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Pregnancy Isn't the Only Cause of Absent Periods

Updated on April 13, 2017
akanga1 profile image

I am a consultant obstetrician and gynaecologist at Macclesfield Hospital, in Cheshire, Northern England.

Pregnant until proved otherwise

One of the most-used lines in medical schools all over the world is this: "Any woman who walks into your consultation room is pregnant until proved otherwise." It is a piece of dry humour that may offend some people but actually carries a very serious message. One of the gravest errors a doctor can make is to miss a pregnancy. That kind of error can lead to extremely serious consequences, and finding out about possible pregnancy can, in most cases, be determined by a simple question: When was your last period? It does not matter whether the person is presenting with a seemingly unrelated ailment; let’s say, pain in the shoulder (you may want to order an X-ray). Just establish the status, even if she enters the room in a nun’s garb.

The other side of this coin, however, is the question of missed periods.

No periods; not pregnant. What's going on?
No periods; not pregnant. What's going on? | Source

Amenorrhoea Can Have Many Causes

There are several other causes of missed periods other than pregnancy. Amenorrhoea is the medical term for absent periods. Primary amenorrhoea is where a girl/woman has never had periods at all. This will be a subject of a separate article. In this article, we are going to look at secondary amenorrhoea, in which periods that had hitherto been normal, cease. On many occasions I have seen questions, even here on HubPages, about missed periods and pregnancy tests that have been repeatedly negative with a bewildered air of "what is going on?" Here are some of the possible explanations.

Polycystic Ovarian Syndrome (PCOS)

This is a fairly common condition, affecting many women to varying degrees of severity. The commonest manifestations of PCOS are being overweight/obese, increased body hair (hirsutism) and erratic periods. In a typical case of PCOS, the affected woman may find that her periods are unpredictable sometimes going several months without one. This particular feature tends to be masked by the use of the combined contraceptive pill. With the pill, the periods will arrive on time like clockwork. It is when the woman decides to come off the pill, usually because she wants to conceive, that this particular feature will be manifest. She may, in fact, believe she has conceived but a pregnancy test will show she is not pregnant. Were she to pursue this further, a hormone profile blood test and a pelvic ultrasound scan will clinch the diagnosis. Absent or erratic periods in polycystic ovarian syndrome (PCOS) are caused by the abnormal hormone environment that underlies this condition. In the majority of cases, a successful reduction of body weight to a normal body mass index (BMI) will lead to a resumption of normal regular periods.

Thyroid dysfunction

This is not a common cause of missed periods but its importance lies in the fact that thyroid disease affects the functioning of many vital organs hence the need to be aware of the possibility of this being the underlying cause. Bothunder- and over-active thyroid disease can cause absent or erratic periods.

In underactive thyroid, the thyroid hormone is produced in insufficient quantities leading to a feeling of lethargy, cold even in warm weather, weight gain, dry and brittle hair and nails, low mood and, yes, erratic periods.

Excessive production of thyroid hormone tends to be characterised by, in the main, the opposite symptoms except for the issue with the periods. A sufferer will experience a sense of restlessness and even hyperactivity, palpitations, feeling warm and poor tolerability of heat, weight loss even though there may be increased appetite, occasionally hair loss, sweatiness and, yes, there may be erratic or absent menstrual periods in this case as well. A condition called Graves’ disease is the main cause of excessive thyroid hormone production.

In both under- and over-active thyroid, correcting the thyroid hormone problem leads to resumption of regular periods and resolution of the other symptoms.

Absent periods is a common occurrence among Marathon and other long distance athletes
Absent periods is a common occurrence among Marathon and other long distance athletes | Source

Excessive exercises

Up to a half of long distant runners and around 4 in 10 of professional ballet dancers will experience secondary amenorrhoea. Excessive exercises will tend to lead to the shutting down of the process in the part of the brain called the hypothalamus which control the menstrual periods. It is one of the ways that the body deals with the excessive energy expenditure that it is being put through. In the case of ballet dancers, the situation is enhanced by the fact that they tend to maintain a restricted calorie intake.  Once the athlete cuts down on her training or exercising, the periods will resume

Pituitary tumours

The tiny gland in the brain called the ‘Pituitary’ is responsible for production of a variety of vital hormones. One of the hormones is called Prolactin. Prolactin hormone is responsible for milk production. Sometimes a hormone producing tumour, usually small in size will develop in the pituitary and start producing prolactin hormone in ever increasing quantities. This will have the effect of suppressing periods and like a pregnant or breast-feeding woman, a person with this type of tumour will experience absent periods.  Prolactin producing tumours are overwhelmingly benign and treatment involves taking medication that suppress the production of the hormone. This is usually effective and periods will resume once the prolactin levels have dropped back to normal. A condition where there is excessive prolactin is generally called hyperprolactinaemia.

