The menstrual cycle is generally 28 days, although anything between 21 and 40 days is considered normal. After a while, however, women know how long a cycle usually is for them, so they notice when their period is late. However, the reason for the delay is not always clear, Dr. Józan Gyöngyi, gynecologist and surgeon at the Gynecology Center, has now taken into account the common reasons.
What could be the reason for late menstruation?
– Of course, at a child-bearing age, one should think about whether pregnancy is behind late menstruation, but if this possibility has been ruled out with, for example, a pregnancy test and a gynecological examination, there are still conditions and diseases that can cause this – summarizes Dr. Józan.
Such possibilities may arise:
Stress
Untreated, long-term stress can upset the hormonal balance and affect the hypothalamus, the area of the brain that regulates the cycle. In addition, stress can also indirectly affect menstruation, since if sudden weight loss or some illness occurs on the basis of this, the period can also be delayed. Besides since stress is an independent risk factor for many diseases, it is worth asking for help in its treatment as soon as possible, even from a psychologist.
Low body weight
Women who struggle with an eating disorder, especially anorexia nervosa or bulimia, may sooner or later experience an upset in their cycle. A body weight that is too low can disrupt or even stop menstruation, as a low body fat percentage tells the body that there is no possibility of pregnancy, so ovulation must be paused. (Women who undertake extreme physical exertion may also face irregularity or missed periods.) Menstruation may also return after successful psychiatric treatment of the eating disorder.
Obesity
The other extreme of body weight can also affect menstruation, because as a result of obesity, the body can produce too much estrogen hormone, which can cause disturbances in the period, and ultimately stop it. If it turns out during the examinations that obesity is the cause of the delay or absence of menstruation, it is worthwhile to seek medical help for lasting and healthy weight loss.
Polycystic ovary syndrome (PCOS)
PCOS causes the body to produce too much of the “male hormone”, androgen, which causes cysts to form in the ovaries. The disease can cause widespread symptoms, such as it can disrupt or even stop menstruation. PCOS is often accompanied by insulin resistance, which also indicates an imbalance in the household of a hormone, insulin. Since it is a complex set of symptoms, the treatment can be multifaceted, for example, menstruation can be regulated by prescribing contraceptives or other drugs.
Contraception
Since hormonal contraceptives contain estrogen and/or progesterone, starting and stopping them also affects the menstrual cycle. After the end, you usually have to wait 2-3 months until the period settles again and the menstruation does not come early or late. Inserted or injected contraceptives can also cause missed periods.
Chronic diseases, conditions
Certain chronic diseases and conditions, such as diabetes and celiac disease, can also affect your cycle. Changes in blood sugar levels can be related to hormonal changes, and although it is rare, it can happen that untreated diabetes also attracts attention with irregular menstruation. And celiac disease causes inflammation that damages the intestinal villi, which prevents essential nutrients from being absorbed.. This can also be the background of upset, late or missing menstruation. Cushing’s syndrome, Asherman’s syndrome and congenital adrenal hyperplasia can also have such consequences.
Primary ovarian insufficiency
Menopause usually occurs between the ages of 45 and 55, so if the symptoms appear before the age of 40, one can talk about primary ovarian insufficiency (POI) or early menopause. POI can develop after oophorectomy, as well as due to genetic reasons and as a result of autoimmune processes. So if regular delay or absence of menstruation occurs before the age of 40, you should definitely consult a gynecologisti.
Thyroid problems
Both an underactive and an overactive thyroid gland can cause late or missed periods. The thyroid gland regulates metabolism, so changes in hormone levels can have a strong effect on this organ as well. In many cases, drug treatment is enough to resolve thyroid dysfunction, and if this happens, the cycle can become regular again.
When should we see a doctor?
- It is definitely worth consulting a doctor if menstruation is delayed or missed and this is not due to pregnancy or menopause – summarize the information dr. Jozan Gyöngyigynecologist at the Gynecology Center, surgeon.
- As you can see, there are cases when gynecological and endocrinological treatment is necessary to treat the situation and the disease behind it, other times “just” lifestyle reform is enough. And if symptoms such as unusual, heavy bleeding, bleeding lasting longer than seven days, severe pain, fever, nausea, vomiting, or bleeding occurring at least one year after the cessation of menstruation occur, an examination is required as soon as possible..
Source: Gynecology Center
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