Missed periods can be very stressful. If you don’t want to be pregnant it can be a very scary time, if you do want to be pregnant it might be exciting (or stressful, until you find out whether you’re actually pregnant or not). Today we will discuss why you might miss a period, what is normal, and what warrants advice from a doctor.
What is normal when it comes to periods?
“Normal” is different for everyone. Most women will have reasonably regular periods, meaning that it comes at about the same time each month. Variation of a few days can be normal.
The textbooks say that a “normal” cycle is 28 days long, meaning that women get a period every 28 days. This does not apply to everyone though. Some women’s cycles are much shorter or longer than this. Any cycle length between 21-35 days is considered to be “normal”.
Whatever is usual for you is your own normal. Around times of big hormonal changes (e.g. puberty, pregnancy and menopause) your cycle might change. If you get sudden changes to your cycle outside of these times it can be worth talking to a doctor.
Some women always have irregular periods. This can make it very hard to predict when your period is going to come. It can also make it hard to tell if you have missed a period or might be pregnant.
Reasons you might miss a period
There are lots of reasons that women sometimes miss a period.
The first, and most obvious one is pregnancy but this is not the only reason.
Common reasons for periods stopping include:
- Contraception (birth control)
- Polycystic ovarian syndrome (PCOS)
- Being overweight or underweight
- Sudden weight loss
Pregnancy causes missed periods
If you are having sex and your period is late there is a chance you could be pregnant. Even if you are using contraception this does not guarantee you will not get pregnant, so it is important to check.
If your period is late, you can take a pregnancy test to check if you are pregnant. Alternatively, you could just wait a couple of days to see if your period starts.
You can get pregnant if you have unprotected sex (sex without contraception, or your contraception fails) around the time of ovulation (when the ovary releases an egg) or in the 7 days before you ovulate. If ovulation is delayed for any reason (e.g. by stress or being unwell) then the time when you might become pregnant is also delayed. This is important to know if you are tracking your cycle in order to avoid (or maximise your chances of) getting pregnant.
Stress and missed periods
Stress can cause a lot of problems in your body and can often affect your cycle. It can make your periods more frequent, less frequent or sometimes make them stop completely. They might also become more painful than usual.
If you are struggling with stress you might want to try some of these techniques to beat stress.
If you are really struggling it might be a good idea to speak to a doctor or therapist for help.
Menopause is a natural part of aging and occurs when oestrogen levels start to decrease. The average age of menopause in developed countries is 51. Menopause is defined as a year after your last period. After menopause, your periods stop completely.
In the time leading up to menopause (perimenopause) your periods might become irregular or very infrequent.
There are many different forms of contraception and they all can have different effects on your periods.
Some contraceptives (e.g. progestone only pill, depo provera injection, implant or Mirena) might completely stop your periods. This does not happen in all women though.
Remember that just because you are using contraception doesn’t mean you CAN’T get pregnant. If you have missed your periods and think you might be pregnant it is important to check.
PCOS and periods
Polycystic ovarian syndrome (PCOS) can affect your periods. It often makes periods irregular and infrequent (but not in all women). PCOS affects the hormonal balance that is required for ovulation (the ovaries releasing an egg). Ovulation is required for periods to be regular so if you are not ovulating your periods will probably become irregular.
Exercise can cause missed periods
Excessive exercise can cause your periods to stop. This is because of the stress that your body goes through when you are doing a large amount of exercise. This can switch off the hormones that cause you to ovulate and make your periods become irregular or stop completely.
If you are an athlete, doctors who specialise in sports medicine may be able to help you. They can give you advice about how to train but keep your body functioning well in terms of hormones and periods.
Weight is an important cause of missed periods
Being overweight or underweight can affect your periods, and so can losing a lot of weight very quickly.
If you are not eating enough or restricting your diet then this will switch off the ovulation hormones. This will then cause a missed period or your periods might stop completely.
If you are struggling with an eating disorder or restrictive dieting please seek medical help. It is worth it to help you get better.
Being overweight can also affect your periods but in a different way. The extra ostrogen being produced by your body disrupts the hormonal balance that regulates ovulation. This can lead your periods to become irregular.
Underlying hormone conditions such as over or underactive thyroid can cause missed periods. This can often be treated but will require a discussion with a doctor.
All the hormonal systems of the body are linked so if one is disrupted it can affect your periods.
FAQ about missed periods
Is it normal to miss a period and not to be pregnant?
It can be.
As we discussed above, there are lots of reasons for missed periods. Pregnancy is only one of them.
Some of them (like menopause) are normal. Some (like PCOS or hormonal imbalances) might need some treatment.
If you are worried about your missed periods and you are not pregnant it is a good idea to speak to a doctor.
Is it normal to miss a period on birth control?
It can be.
As we talked about, hormonal birth control (contraception) can change your periods and your menstrual cycle. If you suddenly start missing periods when you haven’t changed your birth control you should check you are not pregnant. If you aren’t pregnant then it might be due to stress or some of the other causes we talked about.
If you always miss your period with your birth control then that is probably just normal for you.
When do I need to see a doctor about my missed periods?
Lots of the reasons for a missed period are either normal, easy to fix or not “dangerous”. However, there are some situations that it is a good idea to see a doctor.
Talk to a doctor if you are not pregnant and you have missed more than 3 periods in a row. You should also see a doctor if you are younger than 45 and your periods have stopped, if you are still having periods after the age of 55 or if you have been through menopause but then start bleeding again.
If your periods have changed suddenly from their normal pattern, you are getting severe pain or unusually heavy bleeding then you should get advice from a doctor.
If you are struggling with your weight or with concerns such as eating disorders your doctor will also be able to support you.
Your GP is a good first port of call. If needed they might refer you to a specialist for further care.
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