Cushing’s disease

This is an entirely different disease from the one described above. Another hormone produced in the pituitary gland is known as ACTH. When ACTH is produced in excessive amounts it, in turn, leads to excessive production of the steroid cortisol. This leads to the condition known as Cushing’s disease. The presentation of Cushing’s disease is rather dramatic with rapid weight gain, thinning of skin usually with easy bruising; stretch marks may appear on the abdomen and thighs and periods tend to stop. Cushing’s disease is part of the wide spectrum of what is known as Cushing’s syndrome, the common factor in all these being excessive cortisol in the body. This brings us to another cause of absent periods due to problems in the adrenal glands (below).

Adrenal gland problems

Adrenal glands which are perched on top of kidneys are vital for production of various hormones and other chemicals. These include the steroid cortisol. Sometimes cortisol producing tumours develop leading to the condition discussed above; i.e., Cushing’s syndrome. Among other things, Cushing’s syndrome will be characterised by cessation of periods (until the excessive cortisol situation is brought under control).

Another cause of Cushing’s syndrome is when the systemic steroids are prescribed to treat other diseases such as severe asthma or some types of arthritis.

Medications and drugs

Apart from steroids mentioned above, prolonged use of other drugs can lead to temporary cessation of periods.  Phenothiazines are drugs that are employed mainly as anti-psychotics in schizophrenia. Some are used in heart conditions and weaker ones are used for controlling nausea and vomiting. They include such drugs as Chlorpromazine, Thioridazine, Prochlorperazine etc. They are available in an array of different brand names. Long-term use of these drugs can lead to cessation of menstrual periods.

Metoclopromide is used mainly as an antiemetic (to control nausea and vomiting). It is therefore unusual for this to be taken for a prolonged duration and, in any case, it should never be used for more than three months. Side effects are rare but Metoclopromide can also cause temporary cessation of periods. Metoclopromide is more popularly known by the brand names Maxolon, Reglan or Pramin.

Cocaine is an illicit drug with many potential side-effects one of which could be absent menstrual periods. The problem tends to resolve spontaneously within a few weeks of the person coming off the drug.

Stress

Stress of the emotional kind can and does often cause missed periods. Events such as bereavement, exams, marital difficulties or even severe sustained stress at work could cause a woman to miss her periods, sometimes for several months at a stretch.

Anorexia nervosa

Anorexia nervosa, a serious psychiatric condition the hallmark of which is being severely underweight is almost always accompanied by absent periods.

Excessive weight loss starting from normal weight not associated with this anorexia can also lead to missed periods especially if the weight is lost rapidly over a relatively short period of time.

Obliterated uterine cavity

Menstruation is a result of breakdown of the lining of the womb. Sometimes, especially following the procedure dilatation and curettage (D&C), adhesions form within the uterine cavity effectively obliterating it. As a result, the woman may find that she does not get any more periods after undergoing this. The condition is known as Asherman’s syndrome. In some cases, it is possible to reverse this through surgery.

Premature ovarian failure

This can also be called premature menopause. It is estimated that up to 1% of women go into menopause before the age of 40. It is not clearly known why ovaries stop functioning at such an early age. Premature ovarian failure has been known to happen to girls in their late teens and early twenties. Often, the most notable symptom is disappearance of periods without any obvious explanation. A hormone profile blood test will usually clinch the diagnosis. Premature ovarian failure is usually irreversible.

Damaged pituitary gland

We discussed this little gland with regard to over-production of the hormones Prolactin and ACTH. There is another way that the Pituitary gland can come into the picture when a woman is experiencing absent periods. There is a condition known as Sheehan’s syndrome. This describes a situation where the Pituitary gland has been damaged by disease, trauma, radiotherapy or, in some cases, prolonged deficiency of blood supply to the gland as can happen when there is undue delay in correcting severe blood loss for any reason as can happen following childbirth (postpartum haemorrhage).

Post-pill amenorrhoea

Some women, after using the contraceptive pill for a prolonged duration will find that, when they come off, the periods do not resume, at least not for a few months. This is known as post-pill amenorrhoea. This can also happen after using other forms of contraception especially the injection Depo-Provera.

The final Word...

Now, this may appear like a long list. The main message for clinician is to always be diligent in taking the woman’s history when she presents with unexplained absent periods. The answer is often clinched there. For the affected woman, it is really to highlight the fact that there are many and varied causes of absent periods. For somebody who is sexually active, it is perfectly legitimate to rule out (or in) the possibility of pregnancy. When the pregnancy test is negative, it is prudent to get to see a doctor to establish what is going on especially because some of the underlying conditions require early intervention. Pregnancy isn’t the only cause of absent periods.

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    • profile image

      Pebbles 5 years ago

      Is it safe for a pregnant woman to have unprotected sex or sex...What causes the dark brown discharge on a pregnant woman?

    • anusujith profile image

      Anoop Aravind A 5 years ago from Nilambur, Kerala, India

      Hi Doctor all of your hubs are informative.shall I ask one doubt for my wife? She was suffering from this delayed period,but she is 8months pregnant now.Is this delayed periods affect their delivery?

