been going to bed late. Stress is a well-known factor that can disrupt the menstrual cycle. The body responds to stress by releasing hormones such as cortisol, which can interfere with the normal hormonal balance required for ovulation and menstruation. Additionally, changes in your daily routine, such as sleep patterns and increased workload, can also affect your menstrual cycle.

2. Weight and Nutrition: If you have experienced any changes in your weight or eating habits due to stress or a busy schedule, this could also impact your menstrual cycle. Both underweight and overweight conditions can lead to hormonal imbalances that may cause delayed menstruation.

3. Physical Health: You mentioned that you tend to feel "cold" and have a constitution that may be described as "虚寒" (a traditional Chinese medicine term indicating a deficiency in Yang energy). In traditional Chinese medicine, this can be associated with irregularities in menstruation. Cold environments or dietary habits that contribute to a "cold" body can potentially affect menstrual regularity.

4. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal imbalances can lead to irregular or missed periods. If your menstrual irregularities persist, it may be worth consulting a healthcare provider to rule out any underlying conditions.

5. Pregnancy: Although you mentioned that you have not engaged in penetrative sexual intercourse, it is important to note that pregnancy can occur from pre-ejaculate fluid during intimate activities. If there is any possibility of pregnancy, it would be prudent to take a home pregnancy test for confirmation.

6. Age and Menstrual Cycle Variability: If you are in your late teens or early twenties, it is also worth noting that menstrual cycles can be irregular during these years as the body adjusts to hormonal changes.
In conclusion, while occasional delays in menstruation can be normal, especially in the context of stress and lifestyle changes, it is essential to monitor your cycle. If your period does not arrive soon or if you experience other concerning symptoms (such as severe pain, unusual discharge, or significant changes in your health), it would be advisable to consult a healthcare professional. They can provide a thorough evaluation, including a physical examination and possibly blood tests to assess hormone levels, to determine the underlying cause of your delayed menstruation.