Late period is a violation of menstrual function, manifested by the absence of cyclic bleeding for more than 35 days. It can be caused by physiological reasons (pregnancy, premenopause, etc.), as well as various organic or functional disorders. The delay of menstruation occurs at various periods of a woman’s life: during the formation of menstrual function, in the reproductive period and in premenopause. A delay in menstruation for more than five days is an excuse to consult a doctor. The diagnosis is aimed at finding the main cause of this symptom, on which further treatment tactics depend.
A delay in menstruation is considered a failure in the menstrual cycle, in which menstrual bleeding does not occur at the expected time. The delay of menstruation, not exceeding 5-7 days, is not regarded as a pathology. Options for delaying menstruation are menstrual disorders such as oligomenorrhea, opsomenorrhea and amenorrhea, manifested by a reduction in menstrual bleeding. The delay of menstruation can be observed in different age periods of a woman’s life: during puberty, in the reproductive phase, in premenopause and caused by physiological or pathological causes.
Natural, physiological reasons for the delay of menstruation are explained in the pubertal period during the formation of the menstrual cycle, when menstruation may be irregular for 1-1.5 years. In women of reproductive age, the delay of menstruation is natural at the onset of pregnancy and during lactation. In the premenopausal period, menstrual function gradually fades, there are changes in the rhythm, duration of menstruation, and menstrual delays are replaced by their complete cessation.
All other options for delaying menstruation exceeding 5-7 days are not explained by natural phenomena, in such cases an urgent consultation with a gynecologist is required. The menstrual cycle of a woman is a subtle mechanism that maintains childbearing function and reflects any deviations in the state of general health. Therefore, for a better understanding of the causes and mechanisms of late period, it is necessary to clearly understand what is the norm and deviation in the characteristics of the menstrual cycle.
Characteristics of the menstrual cycle
The functioning of the body of a woman of childbearing age has cyclical patterns. Monthly bleeding is the final stage of the menstrual cycle. Menstrual discharge indicates that fertilization of the egg and the onset of pregnancy did not occur. In addition, the regularity of menstruation indicates that a woman’s body functions smoothly. The delay of menstruation, on the contrary, indicates some failures that have occurred.
The onset of the first menstruation usually occurs between 11-15 years. At first, menstrual bleeding may come irregularly, the delay of menstruation during this period is normal, but after 12-18 months, the menstrual cycle should finally form. The onset of menstruation earlier than 11 years and absence after 17 years is a pathology. The delay in the onset of menstruation up to 18-20 years indicates obvious pathological processes: a general lag in physical development, pituitary dysfunction, ovarian underdevelopment, uterine hypoplasia, etc.
Normally, menstruation occurs and ends after certain time intervals. In 60% of women, the cycle duration is 28 days, that is, 4 weeks, which corresponds to the lunar month. Approximately 30% of women have a cycle lasting 21 days, and about 10% of women have a menstrual cycle lasting 30-35 days. On average, menstrual bleeding lasts 3-7 days, and the allowable blood loss per menstruation is 50-150 ml. Complete cessation of menstruation occurs after 45-50 years and marks the onset of menopause.
Irregularity and fluctuations in the duration of the menstrual cycle, systematic delays of menstruation over 5-10 days, alternation of meager and copious menstrual bleeding, indicate serious deviations in a woman’s health. In order to control the onset or delay of menstruation, every woman should keep a menstrual calendar, marking the day of the beginning of the next menstruation. In this case, the delay of menstruation will be immediately visible.
Late period and pregnancy
Pregnancy is the most common cause of late period in women of childbearing age. The probable onset of pregnancy, in addition to the delay of menstruation, is indicated by changes in taste and olfactory sensations, appetite, the appearance of nausea and vomiting in the morning, drowsiness, painful sensations in the mammary glands. It is impossible to reject the possibility of pregnancy even in cases where there was an interrupted sexual intercourse, sexual contact during menstruation, on “safe” days or using a condom, in the presence of an intrauterine device, taking oral contraceptives, etc., since no method of contraception gives a 100% contraceptive effect.
If there was a delay in menstruation, and in the previous month a woman had sexual intercourse, then it is possible to determine pregnancy with the help of special tests. The principle of operation of all pregnancy tests (test strips, tablet or jet) is the same: they determine the presence of chorionic gonadotropin (hCG or hCG) in the urine, the production of which begins in the body 7 days after fertilization of the egg. The concentration of hCG in the urine increases gradually, and modern, even the most sensitive tests, are able to determine it only after a delay in menstruation and not earlier than 12-14 days after conception. It is necessary to “read” the test result in the first 5-10 minutes. The appearance of even a barely noticeable second stripe during this period of time indicates a positive result and the presence of pregnancy. If the second strip appeared later, then this result is not reliable. If menstruation is delayed, it is recommended to repeat the pregnancy test twice with an interval of 2-3 days to obtain a reliable result.