    • akanga1 profile image
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      akanga1 5 years ago

      Hi anusujith, thank you for your comments. Previous erratic periods should have no bearing whatsoever on timing or mode of delivery. My best wishes to you and your wife

    • akanga1 profile image
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      akanga1 5 years ago

      Unprotected sex is never a good idea at any time unless one is in a monogamous relationship. This applies in a pregnancy as well. A dark bown vaginal discharge will be regarded as a case of bleeding and has got to be investigated as such. In most cases, the source of bleeding remains obscure and this problem is usually self-limiting

    • lauranap12 profile image

      lauranap12 3 years ago from Vermont

      Hi, may I suggest that you add MRKH to your list? It is a congenital condition and affects around 1 in 4,500 women and the simplest explanation is that it means a woman is born without a uterus. There are many other "symptoms" associated with the condition.

      Please visit www.mrkh.org or www.beautifulyoumrkh.org to learn more. Even a simple Google search would suffice.

      Thank you,

      Laura

    • akanga1 profile image
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      akanga1 3 years ago

      @lauranap12; thank you for your helpful comment and suggestion. In fact MRKH (Mayer-Rokitansky-Küster-Hauser syndrome) was left out deliberately. This is because, as mentioned above, this hub was going to discuss those conditions which cause 'secondary' amenorrhoea i.e. absence of period where they have occurred before. As you quite correctly pointed out, girls with MRKH syndrome have an absent uterus and an absent or underdeveloped vagina. As such, they almost always present with failure to start having periods ('primary' amenorrhoea). The condition therefore falls outside the scope of this hub. The cause of this syndrome is not clearly understood.

    • lauranap12 profile image

      lauranap12 3 years ago from Vermont

      Oh ok, I didn't see that explanation of the secondary amenorrhoea. Thanks for your answer though.

    • profile image

      janvi13 3 years ago

      I am 16years old and frm stating i am having an irregular periods of 2 months but now it has been 4 months i have not got periods.

      And i have never been to sex !!

      Soo please help me why is this happening??

    • akanga1 profile image
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      akanga1 3 years ago

      Thanks janvi13 for your comment and query. At 16, with a history of rather erratic periods from the outset and now going 4 months without a period, the most likely explanation in your case is Polycystic Ovarian Syndrome (PCOS). This condition is covered above. It is the commonest cause of erratic period. Even though this condition is also characterised by being overweight and having skin problems such as acne and increased body hair, in fact many women affected by polycystic ovarian syndrome may be of normal weight and have no skin problems. The only feature of the condition may very well be erratic unpredictable periods. If you want more details about the condition, this is a good link: http://www.pregnancy-bliss.co.uk/PCOS.html

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      Tessa 3 years ago

      I'm totally confused and need another opinion from a second person. I'm 19 years old and have a 16 month old daughter! I recently back in September had my normal period then five days later on the 29 of September had another "period" was very odd and confusing. So then that was it come October I bleed for not even a full day not even a couple of hours. That happened a week before I was due for my period that month of October. I am now 12 days late took 3 hpt all neg. Took a urine test at the doctors it came back negative I asked for a blood test and still waiting on results. I am sexually activie. The doctor told me I have amenorrhea witch I don't understand at all..I'm healthy I don't ever have health problems nothing can be wrong with my overies when I just had two pregnancies less then 2 years!! Have regular periods on time. Nothing has changed life wise to cause me to have missed my period I'm really confused!!

    • akanga1 profile image
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      akanga1 3 years ago

      Hi Tessa, Thanks for your input here. I can understand why you would be confused and anxious about the pattern you just described here. However, I have a feeling your dates are probably incorrect and, for me, difficult to decipher. If you had a period on 29th of September, your next period would not have been due till around the 25th of October (assuming a 4 weeks cycle). If you had a brief bleed a week before that date, that would be around the 17th of October. If we were to take that to be a true period, albeit different from your norm, it will mean your next period isn't really due until around the 13th of November. Technically you have not yet missed a period. A negative pregnancy test is therefore to be expected.

      The erratic pattern you have experienced these last few weeks is, in fact, not uncommon and is generally termed as 'Dysfunctional Uterine Bleeding (DUB)'. I would expect that to settle in the coming weeks but if it doesn't, you may need a review by a gynaecologist. That may lead to your being advised to go on the pill to regulate your periods (unless you are actively trying to conceive). Hopefully, that won't be necessary. Best wishes.

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      Danielle 3 years ago

      I had no period for over two years and last month was so glad to see its return. I thought it was back for good and to my disappointment the time of the month that it came has already passed with no period. It was meant to be there on the 26th. My partner and I want Children and im so scared that its not gonna happen for us. We have been trying just over a yr now. I went to a gynacologist and he ruled out pcos and my blood testing all came back normal. I made a few lifestyle changes before my period came back as I want to be healthy to increase our chances. I cut out fizzy drinks and reduced the amounts of junk food I eat dramatically and upped my exercise. I also took adios and lost over a stone. I'm trying so hard and am so disappointed to see no period this month.

    • profile image

      Blondy 3 years ago

      Hi there

      I have a son who is 8 months old and still breastfeeding during the night and day. I missed my period this month and that makes it the 6th week of me missing my period. I'am assuming that I'am pregnant but did not show any early signs and symptoms of it.

