Every adult woman has encountered a delayed menstruation cycle at least once in her life. Find out why this is happening.
Although none of us is happy with “those days” in the month and a break from them would always be good in theory, in practice it is not like that. When the period is late, we immediately look for reasons why. It brings panic and nervousness into our lives because we often think that it won’t end well. Unless it’s good news, the desired pregnancy.
What Is the Menstrual Cycle?
The menstrual cycle is a woman’s vaginal monthly bleeding and is an integral part of her life. The word menstruation itself comes from the Latin word for a month – mensis, so the name itself indicates that it is a monthly phenomenon. This bleeding prepares the body for pregnancy and indicates that it is capable of pregnancy.
The first menstruation occurs at the beginning of puberty, mostly between the ages of 11 and 14, and stops around the age of 50, when menopause begins. On average, a woman has 400-500 menstrual periods in her lifetime.
The length of the cycle and the duration of menstruation are individual for each woman. Although it usually lasts 3-7 days, the “normal” menstrual period for one woman may be different from what is “normal” for another. An unwritten rule says that thin women, especially those who smoke, usually bleed longer, and those who are actively involved in sports shorter. Also, women who use the IUD as a contraceptive usually have longer bleeding.
What we all know is that some women go through menstrual cycles easily, with little or no worries. Their menstrual periods are right on time, they start and end almost at the same time every month, causing minimal discomfort. However, other women experience physical, emotional, and psychological symptoms before and during menstruation and have irregular menstruation.
What Can Be the Cause of Delayed Menstruation?
If menstruation is regular, it occurs every month in the same or similar period of time (+/- 5 days), if you are sure about the start date of the cycle and the bleeding is more than 7 days late, you should already ask yourself about the cause of that condition. Menstruation is delayed for various reasons, and here we will list the most common.
As soon as menstruation becomes irregular, every woman first thinks of pregnancy. It is really the main cause of delayed menstruation.
If you have a normal period and it is late or absent, you are probably pregnant. Some women will be happy with the news, and some will not. However, to be sure, before you start panicking or jumping with joy, it is best to do a pregnancy test and make an appointment with a gynecologist to confirm or deny this.
Delayed Menstruation Due to Stress
Being stressed is never good for your health or your body, and can lead to various problems. One of them is delayed menstruation. The menstrual cycle regulates the delicate and complex balance of hormones, so anything that can upset the hormonal balance also affects the menstrual cycle. Stress interferes with the regular functioning of the hypothalamus in the brain, and thus the production of hormones, which can lead to delays or absence of ovulation, and thus to irregular menstruation (from delayed menstruation or absence of menstruation to severe menstrual pain).
In short, stress can only negatively affect a cycle.
Travel can easily be the reason why a woman’s menstruation is late. Traveling is mostly fun, but it usually brings a certain amount of stress, because of packing and planning activities.
Also, eating habits and the level of physical activity change during the trip. Climate change and time zones also affect the body, so all this can lead to delayed menstruation.
Weight Problems and Hormonal Imbalance
If you have recently lost a significant number of pounds or gained weight too quickly, this may be the reason why menstruation is delayed, but also the reason for its absence. Weight gain and weight loss are the most common reasons for these menstrual problems. In order for the body to have a healthy, normal menstrual cycle, there must be a balanced amount of fat – not too much and not too little.
With low body weight and anemia, hormonal functions are disturbed, which can stop ovulation. These hormonal changes are common in people with eating disorders such as anorexia and bulimia. In underweight people, there are not enough fat cells in the body to produce enough estrogen for healthy ovulation. Then ovulation does not occur, which causes a delay or absence of menstruation.
Also, being overweight can affect your menstrual cycle. Obese women have an excess of fat cells in the body, which causes production of too much estrogen. Unfortunately, the body can react to this high level of a female hormone by the absence of ovulation, and thus there is a delay or absence of menstruation.
Because of too many fat cells or too much estrogen, many women suffer from polycystic ovary syndrome (PCOS). PCOS has a genetic component, so the chances of this condition are higher if other women in the family also suffered from it. Women with polycystic ovary syndrome either do not have it at all, or they have heavy, irregular menstruation, which can be painful.