It should be remembered that while living a sexual life, a woman can always get pregnant, so it is necessary to closely monitor the menstrual cycle and pay attention to the delays of menstruation. However, the delay of menstruation can be caused not only by pregnancy, but also by a number of very other, sometimes very serious and dangerous to health reasons.
Other reasons for late period
Gynecology conditionally divides all the causes of late period into two large groups: physiological and pathological causes of late period. In some cases, the delay of menstruation is caused by special transitional, adaptive conditions for the body, and usually does not exceed 5-7 days. However, some of these conditions are borderline, and with their aggravation, organic disorders may occur, leading to a delay in menstruation as a manifestation of a particular pathology. Caused by physiological reasons can be considered:
- caused by strong emotional or physical stress: stress, increased sports, academic loads or work loads;
- due to unusual changes in lifestyle: a change in the nature of work, a sharp change in climate;
- due to insufficient nutrition and adherence to strict diets;
- during periods of hormonal changes: puberty or menopause;
- as a condition after the cancellation of contraceptive hormonal drugs, caused by temporary hyper-inhibition of the ovaries after prolonged receipt of hormones from the outside. If the delay of menstruation is observed for 2-3 cycles, it is necessary to visit a gynecologist.
- after the use of emergency contraception drugs containing a high dose of hormones;
- tin the postpartum period associated with the production of the pituitary hormone prolactin, responsible for the secretion of milk and suppressing the cyclic function of the ovaries. If a woman does not breastfeed, then menstruation should recover about 2 months after giving birth. When breastfeeding is carried out, menstruation is restored after weaning the baby from the breast. However, if the delay in menstruation is more than a year after childbirth, it is necessary to consult a gynecologist.
- caused by colds (ARVI, flu), chronic diseases: gastritis, thyroid dysfunction, diabetes mellitus, kidney diseases, etc., as well as taking certain medications.
In all cases (except those when the delay of menstruation is caused by age-related hormonal changes or lactation), the delay period should not exceed 5-7 days, otherwise it is necessary to visit a gynecologist to prevent the development of serious diseases.
The pathological causes include, first of all, diseases of the sexual sphere. In this group of reasons , there are:
- by inflammatory (adnexitis, oophoritis) and tumor (uterine fibroids) diseases of the genitals. Inflammatory processes in the genitals, in addition to the delay of menstruation, may be manifested by pathological secretions and pain in the lower abdomen. These conditions require emergency treatment, as they can lead to serious complications and infertility;
- to polycystic ovaries and related hormonal disorders. Also, with polycystic ovaries, in addition to the delay of menstruation, there is an increase in body weight, the appearance of seborrhea and acne, excessive hair growth;
- by a cyst of the ovarian corpus luteum, formed as a result of hormonal disorders. For the resorption of the corpus luteum cyst and the restoration of a normal monthly cycle, the doctor prescribes a course of hormone therapy;
- after termination of pregnancy, which, although it occurs quite often, is not the norm. The reason for the delay of menstruation after abortion may be not only a sharp change in the hormonal state, but also mechanical injuries inflicted during curettage of the uterus;
- to frozen or ectopic pregnancy, miscarriage in the early stages, requiring emergency medical intervention;
- by a critical weight gain or loss for health. For women suffering from anorexia, a delay in menstruation can result in their complete cessation.
Thus, regardless of the reasons, late period is the basis for an urgent visit to the gynecologist.
Examination for late period
To determine the reasons for the delay of menstruation, examinations may be required that complement the gynecological examination:
- measurement and graphical display of changes in basal temperature, allowing you to verify the presence or absence of ovulation;
- determination of the level of hCG in the blood, hormones of the ovaries, pituitary gland and other glands;
- ultrasound diagnostics of the pelvic organs to determine pregnancy (uterine, ectopic), tumor lesions of the uterus, ovaries and other causes that caused the delay of menstruation;
- CT and MRI of the brain to exclude tumors of the pituitary gland and ovaries.
When detecting diseases that accompany the delay of menstruation, consultations of other specialist doctors are prescribed: an endocrinologist, a nutritionist, a psychotherapist, etc.
Summing up the above, it should be noted that the delay of menstruation, no matter what circumstances it was caused, should not remain without the attention of a woman. A delay in menstruation can be caused by both a banal change in the weather, or a joyful expectation of motherhood, and the most serious diseases. If there is a delay in menstruation, a timely consultation with a doctor will free you from unnecessary worries and worries that can significantly aggravate this condition. In families where girls are growing up, it is necessary to conduct their competent sex education, explaining, among other things, that the delay of menstruation is a problem that needs to be solved together with mom and doctor.