    • profile image

      Gigi 3 years ago

      I had my last menstrual period last feb.7.. And up to now, I haven't had menses... Sexually active.. 2 pregnancy test results negative .taken last march 22 and 26 respectively... No signs and symptoms of pregnancy... What could be the possible cause for this...really appreciate your response to this matter..thanks

    • profile image

      kem 3 years ago

      I missed my period and conducted absorbent strip test which proved posstive, but there is no early signs and symptons of pregnancy

    • akanga1 profile image
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      akanga1 3 years ago

      #Danielle, thanks for your comment. Your experience isn't unique but I know that is no consolation. As you can see in the hub, there is a whole variety of potential causes of absent periods. If your hormone profile blood tests were normal, that is a major worry out of the way. You do still need to be under the care of a specialist and, if you have been trying for a baby for a year without success, formal fertility tests ought to be initiated. My best wishes in your quest.

      #Blondy; your missed period could of course be a one-off, something that is not uncommon for mothers who are breast-feeding. However, you may wish to perform a pregnancy test just to be sure.

      #Gigi; difficult for me to say from the brief information supplied as to why your period is delayed. Two negative pregnancy tests would tend to suggest that you are probably not pregnant. Again, I would advise that you review the information in the hub to see whether any of the mentioned causes of missed periods could potentially apply in your case. If nothing seems to fit your picture and the period hasn't arrived, a visit to the doctor may be the next logical step.

      #kem; the positive test indicates that you have conceived. I do not know whether this is your first pregnancy but it is worthwhile knowing that not every woman experiences perceptible pregnancy symptoms early on. Apart from a missed period, many women can go for several weeks unaware that they have conceived. If you are still in doubt, you may wish to repeat the test or even arrange an ultrasound scan. My best wishes.

    • profile image

      Jill 3 years ago

      Is it possible for a woman to miss her period for ten days at the same time vomiting and spitting without pregnancy? What could be the other cause of these?

    • profile image

      swapna mondal 3 years ago

      i am 22 years old. my perod off 4 months. i don't have pregnancy, thyroid. i have hair falls. what should i do please tell me?

    • akanga1 profile image
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      akanga1 3 years ago

      #Jill: Yes, it is possible for a person to miss her period for several days without being pregnant even with the said symptoms. In fact, it is fairly unusual for a woman to experience morning sickness (nausea and vomiting) immediately after missing her period. For most, this tends to set in gradually several days after the period was due. If you or somebody you know has missed a period (and the pregnancy test is definitely negative) and is getting nausea and vomiting, the two events may be unconnected. If the symptoms are persisting, a review by a doctor for examination and tests may be appropriate.

      #swapna: Absent periods and losing hair from your scalp could be features of polycystic ovarian syndrome (PCOS). If your periods have tended to be erratic and you have other features suggestive of this condition (overweight, hirsutism, acne etc), you should arrange, if possible, to have a hormone profile blood test and a pelvic ultrasound scan to see if, indeed, you have PCOS. I am including a link for you to read a bit more about the condition (below)

      http://pregnancy-bliss.co.uk/PCOS.html

    • profile image

      sally 3 years ago

      Hi there,

      Should I get a second opinion?

      I am 27, always had regular periods until recently. I have now missed 3 periods, my doctor ruled out everything on the above list including pregnancy. I was told "it will probably sort itself out and we will wait and see"

    • akanga1 profile image
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      akanga1 3 years ago

      #sally: It is possible, albeit uncommon, for periods to cease with no obvious explanation. Such a scenario tends to be transient and, as your doctor said, when all the 'usual suspects' have been objectively ruled out, you can reasonably expect a spontaneous resolution in a matter of months.

      I do not have a list of tests that have been carried out and their results so cannot comment on how comprehensive your doctor has been. If, indeed, all the potential causes discussed in the hub have been ruled out, this justifies the term 'idiopathic amenorrhoea' meaning the cause is unknown. In such a case, a second opinion is likely to be an unnecessary expense and expectations of a spontaneous resolution are not unreasonable. My best wishes.

    • profile image

      natasha 2 years ago

      Hi i had been on implanon for nearly 10 years, had it taken out in feb, it was nearly years overdue to be taken out, the last year i had it in my periods were here every mth in and around the same time time, since having it removed in feb i had 1 period which was 22nd march an have had nothing since. I am waiting for the results of a blood hormone profile? Could my situation be caused due to having the implant taken out??

    • akanga1 profile image
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      akanga1 2 years ago

      #natasha: The taking out of the implant cannot be responsible for your current experience but the long term use of that implant could. Some women who use Implanon or Depo Provera injections over an unbroken period of several years do find that, when they come off, the pattern of their periods could be erratic. This could include phases of absent periods that can last months. This scenario is usually transient and sooner or later the normal cycles resume. How quickly the normal menstrual pattern comes back also depends on the woman's age. Having a hormone profile blood test is obviously the right thing to do to get clarity.

