Reasons for a missed period: when should you worry?

A delayed period is one of the most common reasons women visit a gynaecologist. For some, it is related to pregnancy, for others — to a change in lifestyle, and for others — to hormonal imbalances. In this article, we will look at which causes are completely normal and which signal health problems.

The main causes of delayed periods

1. Pregnancy

The most obvious and common cause. If your cycle is regular and you have a delay, you should take a pregnancy test or have an HCG test.

2. Stress and emotional overload

Chronic stress disrupts the hypothalamus, which controls the hormonal system. This can temporarily ‘turn off’ menstruation.

3. Change in body weight

Sudden weight loss or gain disrupts oestrogen production. This is especially true for a BMI below 18 or above 30.

4. Excessive physical activity

This is often observed in athletes and women who have suddenly started training without adaptation.

5. Change of climate or time zone

Flying, acclimatisation — all of this is stressful for the body, which affects the hormonal system.

6. Hormonal disorders

In particular, polycystic ovary syndrome (PCOS), hyperprolactinemia, thyroid disease.

7. Lactation or premenopause

Hormonal fluctuations during these periods can cause a lack of menstruation for months.

Interesting facts about the menstrual cycle

• The normal cycle length is 21 to 35 days. Anything outside this range requires evaluation.
• In 1 in 5 women, the delay may be physiological (not related to pathology).
• A delay of more than 6 months is called amenorrhea and requires examination.

When should you see a doctor?

A delay of more than 10 days with a previously regular cycle.

Accompanying symptoms: pain, nausea, male-pattern hair growth.

Frequent cycle irregularities (more than twice a year).

Unsuccessful attempts to conceive within a year.

An appointment with a gynaecologist is the first step towards diagnosis.

What tests will help determine the cause?

• HCG — to rule out pregnancy
• Testosterone, LH, FSH, prolactin, oestradiol — assessment of hormonal background
• Pelvic ultrasound — to detect cysts, PCOS, endometriosis
• TTG and free T4 — assessment of thyroid function

Conclusion

A delayed period is not always a cause for panic, but it is always a reason to pay close attention to yourself. If the situation repeats itself, it is better to get tested and know the cause than to guess.