After a few days of delayed menstruation, you're asking yourself questions. Are you pregnant or not? While pregnancy is generally easy to establish, other causes of amenorrhea are not necessarily obvious. In some cases, late or absent periods are normal. Sometimes, however, it is essential to seek medical advice. It's important to be aware of the different possible causes of this disorder, so you know whether you need to consult a specialist.
What is a late period?
A menstrual cycle generally lasts between 21 and 35 days. For those with a regular cycle, menstruation returns after a set interval. In this case, your period is late, meaning that it's not on time. However, there's no need to worry from the first day of delay. Menstruation can occur spontaneously after a few days. For peace of mind, you can draw up your own calendar for calculating your menstrual cycle.
A real delay, which can involve quite serious pathologies, manifests itself in two ways:
Primary amenorrhea: this is the case when a girl over the age of 14 shows neither her first menstrual period, nor any physical changes (pilosity, breast development, fatty tissue on the hips...), or when a girl over the age of 16 shows these physical changes, but still hasn't had her first menstrual period. In general, these symptoms are indicative of delayed puberty, or very rarely of Turner's syndrome;
Secondary amenorrhea: when a woman who has already menstruated suffers a delay of more than 6 months, or of a duration corresponding to that of three cycles when she last menstruated.
Normal menstrual delays
Delayed periods are normal during puberty, after pregnancy, while breast-feeding or at menopause.
To find out if you're pregnant, all you need to do is take a pregnancy test (urine test or early pregnancy test such as Clearblue Plus). Increased levels of the hormone HGC, also known as pregnancy hormone, indicate fertilization. Pregnancy is a possibility in sexually active women, especially in the case of unprotected intercourse. The cessation of menstrual bleeding should suggest the onset of pregnancy, even if you're convinced you're not pregnant. Ultrasound scans and blood tests can help you decide quickly if you have any doubts, bearing in mind that it's possible to have a negative test result even if the woman is about to have a baby (in the case of pregnancy denial, or if the test is taken too early). If you show signs of pregnancy that are common in pregnant women (nausea and vomiting, dizziness, hypersomnia, etc.), the cause of the delay in menstruation is clear.
If the woman is breast-feeding, the return to menstruation takes time, especially in the case of exclusive breast-feeding. The absence of menstruation can last several months.
At the beginning and end of the fertile period, i.e. puberty and menopause, irregular periods are normal. Delays, as well as prolonged periods, are common and need not worry you.
Delays due to lifestyle or shock
Delayed periods can also be caused by hormonal imbalances linked to certain situations:
- A young woman who is too thin, suffering from anorexia or bulimia, may have irregular cycles or no periods at all. The body doesn't have enough adipose tissue to produce estrogen, indicating that the person's constitution is not suited to pregnancy;
- Obesity or significant weight gain may also be the cause;
- Significant weight loss can cause irregularities;
- Demanding sports activities: young women with very athletic bodies also have difficulty producing estrogen;
- Contraceptives: a progesterone-only contraceptive will cause a condition comparable to pregnancy. Taking the pill can also stop menstruation, leaving only "withdrawal" bleeding;
- Stopping a contraceptive after several years' use: the woman will experience delays, especially if her periods were already irregular before starting contraception;
- Taking certain drugs (antidepressants, antipsychotics, chemotherapy, etc.) which cause excessive activity in the pituitary gland. Prolactin is secreted in abundance, reducing estrogen secretion;
- A uterine scar following an operation (treatment of uterine fibroids, curettage, abortion, caesarean section, etc.);
- A major emotional shock (bereavement, job loss, divorce, etc.);
- Sress;
- A poor diet with significant deficiencies.
Finally, there are internal causes of delayed menstruation, such as polycystic ovary syndrome. In the presence of this endocrine disease, the ovary produces eggs of very poor quality. A thyroid disorder can also lead to menstrual disorders, as can anatomical anomalies, but these are extremely rare.
When should I seek medical advice?
If you've had a series of negative pregnancy tests, and the amenorrhea persists, it's best to consult a doctor or go straight to the gynecologist. It's not uncommon for menstruation to return after a week's delay, or even 15 days in the event of major stress. The specialist will be able to determine the cause of the delay.
Il existe également certains troubles qui doivent susciter la vigilance chez les femmes :
Avoir des retards peut être normal dans certains cas. Parfois, la cause demeure bénigne, mais il est important de suivre le traitement adéquat. En effet, une absence de règles prolongée va finir par avoir des conséquences sur le système reproductif, et la femme risque d’éprouver des difficultés à avoir un enfant.
