No period? Sounds kind of nice. Less worry, less planning, and a nice break from the years of month-to-month fatigue, cramping, and hunger cues. Sounds pretty convenient, right? 

But not quite. Having a period is natural and ensures the body’s reproductive system is operating properly. 

Although irregular menstrual cycles can kind of be normal, an entire lack of a menstruation can be a concern. For women who are 16 and older, and never had a period, this is called primary amenorrhea. If they have had a period but have missed several in six months time, that is called secondary amenorrhea. 

There are many reasons you may have amenorrhea. If you’re not pregnant or breastfeeding, a lack of a period could be a sign for other underlying issues. A complete missed period may be one amongst many symptoms for a condition. Underlying conditions that also lead to headaches, cramping without bleeding, and changes in vision. 

In addition, other causes of amenorrhea could be:

Birth Control: birth control pills inhibit ovulation. This also happens with the birth control injections. IUD devices may also be the cause for light or no periods at all. And other medicines like antidepressants may be the cause for missed periods. Normally, with discontinued use of any of these, the period should resume. 

Premature Menopause: if this occurs, doctors can treat you by replacing the hormones lost, especially for heart and bone health. 

PCOS (Polycystic Ovarian Syndrome): a hormone imbalance that encompases various symptoms. One being missed periods. Happens when the ovaries produce more male hormones than normal and can cause cysts to develop on the ovaries. This also means an excess in estrogen and too much of the androgen hormone that causes weight gain around the stomach, as well as acne and facial hair. 

Weight Extremes: women who are considered obese are likely to have missed periods. As well as women who deal with rapid weight loss, especially from surgery. Women who exercise in excess or have lower than 15% body fat have also been known to have missed periods. 

Reproductive Structural Issues: If you’ve had a delivery of a D&C to remove tissue from the uterus, the scarring that occurs from those procedures can affect your body’s ability to have periods. As well as other issues like conditions in the thyroid gland or abnormalities in the vagina are structural issues that can affect menstrual cycles. 

Concerns

Missing menstrual cycles is a reason to sit down with your doctor. A lack of a period can be signs for infertility problems, hormone imbalances, and even other underlying conditions like prediabetes. Talking to your doctor can help find the root cause of your amenorrhea and help you develop a plan to treat it. 

However, if you’ve missed a period this month, don’t fret! It is normal to miss your period once in a blue moon. One missed period can be a response to a lot of things. Stress, change, diet, etc. As well as larger issues. 

Here are a few basic reasons you may have missed this month:

Stress.

We’re all stressed. And sometimes it takes physical ailments to even realize what’s going on inside the body. Our stress-response system is called the hypothalamus. This is the part of your brain that is hard-wired to react as if you’re running from predators. 

When you’re at your peak stress level, your brain tells your endocrine system to turn on fight-or-flight mode with a flood of hormones. When you’re under this kind of profound stress, it alters the production of a gonadotropin-releasing hormone. These hormones help suppress functions that aren’t essential when it comes to survival, interfering with ovulation and regular menstruation. That includes your reproductive system. 

If you’re under excess stress, your body can get stuck in fight-or-flight mode and halt ovulation temporarily. 

This kind of stress isn’t just work or school stress. It’s a severe kind of stress that can be overwhelming or coupled with prolonged anxiety. Managing your stress can help bring your cycle back in a few months. 

Intense Workouts.

Extreme exercise can alter your thyroid and pituitary hormones. This also results in change of ovulation and menstruation. But don’t worry, it doesn’t take just about any exercise to make this happen. For you to miss one or two cycles, it takes strenuous exercise for hours and hours to result in these hormonal changes. 

If this is the type of exercise you’re planning for, make sure to talk to a sports medicine doctor who can help manipulate your nutrition, blood testing, and recommended support to meet your physical demands.

When you burn too many calories, your body doesn’t have enough energy to keep all things going. This leads to hormonal imbalances and can throw off your entire cycle. Which could mean missed and/or late periods. 

