You're a day late getting your period. Then two. Then three. Then... you start freaking out.
Like many women, your first thought may be, "Am I pregnant?" If the answer is definitely no, you might be genuinely stumped.
The good news is that it's actually very common to miss a period once or twice. And in most cases, it's nothing serious. There are several things that can cause you to miss your period.
Before We Continue...
To understand your M-I-A period, let's start with how menstruation normally works.
According to Teri Benn, MD, an obstetrician-gynecologist with Penn Ob/Gyn Chester County, if your hormones are out of sync, your period will be, too. "One of the main things to keep in mind about the causes of missed periods is that your hormones stimulate ovulation. When your hormones are out of balance, you could have trouble ovulating. No ovulation means no period," she explains.
With that in mind, here are 7 reasons why your hormones might be thrown out of whack, leaving you period-less.
1. Menopause
Menopause is when your period stops completely for at least 12 months. The 12-month mark usually occurs during your late 40s or early 50s — the average age in the United States is 52. However, menopause can start as early as your 30s or as late as your 60s.
Here's the thing: Menopause doesn't just hit you out of the blue. "Perimenopause is the phase before menopause — usually lasting 4 to 8 years — where your periods start to become irregular. You will miss some periods, but not all of them. It generally starts during the early 40s," Dr. Benn shares.
If you're younger, don't rule menopause or perimenopause out just yet.
Early menopause occurs between ages 40 to 45, and premature menopause begins before age 40. This can be caused by many different factors, such as smoking, family history of early menopause, certain health conditions (e.g. cancer) or their treatments (e.g. radiation, chemotherapy). But, it might also happen for no reason at all.
So, if you are going to have early or premature menopause, you may begin perimenopause before you even hit your 30s or 40s.
2. Polycystic Ovarian Syndrome (PCOS)
PCOS is a very common and treatable condition that interferes with your reproductive hormones. As the name implies, you may also develop cysts (fluid-filled sacs) on your ovaries. Most cysts are small and harmless, and they shouldn't cause any pain or discomfort.
PCOS can have several causes:
- High levels of insulin (the hormone that controls how food is turned to energy in your body)
- Too many androgens (male hormones that all women produce in small amounts)
- Family history of PCOS
Regardless of the cause, PCOS can interrupt your cycle and cause you to miss periods.
3. Eating Disorders
Eating disorders are diseases that disrupt your eating habits and weight. While there are several types, two that are known to cause hormone issues that affect periods are anorexia and bulimia:
- Anorexia is when you do not eat enough, causing you to become severely underweight. When you have anorexia, your body might not produce or circulate enough hormones to cause ovulation.
- Bulimia is when you binge (eat a lot at once) and then purge (making yourself get rid of the food, often by vomiting or taking laxatives). Binges usually involve foods that are high in fat and carbohydrates, which can cause high levels of insulin — something that's known to influence ovulation and cause irregular periods.
Also, it's not uncommon for people with eating disorders to over-exercise. If the activity gets too physically intense, it can affect your estrogen and progesterone hormone levels. And both of those hormones can affect whether or not you get your period.
4. Thyroid or Pituitary Gland Problems
The thyroid is a butterfly-shaped gland at the bottom of your neck. It produces the thyroid hormone, which controls certain aspects of your metabolism, such as how fast you burn calories.
The pituitary gland is a tiny gland at the base of your brain. It produces many types of hormones, including two that stimulate ovulation — follicle-stimulating hormone and luteinizing hormone.
"If you have thyroid or pituitary problems, your period may be affected. This occurs when the glands are over- or underworked, producing too many or too few hormones. It can cause your body to stop ovulating," says Dr. Benn.
5. Stress
You've heard it before: Stress can actually take a toll on your physical health. And that's true when it comes to your period. When you're stressed, your body might not produce enough estrogen to stimulate ovulation, meaning you won't get your period that cycle.
6. Other Medical Conditions
When one part of your body is acting up, it can wreak havoc on other parts of your body — even if they seem unrelated. There are medical conditions that can affect whether or not you get your period, and the connection between those conditions and your reproductive system might leave you scratching your head.
For example, one common condition that can mess with your period is uncontrolled diabetes. Diabetes can cause your blood sugar levels to rise and fall. The changes in your blood sugar levels can interact with your hormones, disrupting your cycle.
Other conditions, such as HIV, ovarian cancer, or autoimmune disorders, can make your ovaries produce too many or too few hormones, disrupting your cycle. But don't panic — those are rare, and it's much more likely that a missed period is from something significantly less concerning.
7. Medications
It's also possible that your medications, such as antidepressants, antipsychotics, and certain oral contraceptives (birth control medication), are the cause. If you're receiving radiation or chemotherapy for cancer treatment — especially in your pelvic area — those can halt your period, too.
Talk to your primary care provider or gynecologist if:
- You haven't had a period for 90 days
- You start having periods less often than every 35 days
- Your cycle suddenly becomes irregular
If it's only been one month, and you're definitely not pregnant, you can still always talk to your provider — but you can probably just sit back and go with the flow. Pun totally intended.
If you have been missing periods and would like to discuss with a physician, call 610-738-2300 to find a provider near you.
Related Information from Chester County Hospital: