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Wondering where your period is? It’s understandable if you’re feeling some concern about why your period is late. And it’s common for people to wonder if their late period means they’re pregnant. But there are a number of reasons your period may be missing aside from the big one—pregnancy.
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Why is my period late?
The average adult menstrual cycle lasts 28 to 35 days, but your period can vary month to month, and some months may have a cycle that starts a few days later than the month prior. This is not an immediate reason for concern.
However, some people experience periods that are consistently late or infrequent. Healthcare providers refer to this as oligomenorrhea. Those who deal with this condition typically have a cycle that is longer than 35 days, or fewer than six to eight periods per year (Riaz, 2021; Weld, 2021).
Rest assured, a late period doesn’t automatically mean that you have oligomenorrhea. For example, there are two times when it’s totally normal for someone’s period to be “late” or irregular: when it first begins, and when menopause starts.
What causes a late period?
Here are some of the most common reasons a period may be late, and what it could be telling you about your health.
If you’ve recently had unprotected sex (whether that be without protection or perhaps missing a few birth control pills), a late period could be the first sign of pregnancy (Riaz, 2021).
If you suspect you might be pregnant and your period is late, an at-home pregnancy test can confirm this. If the test is positive, the next step should be making an appointment with your health care provider (Riaz, 2021).
Stress and strenuous exercise
Once pregnancy has been ruled out, you may be scratching your head as to why your period is late. One reason may be due to excessive stress in your daily life. High stress levels are linked to irregular menstrual cycles and could delay your period (Nagma, 2015).
Plus, low body weight and eating disorders like anorexia, as well as disturbed sleep patterns, are other reasons your period may be lagging (Ko, 2017; Xing, 2020). This means if stress causes you to skip meals or skimp on getting enough shut-eye, this could result in a late period.
Menstrual cycle: phases, hormones, average length
Strenuous exercise can also cause late or even missed periods. When someone engages in excessive exercise and doesn’t eat enough, it can cause an energy deficiency by burning too many calories. In one study, strenuous exercise that created a calorie deficit of 470 to 810 calories a day over a three-month period caused late or irregular periods in those women (Williams, 2015).
Periods typically go back to normal as soon as you make some lifestyle changes by lessening training intensity and eating normally to cause some weight gain.
As the body begins the shift into menopause, periods may start to become irregular. Early in the transition to menopause, periods are often more frequent. Later, however, cycles become longer (Delamater, 2019).
While the patterns of menstrual bleeding do vary among those experiencing perimenopause, there are some telltale menopause signs you can watch out for: hot flashes, vaginal dryness, sleep disturbances, and mood changes could mean that you are shifting into menopause (Delamater, 2019).
A visit with your healthcare provider can help you determine if perimenopause is at the helm of your period problems.
Hormone disorders like PCOS
PCOS, or polycystic ovary syndrome, is a type of hormone disorder and is one of the more common ones responsible for a late or irregular period. That’s because, with PCOS, your ovaries produce excess androgens, a “male” sex hormone (while considered a male sex hormone, both men and women have androgens in the body, women just have smaller amounts). This surplus of androgens can cause irregular, late, or missed periods (Ajhmal, 2019).
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There are other hormone disorders that may also cause irregular or late periods. Conditions like hyperthyroidism and hypothyroidism, diabetes, and Cushing’s syndrome (when the body produces too much of the stress hormone cortisol) may all affect your reproductive system (Naz, 2020).
Continuous birth control
In addition to preventing unwanted pregnancy, birth control pills or intrauterine devices (IUDs) may lighten, delay or stop your period. Some people who menstruate may choose to use continuous forms of hormonal birth control to reduce the duration or frequency of their periods or suppress them altogether.
The long-term, continuous dose of hormones you receive from your birth control help to reduce spotting, irregular breakthrough bleeding, and the number of days you bleed during your cycle (Hee, 2013).
The thought of having a tumor is scary, but pituitary tumors—clinically known as prolactinomas—are benign, noncancerous tumors located on the pituitary gland at the base of your brain—which can cause high levels of a hormone called prolactin (Kulshreshtha, 2017).
This is the same hormone responsible for helping women lactate after pregnancy, and too much in the bloodstream may result in a late period due to a hormonal imbalance. When this happens, the condition is called hyperprolactinemia. Certain medications such as antipsychotic drugs can also cause hyperprolactinemia, resulting in late or irregular periods (Kulshreshtha, 2017).
Menorrhagia (heavy periods): what is it, causes, and how to stop it
Treatment for a late period
Getting the proper treatment for a late period will vary depending on what is causing your period to be late to begin with.
In some cases, a late period is a sign of an underlying health issue like PCOS. In order to prevent a late period, treating the condition causing the late period will help the menstrual cycle to stabilize. If a late period is due to lifestyle habits or issues such as stress or poor sleep, practicing good sleep hygiene, eating a healthy diet, and managing stress through meditation, mindfulness, and anything else that may calm your mind can help prevent late periods (ACOG , 2021).
When to see a doctor
Oligomenorrhea itself usually isn’t a serious condition, but as we’ve learned above, it can sometimes be a symptom of other health issues. If your period is late because you had unprotected sex and you’ve confirmed pregnancy with an at-home test, it’s time to see your healthcare provider to go over what comes next.
However, if you’re not pregnant, and have gone 35 days without a period, a healthcare provider can look at your full health history and determine what the next steps (if any) should be to address your late period (Riaz, 2021).
- Ajmal, N., Khan, S. Z., & Shaikh, R. (2019). Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 3, 100060. doi: 10.1016/j.eurox.2019.100060. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687436/
- Amenorrhea: Absence of Periods. ACOG. (2021). Retrieved from https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods
- Delamater, L., & Santoro, N. (2018). Management of the perimenopause. Clinical Obstetrics and Gynecology, 61(3), 419-432. doi: 10.1097/GRF.0000000000000389. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400/
- Farrukh, J. B., Towriss, K., & McKee, N. (2015). Abnormal uterine bleeding. Canadian Family Physician, 61(8), 693-697. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541435/
- He, Y., Zheng, D., Shang, W., Wang, X., Zhao, S., Wei, Z., et al. (2020). Prevalence of oligomenorrhea among women of childbearing age in China: A large community-based study. Women’s Health, 16, 1745506520928617. doi: 10.1177/1745506520928617. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479865/
- Hee, L., Kettner, L.O., & Vejtorp, M. (2013). Continuous use of oral contraceptives: an overview of effects and side-effects. Acta Obstetricia et Gynecologica Scandinavica, 92, 125-136. doi:10.1111/aogs.12036. Retrieved from https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.12036
- Ko, K. M., Chung, Y. J., Yoon, K., Park, Y. G., & Lee, S. (2017). Association between body weight changes and menstrual irregularity: the Korea national health and nutrition examination survey 2010-2012. Endocrinology and Metabolism, 32(2), 248-256. doi: 10.3803/EnM.2017.32.2.248. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503870/
- Kulshreshtha, B., Pahuja, I., Kothari, D., Chawla, I., Sharma, N., Gupta, S., & Mittal, A. (2017). Menstrual Cycle Abnormalities in Patients with Prolactinoma and Drug-induced Hyperprolactinemia. Indian Journal of Endocrinology and Metabolism, 21(4), 545–550. doi: 10.4103/ijem.IJEM_515_16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477442/
- Nagma, S., Kapoor, G., Bharti, R., Batra, A., & Sablok, A. (2015). To evaluate the effect of perceived stress on menstrual function. Journal of Clinical and Diagnostic Research, 9(3), QC01-QC3. doi: 10.7860/JCDR/2015/6906.5611. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413117/
- Riaz, Y. (2021). Oligomenorrhea. [Updated Aug 9, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK560575/
- Saei Ghare Naz, M., Rostami Dovom, M., & Ramezani Tehrani, F. (2020). The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. International Journal of Endocrinology and Metabolism, 18(4), e106694. doi: 10.5812/ijem.106694. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887462/
- Williams, N., Leidy, H., Hill, B., Lieberman, J., Legro, R., & Souza, M. (2015). Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. American Journal Of Physiology-Endocrinology And Metabolism, 308(1), E29-E39. doi: 10.1152/ajpendo.00386.2013. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281686/
- Xing, X., Xue, P., Li, S. X., Zhou, J., & Tang, X. (2020). Sleep disturbance is associated with an increased risk of menstrual problems in female Chinese university students. Sleep & Breathing, 24(4), 1719-1727. doi: 10.1007/s11325-020-02105-1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32445135/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.