Women's Health Last updated on 2022-05-16 15:42:38

Why Is My Period Late? How Late Can A Period Be & When To Be Concerned?

Dr. Abhishtita Mudunuri
9 Min Read
Fact Checked

Introduction

Are you worried about your late or missed period even though you know you are not pregnant? Hold on! A late period isn’t usually a matter of serious concern. It is very common even in women with a regular cycle. However, you need to know what is normal, what isn’t and when to see a doctor. And we are here to help you understand just that. In this article, we’ll broadly look at - 13 reasons that delay your periods - What do late periods mean? - What to do if you have delayed or missed periods and - When to see a doctor?

What is a late period?

On an average, women typically have a 28-day period cycle. But it can vary anything from 21 to 35 days, which is considered normal. Suppose you have a regular cycle of 32 days and still haven’t menstruated on the 33rd day, it means you’ve had a late period. But if you’ve not had your periods after 6 weeks or 35 days, it means that you’ve missed your periods. A missed period, that happens frequently, usually indicates an underlying medical condition, and it’s advisable that you see a doctor soon.

How much of a delay is normal in periods?

A period that occurs 1 or 4 days earlier or later is considered normal. Further, a period that lasts between 3 to 7 days long is also considered normal (most periods last 3 to 5 days). But a period that occurs at any time of the month and is unpredictable is considered irregular. Read more on Accurate Period Calculation: No More Pills.

Things that delay your periods

Let’s now look at 13 factors that delay your periods.

(1) Stress

Stress is one of the most common reasons for delayed or missed periods. Stress can be of two types: - Physical stress caused by injuries, surgeries, infections, diabetes, inflammatory diseases, or problems with the GI tract. - Emotional stress due to anxiety, depression, relationship issues, etc. Some amount of stress is normal and sometimes even beneficial for your growth and development. But when stress interferes with the body’s internal mechanism, it can lead to irregular periods. The menstrual cycle is regulated by a complex system that includes the hypothalamus, pituitary gland, thyroid gland, ovaries, and uterus. The hypothalamus triggers pituitary glands to make hormones that trigger ovaries to make estrogen and progesterone hormones responsible for periods. But stress can interfere with the functioning of the hypothalamus, leading to delayed or missed periods. Once you lower your stress levels, menstruation is restored. Seek professional help to manage your stress levels!

(2) Low Body Weight

Being underweight is another reason for delayed or missed periods. Further, rapid weight loss due to dieting and excessive workouts can also cause irregular periods. When you rapidly lose weight, it affects the body's hormones leading to missed or delayed periods. If you are trying to lose weight, do so gradually. If you need professional help in losing weight, consult one of our online dietitians.

(3) Obesity

Just as being underweight causes irregular periods, being obese can also cause the same. Being overweight causes your body to secrete excess estrogen, which can cause late or missed periods. In certain cases, excess estrogen can even halt your periods altogether.

(4) PCOS

PCOS (or Polycystic Ovary Syndrome) is a common health condition that causes irregular periods. PCOS is a hormonal disorder that causes excessive testosterone secretion, among many other things. Testosterone interferes with the menstrual cycle and prevents ovulation; it can cause irregular periods or stop them altogether. If you have PCOS, consult one of our gynecologists available online. Treatment for PCOS usually involves taking birth control pills and intensive lifestyle interventions to help regulate your period cycle. Read more on Diet For PCOD: Healthy Indian Diet Plan & Nutrition Tips. Try the self check for PCOD Risk Book a PCOD Profile Lab Test in Bangalore.

(5) Birth Control

Birth control pills usually make periods regular. But sometimes, it can do just the opposite — it can cause irregular periods. Similarly, when you stop taking the pills, it can take a few months for you to get back to normal. i.e., you may have irregular periods for a few months. If you use an intrauterine device (IUD), implant, or shot, you could completely stop having periods.

(6) Chronic Diseases

Chronic illnesses such as Celiac disease and Diabetes are known to cause irregular periods. Celiac disease is an autoimmune disorder that destroys the inner lining of the small intestines. As a result, your body fails to absorb essential nutrients leading to malnutrition. Malnutrition can affect the production of hormones leading to missed periods or other menstrual irregularities.

(7) Premature Ovarian Insufficiency (POI)

Premature Ovarian Insufficiency (POI) is a condition wherein your ovaries stop working before you turn 40. As a result, they stop producing many important hormones, including estrogen. Low levels of estrogen secretion can cause you to have menopause-like symptoms. You may experience hot flashes, night sweating, and trouble sleeping. Other signs include vaginal dryness, trouble conceiving, decreased sexual desire, and mood disturbances.

(8) Thyroid

The thyroid is an important hormone required for normal menstruation. But when thyroid levels are too high or too low, they can cause prolonged bleeding and irregular periods. In some cases, hyperthyroidism can even stop your menstrual cycle for many months, a condition known as amenorrhea. If you are having a delayed period, your doctor may prescribe a TSH blood test to check for abnormalities in your thyroid levels. Notice weight gain and fatigue? Try the self-check feature for thyroid

(9) Extreme Diet & Exercises

Extreme workouts are another reason why you may have delayed or missed periods. When you exercise several hours a day, you may be burning too many calories than you are taking in. As a result, your body may not be left with enough energy for other bodily functions, eventually affecting your periods.

(10) Early Perimenopause

Perimenopause refers to the time during which your body is transitioning into menopause. It means you are nearing menopause, and ovulation will no longer be regular, leading to delayed or missed periods. Menopause occurs between the ages of 45 and 55. It's a condition in which women stop ovulating and having periods.

(11) Breast Feeding

A missed period is completely normal when breastfeeding your baby. This condition is referred to as lactational amenorrhea. It's that phase where lactating mothers don't experience periods. But don't worry. Your periods should be right back on track after a few months. Meanwhile, keep your doctor in the loop about your health condition.

(12) Sleep Schedule Changes

Irregular sleeping patterns can cause missed or delayed periods. Irregular sleep over prolonged durations can disrupt your circadian rhythm or the internal clock that regulates important cellular processes, including periods.

(13) Medication

Certain medications such as antipsychotics can cause amenorrhea or missed periods. Birth control medications such as IUDs, implants, and shots can also cause missed periods.

Don’t ignore a missed period

Usually, an occasional late period is often the result of something minor. But if you frequently have late periods, check with your doctor to rule out any underlying medical condition. And when you go to the doctor, they may want to know about your previous periods but most women find it hard to explain this to their doctor. Therefore, it’s important that you maintain a period tracker. A period tracker helps you track - Your average cycle duration - Follicular phase - Ovulation phase - Luteal phase and - Fertility window period

What to do if your period is late?

If you are not pregnant and if you haven’t had your periods in three months and cannot identify what the cause is, you may have to check with your doctor. The doctor will usually prescribe blood tests to assess your progesterone and prolactin levels to identify the underlying cause of delayed or missed periods. They may then additionally advise or prescribe medications to treat the underlying cause. Additionally, depending on what the cause is, you may have to - Manage your stress levels - Increase or decrease the intensity of your workouts - Eat a balanced diet - Improve your lifestyle - Improve your sleeping patterns - Manage an underlying health condition etc Also, it’s recommended that you regularly visit your doctor to identify possible health conditions that can cause changes in your period cycle: - PCOS - Endometriosis - Bulimia - Anorexia - Hypothyroidism - Pituitary gland disorders

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How are absent periods treated?

Treatment for absent periods or amenorrhea depends on the underlying cause. If it’s due to hormonal imbalance, it can be treated with supplemental or synthetic hormones. Sometimes, missed periods may require surgical removal of ovarian cysts, scar tissue, or uterine lesions. Treatment for missed periods also requires simple lifestyle changes, balanced diet and regular exercise.

Will I need any tests for a missed period?

You doctor may prescribe the following tests to diagnose the cause of delayed or missed periods:

Blood Tests:

reasons of late period other than pregnancy

- Pregnancy test: It’s done to rule out or confirm pregnancy - Thyroid function test: It’s done to check abnormalities in your TSH levels - Ovary function test: This test measures the amount of Follicle Stimulating Hormone (FSH) to determine if your ovaries are working properly - Prolactin test: It’s done to check the functioning of pituitary gland - Male hormone test: It’s done to check the level of testosterone in your blood.

