Pregnancy is the most common cause for lack of period
Nurse Practitioner Ila Shebar By NURSE PRACTITIONER ILA SHEBAR
What can make my period late?
Pregnancy is the most common cause for lack of period (amenorrhea) A simple pregnancy test can confirm this for you. If you're sure that you're not pregnant, then there are other things to look at that can cause this.
The first half of your cycle can be of varying length. The time from ovulation to menses is always 14 days. Anything that delays ovulation from occurring will make menses come that much later.
Not all cycles are exactly 28 days long. Keep track of your own cycle on a calendar to identify what's normal for you. Perhaps you have a 30 or 32 day cycle, so you're not really late but normal for yourself.
But even if you do have a regular cycle, occasionally the cycle is off. For this particular month you may have ovulated later than usual, which would push your period back. Or maybe, you have miscalculated the date you expected it to occur.
Adolescence is a time when most girls experience irregular menstrual cycles for the first few years. This is considered normal and not usually a cause for concern.
In peri-menopause, the time before menopause, periods get lighter, heavier, more frequent, less frequent and no longer regular. Be sure to continue to use contraception during this time, as you are still fertile.
Menopause is the time in your life when you no longer ovulate or menstruate and can be a natural occurrence or may occur due to surgery or chemotherapy. The average age for this is around 50, with some going through it earlier and some later. If this occurs prior to the age of 45 it is called early menopause.
Premature menopause occurs when a woman younger than 40 no longer produces quality eggs, and stops menstruating.
Breastfeeding can cause amenorrhea, but ovulation can still occur. If you are breastfeeding and do not want to get pregnant, do not assume that the lack of a period will protect you and be sure to use contraception.
What medications are you taking? Some contraception medications can cause an absence of menses. During the first two to three months you take oral contraceptives, your periods are often irregular. And if you've taken them for awhile, your periods may become lighter than you're used to. In addition corticosteroids, antidepressants, antipsychotics, thyroid and chemotherapy drugs can also cause amenorrhea to occur.
Make sure to find out what the expected side effects are if you begin a new medication.
Polycystic Ovarian Syndrome, PCOS, occurs in a woman when there are too many male hormones circulating in the body. All women produce some male hormones, but too much of them can disrupt the normal ovarian function, and can keep her from ovulating. If this occurs, menstrual cycles become irregular.
Thyroid disorders often interfere with normal ovulation and disrupt menses as well.
Are you eating a healthy diet and are you exercising? Women with eating disorders such as anorexia or bulimia, who are extremely underweight, often have amenorrhea. Being underweight or having an eating disorder can disrupt or totally stop your menstrual cycle.
If you don't have enough body fat, it's difficult for your body to produce the estrogen needed to keep your ovulation cycle regular. Without ovulation, you won't menstruate or menstruation will be irregular. Usually, gaining some weight helps cycles return to normal.
Being overweight also can hormonally shift your cycles.
Your overweight body may produce too much estrogen, which can interfere with normal ovulation. Again, as with being underweight, irregular ovulation will interfere with regular menstruation. Most women return to a normal cycle if they lose some weight.
Vigorous exercise or extreme athletic training also can cause amenorrhea.
Even if your body weight is at a healthy level, your body may stop menstruating to conserve energy or you may have low body fat, which interferes with the production of estrogen.
Do you have a chronic illness? Have you been sick for a long period of time? Both of these can cause a delay in your cycle, which will usually return to normal once your body is well.
This is usually a temporary cause of change in cycles. If you were ill around the time of ovulation, you may ovulate later than usual. This will delay your period from arriving at the expected time. Sexually transmitted diseases also can interrupt your cycle; get screened if you are at risk.
Experiencing an unusual amount of stress also can change your cycle by decreasing production of hormones needed to ovulate and menstruate. Stress takes many forms and is not always a bad thing. Travel or change in your daily schedule can cause stress as easily as a new job can cause stress.
Changes in shift work can change your cycle. Once you adjust to the changes, the stress may go away. Reducing or eliminating the stress from your life can help to resume normal menstruation. Stress around the time of ovulation can delay ovulation from occurring, which would delay your period from coming.
If you're sure you are not pregnant and are unable to attribute the lack of menstruation to anything discussed here, make an appointment with your provider to rule out and determine the cause.
Ila Shebar is a women's health nurse practitioner specializing in women's pelvic health and continence at Pioneer Valley Urology in Springfield. Her "Ask Ila" column appears every other Wednesday in the Health & Science section of The Republican and on MassLive.com. She can be reached at ilashebar np.pvu@gmail.com