Keeping tabs on your period’s monthly attendance is a unique facet of women’s health. And while the female body’s ability to reproduce is a beautiful thing, few women experience regular 28-day cycles. But should a missed period be cause for alarm? Here are eight common reasons, besides pregnancy of course, that can explain a missed period.
01. Lifestyle Changes
Your menstrual cycle is a complex dance that requires perfect timing of hormones working together. When you do the same thing on the daily, your body and mind just go with the flow (pun intended). But when a major life change happens, the regularity your body loves can get thrown for a loop. When you move to a new city, get a different work schedule, adjust your diet, switch up your sleeping habits, or change environments, that delicate balance of hormones is thrown off and can interrupt your cycle. Remember, both good and bad life developments can influence your period. So if you’re going through a bit of a change, don’t fret. Once you adjust to your new routine, your cycle should go back to normal.
It’s no surprise that life changes and stress come as a package deal. Whether you’re planning a wedding or chasing a deadline, stress is a normal part of life. While it can encourage motivation and productivity, life can get a little wonky if there’s too much of it. When you’re emotionally or mentally drained, your brain’s hypothalamus gland may decrease or stop producing gonadotropin-releasing hormone (GnRH), a hormone in charge of starting the menstrual cycle. Luckily, your cycle should get back on track once you lower your stress levels. Stressing about a late period might delay it even more. Try to take it easy and practice stress management. A simple at-home massage is a perfect place to start.
03. Major Weight Loss or Gain
When it comes to surprise weight changes, Aunt Flo is the first to notice. “The length and heaviness of a menstrual cycle is directly correlated with weight,” says A. Nicky Hjort, M.D., OB-GYN. If you gain weight, an abnormal period often happens next. It might be heavy one month and absent the next. Rapid weight loss produces a similar effect, causing a light or missed period. This is also true if you’re engaging in excessive exercise, Hjort adds. Endurance athletes who are often on the move are likely to experience this. Why the correlation? It comes down to the ability of fat cells to produce extra estrogen, the female sex hormone that regulates the menstrual cycle. When there’s too much or too little, a hormonal imbalance occurs and causes irregular or missed periods. In essence, any rapid weight change can shock your body. Getting your body back to an appropriately healthy weight can help regulate your cycle.
When you’re sick, your body goes through all kinds of chaos. It may delay ovulation because your body isn’t well enough to release any eggs. And when your ovulation is delayed, you can have a late or missed period. While the common cold isn’t enough to warrant this change, illnesses such as the flu or pneumonia may do the trick. High levels of stress can also suppress the immune system, increasing your risk for sickness. Again, stress management is vital for keeping your body on a healthy track.
For some, medication is a part of everyday life. A few medications may lead to irregular periods. “Some antidepressants and antiseizure medicines can affect hormonal balance and disrupt the menstrual cycle,” Hjort says. If you’re taking these medications, talk to your doctor about your cycle. This will help cut any risks and long-term effects. In some cases, other side effects caused by a medication can mean irregular periods. Prolonged appetite loss and dehydration from taking antibiotics, for example, can impact your cycle. In a sense, taking medications is a lifestyle change that the body—and your cycle—may not be used to.
06. Thyroid Disorders
Like most of our body’s processes, hormonal balance rules the menstrual period. One of the major players in this balance is the thyroid gland, located at the base of the neck. Women are five to eight times more likely than men to develop thyroid disorders, so many women need thyroid hormones (TH) to regulate their menstrual cycles. If TH levels are too high, you can develop hyperthyroidism and have fewer (or lighter) periods. The most common cause of hyperthyroidism is an autoimmune disorder called Graves’ disease. But medications, thyroiditis (inflammation of the thyroid), and excessive iodine intake can also cause hyperthyroidism. Aside from missed periods, symptoms of hyperthyroidism also include anxiety, insomnia, and muscle weakness. Hypothyroidism, caused by low TH levels, has the opposite effect on periods. Menstrual bleeding is heavier, more frequent, and accompanied by worse cramps than usual. Additional symptoms include exhaustion, weight gain, and dry skin. To check out how your thyroid gland is functioning, have complete blood work done by your primary care practitioner.
07. Polycystic Ovary Syndrome
Like thyroid disorders, polycystic ovary syndrome (PCOS) can meddle with your cycle through hormonal imbalances. Characterized by low levels of estrogen and progesterone, PCOS affects more than five million women in the U.S. and is often diagnosed during a woman’s twenties or thirties. Women with a mother or sister who has PCOS are more likely to develop the condition. In addition to low levels of these two hormones, those with PCOS also have a high level of luteinizing hormone (LH) and a low level of follicle-stimulating hormone (FSH). These imbalances prevent ovulation, or the release of eggs, from occurring each month. And when there’s no ovulation, there’s no period.
According to a study in the Journal of Clinical Endocrinology and Metabolism, it’s not uncommon for insulin resistance to accompany PCOS. This means that while the body produces insulin—the hormone that manages sugar balance—cells aren’t able to use it properly. As a result, blood sugar rises, causing unfavorable levels of LH and FSH and late or missed periods. Hjort warns that most PCOS patients have a strong family history of diabetes, so it’s crucial for at-risk women to control sugar intake and maintain a healthy weight.
These hormonal conditions can also lead to ovarian cysts, which are diagnosed with an ultrasound. Sometimes, the ovaries are swollen and enlarged before an ultrasound is even prescribed. Your gynecologist can check if ovaries are swollen during a physical pelvic exam. Regular checkups are especially important if you have a family history of PCOS.
As a natural part of aging, menopause includes the changes that occur when menstruation stops and a woman’s reproductive period ends. On average, these changes start in our early fifties, usually by age 51. But did you know the transition can start as early as your forties and sometimes even thirties? Known as perimenopause, this is the time before menopause officially begins. For the average woman, perimenopause begins in her mid-forties. But many women will begin to experience perimenopause in their thirties and early forties. During this time, periods can still occur but may be irregular or completely absent. As with menopause, symptoms include hot flashes, changes in cholesterol levels, and sleeping problems. Women are more likely to experience earlier perimenopause if they have had radiation therapy or hormone treatments, have never delivered a baby, smoke, or have a thyroid disorder.
Knowing these common reasons for a missed period can help put your mind at ease about what your body is up to. Depending on your life situation and symptoms, your doctor can help you pinpoint the reason for a missed period and advise on appropriate next steps. Be honest and transparent about your concerns so your doctor can help you in the most effective way possible. You are the best and biggest advocate of your health.