    • profile image

      coop24 2 years ago

      My husband and I have been ttc for months. My last period was on July 4, 2014. Today, is August 19 2014 and I have not started. I am always on time, every 28 days. I am currently 19 days late with 4 negative pregnancy tests. I am extremely tired, have a K9 nose, cramping, back ache. My Dr. wants me to come in for a blood test. I have had 1 ectopic and tube removed and cervical cancer cells removed. Has anyone else ever experienced this?

    • akanga1 profile image
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      akanga1 2 years ago

      #coop24: Clearly worrying times and understandably so. This hub was meant to at least try to explain situations such as yours. 4 negative pregnancy tests would suggest that you are almost certainly not pregnant and your absent/delayed period has a different underlying cause. It is difficult to envisage four tests being falsely negative and current tests are quite sensitive. Your doctor would try to confirm this by checking the pregnancy hormone (beta-hCG) level in your blood. A negative blood test will be confirmatory and definitive. If, indeed, that is negative, your doctor will then need to do tests for alternative explanations for the absent/delayed period most of which are discussed in this hub. I do hope you get clarity on the situation soon and my best wishes on you and your husband's quest.

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      Charlene 2 years ago

      I have an irregular period cycle some ranging mainly between 27-29 day cycle how ever I have not had a blood flow period since the 1st of July 2014. .. for the last 2 months when i'm due for my period i've been experiencing spotting which only last a few times when i wipe after going to the toilet for eg. 27th july I thought my periods were coming i had a brown spot/clot thingy looked like my periods were starting then nothing all day, 30 july 2 bright pinkish spots, 31 july 1 spot. 20th august 2 pinkish spots, 22 aug about 3 spots of the same pinkish watery spots and no more since then. I was just wondering if anyone has experienced this before? - I took a pregnancy test on the 5th august which was negative but haven't taken another one. Going to the drs to see what I need to get check out & was wondering what you would suggest. Thanks :)

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      camille 2 years ago

      My name is Camille bruno Valdez my partner and I have been trying for a baby for over two years now, We were going to a fertility clinic for about 5 months before somebody told us to contact this spell caster who is so powerful, We contacted him at this email; arewaspecialistttemple@gmail.com , for him to help us, then we told him our problem, he told us that we will either conceive in February 2014 or March 2014,but after two years of trying we were at a point where we were willing to try anything. And I'm glad we came to Dr Dahiru, Because his pregnancy spell cast put us at ease, and I honestly believe him, and his gods really helped us as well, I am thankful for all he has done. contact him via email: arewaspecialistttemple@gmail.com if you are trying to get a baby or want your lover back. he has powers to do it, he has done mine,

    • profile image

      Lost Girl# 2 years ago

      I'm turning 22 this month and since last year there was a time whereas I've missed my period for almost 4 months,decided to go on the pill and it came back but this time its very light and accompanied by period pains on the 1st day. It seems my period won't appear unless I'm on the pill. I'm overweight yes and recently always feel bloated,tired and Gasy. I don't Understand this situation and I've done several preg tests and all came negative.

    • profile image

      Senah 8 months ago

      I read your hub and it helps me a lot.. I want to ask some questions. I'm 19 and

      I'm 3days delay my LMP was aug.8 and I've been regular since june. I'm afraid of being pregnant but I already took a pregnancy test last sept.9 and it result to negative. Yes, I'm having sex with my boyfriend but not actively like that.. once a month for sure..I'm a nursing student and two weeks ago prior to my due date of menstruation , I'm so stressed with our paper works to be passed, missed meals, sleeping 4 to 5hrs, taking meds for my colds and cough and multivitamins as well.. and it really bothered me missing my period.. and I already read some articles about Amenorrhea. . I'm going to repeat my urine pregnancy test this coming sept 16 if I'm still not have my menstrual period. And if it result to negative I'm going to have HCG via serum to make it more accurate. so please help me.. what could it be the reason ? Thank you hoping for your response! Godless!

    • profile image

      Stella 8 months ago

      I'm 44. I've been on Yaz for a year due to severe PMS. This time around I took two months worth of pills back-to-back due to going on vacation, and wanting to skip my period while away. I had a couple of late pills on non-consecutive days during vacation. By "late" I mean a few hours late. Now my period is 12 days late. I've had three negative urine tests and one negative ultrasound. The last possible day of conception would have been one month ago. I am having symptoms of pregnancy (I have two kids, so I know). I wonder what's up? Any insight or suggestions for next steps?

    • akanga1 profile image
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      akanga1 8 months ago

      Hi Senah

      Sorry to hear of all the stress. Though not impossible, I think it is unlikely that you are pregnant. The stress you describe is the most likely explanation for the absence of the periods. Your plan to do a blood hCG test to be certain is clearly the right strategy if you remain amenorrhoeic and the urine pregnancy test is still negative

      **********************************

      Hi Stella,

      This is likely to be post-pill amenorrhoea. Even though this tends to happen after a person has been on the pill for a long time, it has been known to happen after a short stint like yours. Pregnancy is unlikely in the circumstances described. If the period does not arrive in the next 4 weeks or so, I would suggest you have a hormone profile blood test specifically for beta-hCG and FSH. Best wishes.

