Understand Delayed Menstruation and The Causes

Edited by Debbie, Charmed, Eng, Alma and 4 others

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Have you been experiencing a problem with your menstrual cycle, not having your period on regularly? Has it been over a month, or possibly several months since your last period? Are you feeling anxious or stressed out with the simplest things?

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Whenever a woman misses her period, the first thing that comes to her mind is the possibility she's pregnant, especially during her fertile years and if she's sexually active. There are other reasons that can cause your menstrual cycle to be delayed, or to stop completely. Amenorrhea is a medical term to describe the absence of menstrual periods. Amenorrhea, or late periods or the cessation of them completely, is not a disease in itself, but it's usually symptom or manifestation of a medical condition or chronic illness. Find out the various causes or underlying factors that might result in the disruption or absence of menstruation. Knowing the trigger of late or missed menses, will empower women to effectively deal with delayed menstruation, and encourage them to seek proper treatment as soon a possible.

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Overview of Menstruation

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Menstruation, menarche, menses or menstrual period is defined as the routine shedding of the lining of the uterus or endometrium, which happens regularly, usually every 28 – 31 days. After a woman's body has prepared itself for pregnancy, menstruation occurs when the implantation or fertilization does not occur. Vaginal bleeding transpires from the shedding of uterine lining that is not longer necessary as there is no baby to nourish. It is a composite of tissues and blood that finds its way out through the cervix and then the vagina. Adolescent girls usually begin menstruating at the age of 11 to 14 which typically. Bleeding usually lasts from 3 to 5 days. The average menstrual cycle usually is about 28 days, but can go as long as 31 days for adult women and up until 45 days for teenagers. Menstrual flow and length varies from one individual to another. Some experience light bleeding with no cramps, while others experience heavy bleeding and painful cramps, while many more experience any combination of those two symptoms, as well as headaches, mood swings, etc. The severity of your menses depends on age, stress, hormones, lifestyle and environmentally related factors, or certain associated illnesses.

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How The Menstrual Cycle Works

Having a regular menstrual cycle corresponds to a normal, healthy body. Woman's hormones, specifically progesterone and estrogen, work primarily by regulating the menstrual cycle. The 1st day of the menstrual cycle is also the 1st day of your menstrual period. The cycle starts from the 1st day of a woman's menstrual period up until the 1st day of your next menstrual period or luteal phase. Estrogen and progesterone produced by the ovaries are crucial for ovulation and the development of a female body's secondary sexual traits. Estrogen is considered to be the primary hormone essential for not just menstruation and pregnancy, but also for maintaining bone strength due mainly to improved calcium absorption, promoting skin elasticity and thickness, enhancement of cardiac muscles, as well as improved vaginal and bladder functions. Estrogen prepares the endometrium for potential implantation of fertilized egg while the progesterone upsurge keeps the endometrial lining thick just in time for fertilization. These two hormones help keep a woman's body in perfect balance as too much production of estrogen has been proven to increase the chances of getting cancer which is counterbalanced by the elevated levels of progesterone in varied body receptors. Too much estrogen can also result to premature labor, which is triggered and controlled by progesterone.

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28-day Menstrual Cycle

Day 1 - This is the 1st day of the menstrual cycle or the onset of vaginal bleeding which also ends the previous menstrual cycle. The breakdown of the endometrial lining or bleeding happens with the drop in both progesterone and estrogen levels. Vaginal bleeding occurs for 3 to 5 days.

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Day 7 - This is commonly referred to as the follicular phase or the time wherein the ovarian follicles start to produce an egg or ovum.

Day 7 to 14 - Only 1 egg gets to reach full maturity. The uterine lining has also started to thicken which is composed and enriched in nutrients and blood in preparation for pregnancy.

Day 14 - This is also coined as the ovulation phase. At this point, the ovarian follicles erupt and release the egg or ovum.

Day 14 to 24 - Over the next days, the egg will travel all the way down the fallopian tube. If a sperm cell permeates the egg, fertilization then occurs. The fertilized egg then proceeds to travel down the fallopian tube and attaches itself to the wall of the uterus.

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Day 25 - The hormonal levels tend to drop around this time. If no fertilization occurs at this point, the egg then ruptures and the endometrium lining breaks down to begin with the next menstrual cycle.