You May Have PCOS.

Polycystic ovary syndrome is caused by an imbalance of reproductive hormones. This means you may not ovulate regularly, which results in lighter than normal, inconsistent or missed periods. This could also come with additional symptoms that look like:

• excess or coarse facial and body hair
• acne on the face and body
• thinning hair
• weight gain or trouble losing weight
• dark patches of skin, often on the neck creases, groin, and underneath breasts
• skin tags in the armpits or neck
• Infertility

Drastic Schedule Changes.

By throwing off your routine or frequently changing your schedule, your period can become unpredictable. Different work shifts, erratic day to night or night to day changes, can all be factors. Even jet lag.

Normally this doesn’t mean a complete miss or frequently missed periods but it can push your period further back or earlier than you expect.

Birth Control.

Birth control can be used for a multitude of reasons. Some women take it for contraception, some for acne, some for regular periods. However, this can sometimes have the opposite effect on women, especially in the beginning. 

As well as discontinued use of the pill. Once you stop taking the pill, it may take your period a few month cycles to be normal. Your body will take it’s time to return to its baseline hormone levels.

Rapid Weight Changes.

Drastic changes in your weight can impact your cycle. Being underweight, overweight, losing a lot of weight or gaining a lot of weight can all be factors. 

Being underweight means the body is lacking in fat and nutrients that affect the production of certain hormones. Women who suffer from anorexia or burn way too many calories with exercise may also deal with amenorrhea. When weight is gained back, your periods will most likely return.

Being overweight means an influence of estrogen and progesterone. A very high BMI can be associated with missed periods and decrease chances in fertility. Weight loss is a helpful solution to menstrual and fertility issues. 

Weight changes that are attributed to illness, medication, and nutrition may also interfere with hormone production and whether or not you miss a period entirely. 

Illness.

Like PCOS, additional chronic disease can affect your menstrual cycle. This includes, pituitary tumors, thyroid disease, ovarian cysts, diabetes, liver dysfunction, and disease of the adrenal gland. When it comes to any of these interfering with your cycle, the possibility of it returning to normal may be slim until the condition is treated. Androgen insensitivity syndrome and Turner syndrome cause both menstrual and fertility issues and are often associated with amenorrhea. 

Acute illnesses like kidney failure, meningitis, pneumonia, and heart attacks can result in quick weight loss, normally from a nutrition deficient or hormonal dysfunction. These can also cause you to miss a period. And your period may not resume for a few months until the illness is resolved.

Medication.

Not only birth control and hormonal contraceptives like progesterone-only MiniPill, Nexplanon, the Depo shot, and the Mirena IUD but some medications like antipsychotics, anticonvulsants, antidepressants, thyroid medication, and some chemotherapy medications may delay your period, if not gone altogether. 

Newly Started Periods.

Normal menstrual cycles in healthy women are considered to last and vary 21 to 35 days. They can most definitely vary for women just starting to get their period or for women who are trying to start their period again after years of missing. 

Women who are just starting their periods may go through a few irregular cycles, or months without another period until the period regulates its pattern. 

When Should You Call Your Doctor for a Missed Period?

If you’re missing more than one period, it’s best practice to call your doctor to investigate and determine the severity of the reasons. 

You should see your doctor urgently if you experience any of the following:

• New or worsening headaches
• Vision changes
• Nausea or vomiting
• Fevers
• Hair loss
• Breast secretions or milk production
• Excess hair growth

Concerned About Missed Periods? Call Rosh Maternal & Fetal Medicine in NYC For All Your Questions and Concerns. 

Irregular and missed periods shouldn’t be accepted as normal.

Both conditions can signal an underlying health problem that should be treated to prevent serious problems from developing. You can count on the extensive experience of the doctors at Rosh Maternal & Fetal Medicine to identify the cause and effectively treat irregular and missed periods.

If you have any questions about your menstrual periods, call their office in the Midtown East area of New York City, or schedule an appointment online.