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      fridah 7 months ago

      My period miss five day I'm worried coz I have back pain an cramps breast thunder an i did pregnancy test come negative an also did scan nothing show I don't know what is going on Pls help me

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      anne 6 months ago

      I am going to be 21 after 2 months.Until September I was having regular periods .pretty regular only 2-3_days here and there but since then I had had no periods that would be 2 missed cycles (It was due on 3/4 of month).However somewhere in late mid october I did bleed but for once like just little a thick brown something and reddish tinge in pot after i peed .I have never had sex.Years ago I once remember my period being very late but it became nirmnal after that also sometime once in several months they can come a little late.That's it.

      Other things: I have always been very hairy more than normal.

      For the past 4-5 months I am under considerable stress study related.

      I do have gained weight and experiencing hairfall but there are present many reasons that these could be attributed to.Please give insights.Should I see gynec?

    • akanga1 profile image
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      akanga1 6 months ago

      Hi Anne,

      Yes, I think a review by a gynaecologist will be a good idea but it is not an emergency. The picture you paint is vaguely suggestive of polycystic ovarian syndrome. However, I do not have enough details here to declare that with confidence. The stress you describe could also be muddying the waters to some extent. I think a pelvic ultrasound scan and a hormone profile blood test should help bring clarity.

      Best wishes

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      Cathy 6 months ago

      Hi, I have had regular periods from the age of 13 and am now 30! I have had 4 children (all delivered by Caesarian). My youngest child is now 2, I haven't had a period for 9 months! Were regular after last child. I have visited my doctors surgery and saw a nurse practitioner who sent me for blood test which all came back normal!!

      I have however lost over 6 stone but my bmi is still within the healthy range at 20 so I don't see why this would be the cause!! I just want some reassurance that it is nothing to worry about! TIA

    • akanga1 profile image
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      akanga1 6 months ago

      Hi Cathy,

      Congratulations for that weight loss which I assume was deliberate. You are right in saying that this cannot explain the absent periods since your BMI remains within the normal range.

      I am not sure how comprehensive the hormone profile blood test you had was. As you can see from the list of potential causes of absent periods, sometimes extensive tests are required to get to the bottom of the issue. The hormones that should almost always be checked in a case like yours (once pregnancy has been excluded) are LH, FSH and Prolactin. This is to check for the relatively common causes. If these come back normal, then further tests are required and ideally your GP should refer you to a specialist for a detailed look at the whole picture. This is unlikely to be something serious but, for peace of mind, you need evidence for whatever form of action a doctor may advise. Best wishes.

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      Tilly 6 months ago

      Hi,

      I had my second son in June this year. Tragically he passed away at 15 days old due to a heart condition. We have previously fell very quickly with both our sons and I have had no problems with my periods at all until now. I have had no period since giving birth. I had my bloods tested and my fsh was 36 and my lh 21. All other levels were fine apart from ferritin which was a little low at 39. I have also been experiencing a lot of hair fall and obviously a lot of stress. The male doctor at my practice said I was menopausal but the female doctor wasn't so sure. I am finding it hard to get my head round being pregnant to then being menopausal?! I have no other symptoms of being menopausal other than lack of periods and the high test results. Could it be something else going on?

      Thank you in advance.

    • akanga1 profile image
      Author

      akanga1 6 months ago

      Hi Tilly,

      I can understand your confusion and anxiety. If you have missed periods and the FSH level has been found to be raised albeit modestly, there is a legitimate concern about the possibility of premature ovarian failure. I do not know what age you are but, if under 40, then this will need to be actively explored as a possibility. Just one high FSH reading can never be used to make a conclusive diagnosis. You will therefore need to have the hormone profile blood test repeated, ideally with at least a two months interval from the original. It is entirely possible that the current absence of periods is due to other transient causes so a definitive explanation cannot be given right now. My best wishes.

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      Laura Davila Juarez 4 months ago

      Hello I just had baby 2. I'm not breastfeeding but i just missed my third period. My first period came in at 10 weeks postpartum. I have read that your body may be adjusting but I had two normal periods already! Negative pregnancy test!! I just notice like a week ago a lot of mucus clear discharged I was amazed of how much? What could be wrong?

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      Katie 4 months ago

      Hi doctor. Im currently in my seventeenth month post baby via c section and still no period. I ceased breast feeding at three and a half months due to the fact I was on antibiotics after my childs birth she could not have in my breast milk from an mrsa positive swab and complications with my stitches resulting in a bad infection. She never latched so I pumped and dumped until the antibiotics were completed but by this time she was a bottle baby. I continued to pump and feed her breast milk until almost four months when I gave up because without her actively feeding I was unable to produce. Anyway, I am not sexually active at all, and I am concerned because there has not even been an inkling of my cycle returning. I also seem to show some signs of the overactive thyroid effects yo described. Im hot all the time and sweaty. Have trouble falling and staying asleep. Severe morning headaches, along with fatigue etc. Any advice or ideas what it may e?