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PMS – Premenstrual Syndrome

Many women experience a variety of premenstrual symptoms. Severity and frequency of the above premenstrual and menstrual symptoms vary from one person to another depending on certain biological, environmental, and lifestyle factors. Examples of PMS symptoms might include:

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  • Tenderness of breasts.
  • Bloating or water retention.
  • Acne eruptions.
  • Hypersensitivity, overly emotional.
  • Mood swings.
  • Menstrual cramps, called dysmenorrhea (back, pelvic area, and lower extremities).

About Amenorrhea

What is Amenorrhea?

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Normally, women aren't experiencing menstrual cycle before puberty, while they are pregnant, and once they reach the menopause (usually between 45 and 55 years old). Amenorrhea medically pertains to the absence of menstrual flow, whether the period is late, or you go months without your period making an appearance. It might seem like a fine thing, but you really need to find out what's going on inside your body. If you happen to miss one regular monthly cycle there is probably nothing to worry about, but if it extends longer like for 3 months or so then that could be a symptom of a worsening underlying illnesses which may warrant immediate medical attention.

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Symptoms of Amenorrhea

  • Cessation of menstrual flow
  • Vaginal dryness
  • Throbbing headache
  • Hirsutism or development of unwanted and excessive body hair
  • Acne formation
  • Hot flashes
  • Infertility
  • Night sweats
  • Sudden voice changes
  • Reduced libido or sexual appetite
  • Mood swings or irritability
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Types of Amenorrhea

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  1. 1
    Primary Amenorrhea.
    This can occur when by the age of 16, a girl still hasn't gotten her period, and is not pregnant. This could be caused by certain genetic reproductive abnormalities of the organs, and hormonal imbalances or issues with the pituitary and hypothalamus glands. This can also happen when there is a narrowing or blockage of the cervix.
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  2. 2
    Secondary Amenorrhea.
    This happens when a woman has a regular menstruation, but then all of the sudden it stops. This type of amenorrhea could start early on or could manifest at a later age. Usually caused by health condition, which may be either temporary or permanent. More so, this refers to the disruption of menstrual period for at least 3 regular monthly cycles or a time-frame that ranges from 3 to 6 months or for a longer duration. The only relief is that most causes of this type can be cured.
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Causes of Amenorrhea

