To the uninformed, a missed period can only mean one thing: You're
pregnant. But in reality, there are numerous reasons why your period
might be late -- or missing altogether.
The
28-day menstrual cycle is closely tied to your overall well-being. And
when your body is out of balance, it can adversely affect the timing of
your period.
The medical term for absent menstruation is called "amenorrhea."
Primary amenorrhea
refers to late onset of menstruation, or not having started
menstruation by the age of 16. However, the condition is quite rare,
affecting less than 1 percent of girls in the United States.
Secondary amenorrhea
refers to a situation where menstruation begins at the appropriate age,
but later stops for more than three cycles or six months. Affecting
roughly 4 percent of the general female population, secondary amenorrhea
is more common, and can be caused by a host of factors.
Most of
those components center on hormonal shifts caused by heightened stress
-- whether physical, mental or emotional -- which in turn can prevent
ovulation, the precursor of menstruation (ovulation occurs roughly 14 to
16 days before women have their period). The female reproductive system
is incredibly efficient, yet remarkably complex. As a result, it's
vulnerable to outside factors -- both subtle and overt -- that can
interrupt your body's equilibrium.
Of course, if there's a chance
that you might actually be pregnant, rule out that possibility first.
Home pregnancy tests are fast, inexpensive and 97 percent accurate when
the directions are followed. If the test is negative, check with your
doctor, but also consider one of the following five possibilities.
1: Under Pressure
Stress is a silent menace and the primary cause of many physical
ailments, not the least of which is internal clock disruption. In fact,
emotional stress
is the second most common cause of late or missed periods in teenagers
and can play a huge role in adverse effects on the cycles of more mature
women as well. Just think how problems with your love life (or home
life, school or work) impact every other facet of your everyday life. It
is the classic mind-body connection.
Emotional or mental anxiety can negatively affect the
hypothalamus,
the part of the brain that regulates hormones -- specifically
gonadotropin-releasing hormone (GnRH) -- for both ovulation and
menstruation, according to the National Institute of Child Health and
Human Development.
If a woman's hypothalamus is impaired in any
way, there's a distinct possibility her hormones won't manage ovulation
properly. That can result in delayed or interrupted menstrual cycle.
One healthy option in overcoming the rigors of stress is to practice relaxation techniques, ranging from yoga to meditation.
2: A Weighty Issue
The odds of having secondary amenorrhea increase if you're severely
underweight (less than 15 to 17 percent body fat) or obese. The Centers
for Disease Control and Prevention considers someone obese if that
person has a
body mass index (
BMI),
which is calculated from your height and weight, of more than 30. For
example, a 5-foot-9-inch (1.75-meter) person weighing more than 203
pounds (92 kilograms) would be considered obese.
Both conditions stress your body's vital organs and, in turn, can delay or cease menstruation.
In
most cases, a gradual weight gain or weight loss (depending on your
condition) will typically cause the return of a normal cycle. It's
critical to avoid rapid weight gain or loss, as both of these further
strain your body. Women who undergo gastric bypass surgery should also be aware of the possibility of menstrual disruption.
Similarly,
eating disorders such as anorexia nervosa and bulimia (binging and
purging) can be the culprit in a missed or late period. However, these
eating disorders can have serious consequences that go far beyond
missing your period. If you suspect that you or someone you care for
might suffer from either condition, consult with a medical professional.
3: The Travails of Travel
Travel can throw you, and your cycle, for a loop. Just think how jetlag can leave you off-kilter for days.
Though
everyone's body adapts more readily to a regular schedule, women are
particularly susceptible to the upheaval that travel can wreak on a
daily agenda -- and their bodies. It can throw off their sleep and
eating patterns, both of which can have a negative effect on their
menstrual cycles.
To make matters worse, most people don't eat
properly while on the road, whether skimping on meals while traveling on
business or overindulging while traveling for pleasure. Either
situation, coupled with the added stress of getting acclimated to a
different routine, can lead to delayed ovulation and menstruation.
Likewise, a change in work schedule (such as taking on a night shift) can have similar consequences.
4: Excessive Exercise
File this under, "Too much of a good thing." Exercise
generally has tremendous health benefits, but moderation is equally
important. Overdo it, in terms of either intensity or duration, and you
run the risk of putting your body under undue physical stress.
That can have consequences that go beyond repetitive strain
injuries, such as shin splints or knee pain. Like mental or emotional
anxiety, an unhealthy amount of physical stress forces your body to
protect itself, and preventing ovulation can be a by-product of that
phenomenon.
This form of secondary amenorrhea is often seen in
endurance athletes, such as cross-country runners or professional
cyclists (typically, their lower body-fat content also plays a role in
delayed menstruation).
Coincidentally, the same condition can be
experienced by women who suffer from a chronic illness that, on the
surface, may not appear to be related to their menstrual cycle.
5: Doctor Knows Best
Late or missed periods can also be the
result of more complicated or serious medical conditions. Polycystic
ovarian syndrome (an imbalance in female sex hormones such as estrogen
and progesterone), thyroid disease, pituitary disease, a pituitary
tumor, sexually transmitted diseases, infections, perimenopause and
menopause have all been linked to menstrual cycle irregularities.
In
rare cases, diseases such as diabetes, liver ailments and irritable
bowel syndrome can delay or prevent menstruation. Furthermore,
medications, including some birth control methods and antidepressants,
can also result in lighter, less frequent or missed periods.
For
women who recently stopped using birth control, their bodies may take as
long as three months to acclimate and resume normal cycles.
So,
in short, if you have questions about why you've missed your period and
you've ruled out pregnancy, don't worry unnecessarily. Take the next
step and consult your medical professional to determine the underlying
cause.
Last edited 13/04/2011