Excessive Exercise Is a Reason for Delayed Menstruation
Extreme exercise can negatively affect hormone disorders. Excessive exercise leads to stress and menstrual cycle disorders, especially when it is accompanied by great weight loss.
The Use of Certain Medications Is the Reason Why Menstruation Is Delayed
The most common drugs that cause menstrual changes are birth control pills. Hormonal drugs work by preventing ovulation, and without ovulation, there is no menstruation. Emergency contraception, or the “morning-after pill”, can also affect ovulation.
Some other medications that can cause delayed or missed periods are antidepressants, some antipsychotics, corticosteroids, and chemotherapy drugs.
Other Reasons for Delayed Menstruation in Women
Some other reasons why menstruation is late or absent are:
- breastfeeding a baby
- thyroid dysfunction
- uterine scarring (due to medical interventions)
- alcohol and liver disease
- celiac disease (gluten hypersensitivity)
- change of daily routine (eg switching to night shift)
- a cold or other illness during ovulation
Other Menstrual Disorders
If there are one or more symptoms that cause problems before or during menstruation, then it is a disorder of the menstrual cycle. In addition to delayed and absent menstruation, the disorders are: heavy menstrual bleeding, irregular menstrual bleeding (bleeding between periods), painful menstruation, premenstrual syndrome (PMS), and premenstrual dysphoric disorder (PMDD).
Heavy Menstrual Bleeding
The cause of this disorder, which is called menorrhagia in medicine, can be an excess of estrogen, fibroids, or a hormonal imbalance. The consequences can be terrible – from simple discomfort, over fatigue, to anemia. And it most often occurs in girls in adolescence, but also in women who are entering menopause.
It is very difficult to find the cause of menorrhagia. Doctors divide them into three categories: organic, endocrinological, and anatomical.
Namely, in a normal menstrual cycle, the balance between the hormone estrogen and progesterone regulates the growth of uterine tissue, which is rejected when menstruation does not occur. Due to the hormonal imbalance of the endometrium (uterine tissue), it can be larger than usual, and that is why heavier menstrual bleeding occurs.
Menorrhagia can also be caused by thyroid disease, due to hormonal imbalance, improper use of hormonal drugs. Other causes include fibroids, a benign tumor of the uterus, polyps, ovarian cysts, ovarian dysfunction, adenomyosis, intrauterine devices, complications in pregnancy, cancer, or medications.
- menstrual bleeding that leaks through one or more pads or tampons every hour for several hours in a row
- the need to use double sanitary protection to control menstrual bleeding
- change of pads or tampons during the night
- menstrual bleeding lasting more than seven days
- menstrual bleeding with larger pieces of clotted blood
- abundant bleeding that interferes with your daily activities
- constant pain like cramps in the lower abdomen during menstruation (does not occur in everyone)
- irregular menstruation
- fatigue, loss of breath, fainting, anemia
Irregular Menstrual Bleeding
The absence of menstruation is professionally called amenorrhea. This phenomenon is normal during pregnancy, after menopause and before puberty. If we are not talking about these categories, then we distinguish two types of amenorrhea: primary and secondary.
Primary amenorrhea is the absence of menstrual bleeding until the age of 16 when 95% of girls get their first period, or by the end of the 18th year, when 98% get it. If a girl has developed secondary sexual characteristics (breasts, underarm and genital hairs), the cause of non-appearance of the first menstruation are most often anomalies in the structure of sexual organs, such as imperforate hymen, vaginal septum, absence of the vagina, and/or uterus, or premenstrual hormonal disorders. However, if the secondary sexual characteristics are not developed, the cause of primary amenorrhea can be delayed puberty, gonadal dysgenesis, or lack of true ovarian tissue with chromosomal abnormalities or pituitary gland malfunction.
Secondary amenorrhea is the absence of menstruation for six months, in a girl or woman who has previously had regular menstruation. However, as absences are common for up to three years after the onset of the first menstruation, in that period, a girl who does not menstruate for six months only in the third year after the onset of menarche is considered secondary amenorrhea.