  1. 1
    Pregnancy.
    This is certainly one of the most common causes of delayed menstruation in women. If you are a new wife, pregnancy could have been planned and anticipated, but, if you are a young teen and still in school, this could be a challenging ordeal for the entire family. Once the egg has been fertilized by a sperm, it attaches to the uterus and progresses for a period of 40 weeks. No shedding of endometrium occurs during pregnancy, as this is how the placenta is formed, and provides nourishment to the fetus growing in the womb.
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  2. 2
    Weight Gain or Weight Loss.
    In order to have a normal period, you need to have a certain amount of body fat. The fat cells make estrogen, so that you can ovulate and have normal menstruation every month. If you are too thin or overweight, this can cause missed periods and can affect ovulation or a woman's capacity to bear a child. Achieving the right body weight definitely helps, not just for aesthetic purposes but for ensuring overall optimum health.
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  3. 3
    Stress.
    This can do crazy things to our body. From stress, women can experience hair loss, anxiety, mood swings, and can even cause an interruption in ovulation, which then results in the menstruation cycle coming to a halt.
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  4. 4
    Eating disorders.
    People who suffer from certain eating disorders such as bulimia or anorexia nervosa tend to have low body weight, which creates a hormonal imbalance that adversely affects ovulation and regular menstrual flow. Certain extreme and ridiculously fast fad dieting techniques can cause hormones to go berserk and cause disruption in menarche flow as well as upset the balance of your life and career balance.
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  5. 5
    Hormonal Imbalance.
    There are different factors that can contribute to hormonal imbalance in a woman's body such as high testosterone levels, low spikes in estrogen levels, presence of tumors or issues with either the pituitary or thyroid glands.
    Virtual.marian hormones and pituitary gland.jpg
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  6. 6
    Hormonal Medications.
    An injectable type of birth control called Depo-Provera can cause irregular menstrual periods or amenorrhea. Also, certain psychiatric drugs like antidepressants, or chemotherapy medications, and corticosteroids can also trigger disruptions in a woman's monthly menstrual period and have been known to cause irregular or missed monthly periods.
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  7. 7
    Extreme Exercises.
    When a woman regularly overdoes it in sports training and physical activities, they tend to experience missed periods. Women who undergo rigorous sports training or routine workouts may experience disruptions or subsequent interruptions in their menstrual cycle. In fact, most athletes involved in gymnastics or running miss their monthly menstrual periods due to combination of stress, fatigue from too much exertion, and low body fat percentage.
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  8. 8
    Taking oral contraceptive pills.
    Women who are on the pill usually experience periods of amenorrhea or delayed menses due to the hormonal effect of the oral contraceptive. Regular menstrual cycles usually resumes after 3 months of being off the birth control pills (BCP).
    Virtual.marian oral contraceptive pill.jpg
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  9. 9
    Breastfeeding.
    This is recognized and recommended as an effective natural birth control method or what is commonly called lactational amenorrhea method (LAM) which is based on scientific findings that breastfeeding can delay menstruation in most mothers. Breast milk production, or lactation, is said to cause amenorrhea which is regarded to be effective especially if you decide to nurse your baby round the clock. This is recommended by most obstetrician-gynecologists for moms who are not yet menstruating, and are committed to nursing exclusively. This prevents new moms from getting pregnant for the first 6 months after they give birth.
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  10. 10
    Menopause.
    This is an age-related condition which results in the cessation of menarche. Most women experience menopause when they reach the age of 44 to 54 years old. On the average, women go through the gradual menopausal phase at age 51. It is alarming to note that there are some rare cases wherein women experience early menopause (in their 20's), which can however be reversed or remedied with varied treatments and medications. The menopausal transition does not happen in an instant but one goes through a "perimenopause" or a process that is usually experienced 3 to 5 years before the actual menopause occurs. A woman is considered to have reached menopause when she has missed at least 12 monthly cycles or equivocal to 1 year of regular monthly menarche cycles.
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What are the Treatments for Amenorrhea?

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In the case of pregnancy, it does not need to be treated. Treatment depends on the underlying reasons that caused amenorrhea or the disruption of menstrual cycle.

  1. 1
    See Your Physician.
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  2. 2
    Try to Manage Your Stress.
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  3. 3
    Eat a Well-Balanced Diet.
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  4. 4
    Maintain an Active and Healthy Lifestyle.
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  5. 5
    Hormonal Therapy.
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  6. 6
    Stress or Behavioral Modification Therapy.
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  7. 7
    Lose Weight.
    (If being overweight is causing it).
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  8. 8
    Gain Weight.
    ( If you are underweight).
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  9. 9
    Possible Surgery.
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Tips Tricks & Warnings

  • Keep regular appointments for pap smears.
  • Eat a nutritional diet
  • Find ways to relax.

Questions and Answers

What could be possible reasons for delay in my monthly cycle?

Hi, I'm 30 years old, no children and have had problems with my menstruation since I was 25 years old. I'm currently facing a similar problem; I've missed my period since May 2015 for which I did a pregnancy test, ultra sound and all was negative. I need your help cause I'm really disturbed.

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As you can see in the VisiHow article, there are many causes for delays but one of the biggest factors is stress. Use Red Raspberry Leaf Tea to Regulate Your Menstrual Cycle might jump start your cycle. Use Cinnamon for Menstrual Cramps and Fertility can be used to regulate your hormones. You can even combine the herbal remedies. If you still have a delayed period on a regular basis then you should be examined for PCOS or other hormonal abnormalities such as you could be perimenopausal. even at the age of 30.

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I am 25 years old unmarried girl. My menses have stopped for one month.

My menses stopped before six months, but than start after month. Why menses delay even though I m a healthy 25 year old woman. I am unmarried. Please answer me. I take medicine but sometime this problem starts again. I have tried: Can I have difficulty when I get married? Will I be able to conceive? I think it was caused by: My skin does not glow. I'm in pain. I worry about this.

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You really need to make an appointment with a doctor, who will probably do some tests. You do need to know what's going on inside you.

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Categories : Blood Disorder & Issues

Recent edits by: sukhdeep, Maria, Marian Raquel F. Roncesvalles

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