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      akanga1 4 months ago

      Hi Laura,

      Skipping a period in the first few months after delivery is not all that unusual. The regular cycle may not re-establish for a number of months in some cases. If the periods were to remain absent for several more weeks, let's say 6-10, then you may wish to bring that to your doctor's attention. For now, I really wouldn't worry. The episode of a mucousy discharge is also unlikely to be significant especially if it has not persisted

      Hi Katie,

      17 months is a long time and you really need to see a doctor about this. There could be a number of possible causes in your case. A thyroid problem is one possibility of course. Other possible causes would be premature ovarian failure. I don't know your age but this could happen to any woman at any age. You don't need to panic as this is unlikely but clearly needs to be ruled out with appropriate tests. You mentioned that you had a 'bad infection' after your caesarean section. Did this affect the womb? This is because we have to think of the possibility of Asherman's syndrome which is described above. All in all, I think it is important that you bring this to the attention of your doctor now. This will bring clarity to the picture, give you peace of mind and, in all probability, will be found to be something that can be easily corrected. My best wishes.

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      cagd 4 months ago

      Hi, I'm 34 and have had regular periods. The last I had a regular period was October 11.

      In November I got it a week early on November 2nd but it was not a regular period, I was only spotting very light pink and it lasted 11 days.

      In December I started spotting again on December 6th but this time it lasted 16 days. There were random 3 days out of the 16 days that my period was light to medium but very light pink.

      During these irregular period I've had pregnancy symptoms but pregnancy home test has all been negative.

      My husband then started to notice that my stomach has gotten firm around my belly button area. I am plus size so you can not easily tell by looking but we can feel it when I am laying down on my back. I have consistent uncomfortable pain on top of my pelvic bone, lower abdomen, sore under my ribs, sore breast and I feel pain in my stomach from even just lifting groceries.

      I finally went to my Doctor, got blood work and that came back negative as well. It is now January 15th and my period hasn't shown up I had a tiny very light pink when I wiped January 13th.

      The doctor said we should induce my period. I told her I do not feel comfortable doing that and would like to get an ultrasound. I feel like she thinks I'm crazy as she said my stomach pains are from being full and she felt nothing in my stomach. I'm still getting an ultrasound tomorrow because I want to be 100% sure. If I am not pregnant that is okay but I obviously feel pain and would like to know what is causing it.

      I was reading your post and you said ‘Any woman who walks into your consultation room is pregnant until proved otherwise’. Do you think my doctor was right telling me to induce my period without an ultrasound?

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      akanga1 4 months ago

      @cagd

      Hi, thank you for your query. I'm afraid I don't agree with your doctor. You cannot simply induce a 'period' before trying to establish why the periods stopped in the first place.

      From your details, you are almost certainly not pregnant but your plan to have a pelvic ultrasound scan is the correct one. This will likely confirm absence of pregnancy but may shed some light on exactly what is going on. It is also possible that the scan will be negative but that will not have been a wasted effort. Sometimes you reach a diagnosis by exclusion. As detailed in the article, quite a number of causes of changed or absent periods are not in the pelvis and that might turn out to be the case with you.

      I would certainly not recommending trying to induce a period before this change in the periods pattern has been properly investigated.

      Best wishes.

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      Isaiy 4 months ago

      hi,.I had a csection on 16 nov 2016 but baby passed away after 7 days. i had my 1st period on 18 dec 2016 and over on 24th dec it was really a heavy mens this one.. we had unprotected sex on 25,31 dec and 4th jan. after three days i had brownish spotting which lasted 2 days.my mens is still due am 5 days late.am having severe headache,white discharge,bloating, heavy breasts,lower abdominal pain and low back ache. did 3 pregnancy tests all came out negative.what should i do please help...

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      akanga1 3 months ago

      @lsaly. Sorry to hear about your loss. That must be harrowing. I hope you do find peace in time.

      It is difficult to be certain as to what is causing the symptoms you describe. However, it is probably nothing serious and is likely to be a self-limiting issue. Erratic unpredictable 'periods' in the weeks following delivery is by no means unusual. Ovulation may not resume for 6-8 weeks, even longer, for those not breast-feeding and not on contraception. The consequence of this is unpredictable bleeding. The bloatedness could be a consequence of the prevailing hormonal environment in the body at the time. Progesterone levels, when high, tend to cause this. Hopefully your period has arrived by now (since I'm responding 4 days since you posted the query). If not and if the symptoms are persisting, you should bring this to the attention of your doctor. An ultrasound scan and some hormone profile blood tests may be required. However, I need to reiterate my original view on the basis of limited information I have that this probably is something that will resolve on its own relatively shortly. Best wishes.