Hormone challenge test:

Here, your doctor will prescribe hormonal medication for 7 to 10 day to trigger menstrual bleeding. This test is done to check if delayed or missed periods are due to a lack of estrogen.

Imaging Tests:

It includes - Ultrasound: It’s done to check for abnormalities in your ovaries. - Magnetic Resonance Imaging (MRI): It’s done to check for abnormalities in your pituitary gland present in the brain.

Are there any complications of a missed period?

Occasional delayed or missed periods are due to minor issues as discussed above and easily treatable. But frequent missed periods may indicate the following:

(1) Infertility

Chances are that women who aren’t menstruating aren’t ovulating i.e., not producing eggs from their ovaries.

(2) Weak Bones (Osteoporosis)

Missed periods due to menopause would over the years cause osteoporosis. It’s a medical condition where bones become weak and fragile. Women, after hitting menopause, are at higher risk for osteoporosis than others.

(3) Heart Disease

Women with low estrogen levels are at higher risk for heart diseases. Further, women with PCOS are also more likely to develop heart diseases, high blood pressure and diabetes.

(4) Oligomenorrhea

It’s a medical condition wherein you don’t get your periods for 35 days or more. As a result, you have only 4 to 9 periods in a year. The most common causes of oligomenorrhea are: - PCOS - Cushing syndrome - Prolactinoma - Congenital adrenal hyperplasia - Pelvic inflammatory disease - Asherman’s syndrome - Primary ovarian syndrome - Hyperthyroidism and - Eating disorders Other factors that also lead to oligomenorrhea are - Type 1 diabetes - Tumors in your ovaries or adrenal glands - Hormonal contraceptives - Antipsychotic and antiepileptic medications - Intense physical workouts

Supporting your child when they start menstruating

When young girls first start menstruating, it takes a few years for their period cycle to settle down. They may not immediately start having a regular 28-day period cycle. That’s because young girls in their teens or preteens have an immature Hypothalamic-Pituitary-Ovarian (HPO) Axis. The HPO axis system regulates ovulation and menstrual cycles. It takes a few years for their system to mature and regulate their periods. Once the HPO axis system matures, their periods become more predictable. Here are a few tips to helping your child when they start menstruating: - Talking about periods, flow, period pain, what’s normal or abnormal, pads, etc - Encourage keeping track of periods using online period trackers such as this and - Discuss menstrual hygiene

Conclusion

Occasional delayed or missed periods may be due to minor reasons and isn’t a matter of serious concern. It could be due to stress, abnormal sleeping patterns, obesity or low body weight which can be easily fixed through healthy lifestyle modifications and eating habits. But frequent missed or delayed periods may indicate an underlying medical condition. If you have not had your periods in 35 days or after 6 weeks, it’s high time you seek medical attention. Read a complete guide on Periods: Cycle, Problems and Tracking.

References

https://www.healthline.com/health/womens-health/why-is-my-period-late
https://www.healthline.com/health/how-late-can-a-period-be
https://health.clevelandclinic.org/why-is-my-period-late/
https://vitalrecord.tamhsc.edu/9-reasons-missed-period/
https://www.medicalnewstoday.com/articles/318317
https://patient.info/womens-health/periods-and-period-problems/missed-periods#:~:text=As%20long%20as%20you%20are,start%20later%20than%20in%20others.
https://www.healthline.com/health/how-late-can-a-period-be
https://flo.health/menstrual-cycle/health/period/reasons-for-a-delayed-period
https://health.clevelandclinic.org/why-is-my-period-late/
https://www.medicinenet.com/how_late_can_period_be_before_know_youre_pregnant/article.htm

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Written by

Dr. Abhishtita Mudunuri

Dr. Abhishtita Mudunuri is an Internal Medicine Physician Diabetologist with over 10 years of experience in treating lifestyle disorders like Diabetes, Hypertension, Dyslipidemia, etc. She has worked previously at Columbia Asia, Sunshine Hospitals, and Apollo Group of Hospitals. Currently, she is working as a Senior Manager and Diabetologist at MFine.

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