Absence of menstruation is influenced by a number of factors, from inappropriate physical activity, excessive or too little body weight or eating disorders, to pregnancy, hormonal disorders, and stress. Since the causes of absence are numerous and diverse, it is first necessary to determine exactly why the menstruation was absent, and only then to make a decision on the method of treatment. It is of great importance to do laboratory analysis and a good anamnesis and perform a detailed ultrasound examination.
Bleeding Between Periods
This is one of the reasons why a large number of women worry and think that something is wrong. Bleeding between periods is a common type of menstrual problem and can be a symptom of another health condition, more or less serious.
When we get menstruation after only two weeks from the previous one, we always wonder what the problem is.
This condition can be caused by:
- blood clotting disorder or the use of certain anticoagulant drugs
- thyroid problems
- infections in the reproductive system
- polycystic ovary syndrome
- fibroids or polyps in the uterus.
Just in case, women who experience this type of bleeding should contact their doctor.
Painful menstruation or dysmenorrhea is a problem that affects the majority of the female population, although it is somewhat more common in younger women. According to research, over 50 percent of women in one period of menstrual activity suffer from painful menstruation, and after childbirth, improvement usually occurs.
Dysmenorrhea is the professional name for the pain that occurs during a woman’s menstrual bleeding. The pain if located in the area of the abdomen and lower back, can be of different intensity, so some women feel weak or moderately strong pain, while others feel very strong pain. Pain has the character of cramps and can be accompanied by headache, nausea, vomiting, diarrhea, emotional instability (crying, hypersensitivity, insomnia…).
So It Is True, PMS Really Exists?
Premenstrual syndrome – PMS means the cyclical appearance of certain disorders – from headaches to emotional or psychological problems that usually occur in the second (luteal) phase of the cycle, in most cases 5 to 10 days before menstruation and disappear with the onset of menstrual bleeding. It most often occurs between the ages of 30 and 40, although it can also occur during puberty or premenopause. The incidence of PMS is estimated at about 60-85% of all women.
The symptoms are very different, both in type and intensity of symptoms, the common characteristic of these symptoms is their cyclic recurrence. There are four basic types of PMS:
- PMS type A: fear, irritability, and heightened mental sensitivity.
- PMS type C: a feeling of unbearable hunger and increased appetite.
- PMS type D: depression, insomnia.
- PMS type H: weight gain, chest tightness.
Other symptoms that may occur in PMS are:
- emotional instability
- difficulties in coordination
- eye problems
- back pain
- sore throat
- a headache
- cramps and bloating
- variable libido
- sinus problems
- difficulty urinating
- exacerbation of pre-existing diseases (lupus, arthritis, glaucoma)
The true cause of premenstrual syndrome symptoms is still unknown, but it is thought to be related to changes in blood hormone levels (estrogen and progesterone) whose concentration changes at different stages of the cycle, and hypersensitivity of some women to such hormonal fluctuations.
In addition, there are assumptions that some conditions in the body such as calcium and magnesium deficiency and serotonin deficiency, the so-called “happiness hormone”, contribute to the onset of PMS symptoms. Also, genetic predisposition is thought to play a significant role in this. However, despite all the theories that exist about the development of premenstrual syndrome, it is still not known exactly why some women tolerate this phase of the cycle better than others.
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is a condition characterized by depression and severe irritability immediately before and during menstruation. Generally, less than 10% of fully mature women have it.
PMDD is more common in women who have a history of depression but can also occur in women without a previous history of the disorder. It can range from mild anxiety to a strong feeling of hopelessness and suicidal thoughts.
The imperative for this disorder is to see a doctor.
Most menstrual problems have simple explanations and there are numerous options for treating and alleviating the symptoms.
If menstruation is late or absent, and you are not pregnant, do not panic because there is probably no reason to panic! Try to relax. Restoring life to emotional and physical balance can help the cycle return to normal next month.
If you have unusual bleeding, fever, severe pain, nausea, and vomiting, or bleeding that lasts for more than seven days, see a doctor immediately.
Keep track of the cycles. Talk to your doctor about changes and problems in the cycle and irregular menstruation. This will help the doctor to make a diagnosis and choose the best treatment so that the menstrual cycle is regular and normal again.