Missed Periods
Amenorrhea (a medical term for the absence of menstruation) can occur to girls during puberty or to women who have been through puberty. Periods usually begin between the ages of 11 and 14, although some girls begin earlier and others later. If a girl has not started to menstruate by age 16, she may have amenorrhea. Hormone imbalances or problems with the ovaries, uterus or vagina may be at fault. If menstruation hasn't begun by age 16, it is wise to see a doctor.
Causes
For most women who have been through puberty and are still having regular menstrual periods, the first thing to come to mind when a menstrual period is missed is pregnancy. Although pregnancy is a common cause of missed periods, there are many other factors that can cause a woman not to menstruate (amenorrhea). Stress, being very overweight or underweight, eating disorders, birth control pills and some other medications, breast-feeding, underactive thyroid gland, regular but excessive exercise, and the approach of menopause are all possible causes of amenorrhea. Menstrual periods may not resume for several months after a woman gives birth or while she is breast-feeding. Diseases that affect the body's hormonal system can also lead to missed periods, but these are rare.
Sometimes birth control pills prescribed to regulate irregular periods can cause missed periods. If your periods stop while you are taking one type of pill, switching to another birth control pill may solve the problem. If you are on the pill and your periods stop, talk with your doctor or nurse practitioner. Going off the pill after being on it for a while also may disrupt your menstrual cycle for a few months while your body adjusts to the change in hormones.
Self-Care Steps for Missed Periods
The first thing to rule out if you miss a period is pregnancy. Home pregnancy tests on the market today are considered very accurate when the directions are followed. If the test is negative, but you strongly suspect you might be pregnant, repeat the test after one week. It is important to avoid alcohol, tobacco and chemicals until pregnancy is ruled out.
If you are in your 40s or 50s, a missed period may mean you are starting menopause. Before your periods stop entirely, they may be irregular for a time. If you miss more than two periods, call your doctor.
For some women, a bout of the flu or stress at work or home can throw their menstrual cycles off. If you are under stress, find ways to relieve it. Take time out daily to meditate, listen to soothing music or read a book. Regular exercise and getting enough sleep each night can also reduce stress.
Rapid weight loss or being very overweight or underweight can also cause amenorrhea. If you are trying to lose weight, make sure you are eating at least 1,200 calories a day from a well-balanced variety of foods. If you are underweight, eat a well-balanced diet that provides about 2,000 calories a day. Whether you are overweight, underweight or dieting, your doctor, nurse practitioner or dietitian may be able to help you set up a healthy diet and exercise plan.
Very hard training and exercise are other causes of amenorrhea. If you are in training and are missing periods, easing up may return your periods to normal. If you are an endurance athlete, ask your doctor or nurse practitioner if hormone therapy or calcium supplements might be right for you to help prevent osteopenia or osteoporosis.
Decision Guide for Missed PeriodsSymptoms/Signs | Action |
|---|
Occasional missed period | Use self-care |
Missed one period and have a positive home pregnancy test | Call provider's office |
Missed two periods and are not pregnant | Call provider's office |
Missed two or more periods, not pregnant, and on birth control pills | See provider |
Age 16 or older and have never had a period | See provider |
Missed periods and have irregular spotting or pain in lower abdomen | See provider |