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      Mommaof3littles 3 months ago

      I am 36, my husband is snipped so we aren't trying for more. In December I was 7 days late and lactating in one breast. They did a mammogram and ultrasound and tons of blood tests. Everything came back normal but my pregnancy test showed a low amount of hcg. It didn't change from week to week but stayed the same. They ordered me a brain MRI scan without contrast to look at my pituitary gland. It is now February 6 and I haven't had a menses since December 9th. Not lactating but nauseous exhausted foggy and lethargic. My MRI is thirsday. What could they be looking for?

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      akanga1 3 months ago

      @Mommaof3littles

      Thank you for your query

      Most likely the MRI is to search for a possible pituitary adenoma. These are relatively common benign tumours which develop in the pituitary glands. Sometimes the adenomas produce hormones which can stop periods and/or cause milk production from breasts. It is unclear what blood tests you had done but I would guess one was to check for levels of the hormone Prolactin. Since you said all the results were normal, a functional adenoma producing Prolactin is unlikely but not impossible. This can happen with a 'false negative prolactin test'. It is a complicated pathophysiological phenomenon whereby a person has high levels of prolactin and the attendant symptoms (such as milk production and absent periods) but the prolactin blood test is negative.

      Doing the pituitary MRI will help you and your doctors get clarity on whether your absent periods are due to a pituitary problem.

      My best wishes.

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      akanga1 2 months ago

      @Jen flores

      You said you had a normal period in January (last month). You haven't said when exactly in January you had the period so it is not possible for me to calculate how many weeks you have gone without a period. In any case, it appears you have only missed one period and it may be the case that it is too early for an ultrasound scan to detect a pregnancy. Unfortunately because the information you have given is not precise enough, it makes it difficult to advise more specifically. As I said, it is still possible that you are pregnant and you may need to wait another 2-4 weeks before repeating the pregnancy test and/or scan. If this is still negative, you will need to see your doctor for a proper consultation, examination and appropriate tests.

      My best wishes

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      Josie 3 weeks ago

      I'm going on 3 months of no menstural im 29 and never had a abnormal mensteral in my life

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      akanga1 3 weeks ago

      Hi Josie,

      Thank you for posting a query.

      Unfortunately there are very brief details so I'm unable to give you any meaningful advice. As detailed in the article (which you would have read), there could be many possible causes of missed periods. If none of these seem to apply to you and you are certain you are not pregnant, it would be best to consult your doctor for some tests.

      Best wishes.

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      Ishita 2 weeks ago

      I'm 27 old from 10 weeks I don't get my period but the pregnancy test shows negative,am I pragnent or some disease infected to me?

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      Billi79 2 weeks ago

      Just curious on thoughts, I am 38 years old when my cycle started as a teen I would have 2 cycles per month at 19 they started skipping few months here or there.now at 38 I haven't had a cycle in over a yearnd have started experiencing discomfort in the lower stomach. All blood tests have come back normal. Same with the pelvic sonogram, it was normal.

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      akanga1 2 weeks ago

      @Billi79

      Your long standing history of irregular periods does strongly suggest a hormonal issue as the underlying cause of the picture you describe. Absence of periods for the last year seems to be a progression of the same phenomenon you have experienced over the last two decades or so. On the face of it, Polycystic Ovarian Syndrome (PCOS) would be the main suspect but a normal pelvic ultrasonogram makes this less likely (but not impossible). Other hormonal abnormalities as detailed in the article are also possible and need to be actively ruled out. Also, at 38 and with no periods for a year, premature ovarian failure (POF) is a possibility. I am not sure what blood tests you have had but for POF, the level of the hormone FSH would normally clinch the diagnosis. FSH would be significantly raised in such a case.

      I hope you are able to get clarity on your situation soon.

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      nerdycatt 12 days ago

      hi, im 18 yrs old and i havent had my period in about 3 to 4 months now. ive taken several hpts and theyve all been neg. i have a normal thyroid level, and no stds of any kind, (ive gone to the drs for those tests) , everything seemed normal. ive never had irregular periods until around last September and since then ive only had maybe 3 during that time till now. the drs have taken blood tests and they all came back neg. right now i feel tired, bloated, like im full so i dont eat very much but ive been gaining weight, my breasts feel sore every once in a while. and my lower stomach sometimes has shooting pains that go into my viginal area. i dont have brown discharge, its still clear like normal, but i still dont know what to do. im positive im not pregnant. any advice?

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      akanga1 12 days ago

      @nerdycatt

      You seem to be having irregular and erratic periods and not completely absent periods.

      It is of course difficult for me to be precise on what this could be as I've nowhere near enough information. In any case, this may not have any significant underlying issue especially at your age. You have mentioned gaining weight. If there has been much weight gain, that could be significant. However, if your BMI is normal, then that can't be the issue. If all your hormone profile blood tests have been normal (these should include FSH, Prolactin and Testosterone) then then there is probably not much to worry about. Polycystic ovarian syndrome remains the commonest cause of erratic periods especially in young women like yourself.

      You can calculate your BMI here: http://www.pregnancy-bliss.co.uk/BMIcalculator.htm...

      Best wishes.

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      Briana.M 3 days ago

      Im 21 and im not on birthcontrol, but ive not had a period in years. But i am suddenly spotting with weird discharge. Why?

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