Missed periods

An introduction to missed periods

Missing periods (amenorrhoea) are often a cause for concern – many women initially assume they are pregnant, and yes, this is often a possibility and taking a pregnancy test is probably a good idea.

But what happens if you aren’t pregnant? There is often another reason that your period hasn’t arrived – actually there are a whole host of possibilities; ranging from stress to the amount of exercise you are doing.

Most women have, on average, 11 – 13 periods each year. However, for women with irregular periods this can range from 4 – 17! Generally though, if you have less than 4 periods per year this is classed as amenorrhoea. The chances are if you are missing periods you are more likely to have problems conceiving, which can be a real worry.

Often missed periods can be hard to distinguish from irregular periods, so, on this page we explore in detail, the different types of missed period, causes of missed periods and finally what can be done to help.

Types of amenorrhoea

There are different types of amenorrhea as described below:

Primary – Primary amenorrhoea is when a young woman fails to start her periods. Beyond the age of 16 if you still haven’t had your first period it would be advised you pay a visit to your doctor. There are several causes of primary amenorrhoea as described below.

Secondary – Secondary amenorrhoea is more common and occurs when a woman who has previously had normal periods find that her periods have stopped.

Causes

There are several possible causes of amenorrhea, depending on the type:

Causes of Primary amenorrhoea

• Problems with the ovaries – The ovaries are the reproductive organs which are responsible for releasing the sex hormones necessary for ovulation (the release of the egg). If there is a problem with your sex hormones or ovulation, it is likely you won’t get your first period

• Problems with the pituitary gland – The pituitary gland is often called the body’s ‘master gland’ as it secretes hormones which then signal to the ovaries to release your sex hormones. Therefore, if your pituitary gland isn’t working as it should be, your ovaries will fail to do their job properly and your periods could fail to start

• Physical abnormalities – Problems with the womb and surrounding pelvic structures could be the source of the problem, this includes blockages or narrowing of the cervix or a closed hymen

• Others – Other issues could include: poor nutrition and / or anorexia, tumours in the ovaries or womb, birth defects or genetic disorders affecting the womb or vagina.

Causes of secondary amenorrhoea

• Pregnancy and breastfeeding – Pregnancy is one of the most common reasons for a missed period so if this is a possibility you should investigate this first. If you are a new mother, you may also find that your periods take a while to return to normal after having your baby, especially if you are breastfeeding. This is due to high levels of the hormone prolactin which can prevent you ovulating and having your period

• Hormone imbalance – Imbalances in sex hormones can prevent you having your period. Low levels of oestrogen (and high progesterone in ratio to this) is the most common imbalance which can cause your periods to stop

• Menopause – From age 45 - 55 many woman experience irregular periods in the lead up to the menopause. Falling levels of oestrogen can cause you to miss a period and will eventually cause your periods stop all together

• Stress – Stress has a lot to answer for! It really affects your whole endocrine system and your sex hormones aren’t an exception. During the stress-response your digestive, immune and reproductive functions can become compromised and your periods can stop as a result of this

• Body weight – Being under or over weight can affect your periods. Fat cells harbour oestrogen and therefore having too much or too little fat around your body can upset your balance of hormones

• Over-exercising – Believe it or not, over-exercising is a form of stress on your body. In extreme cases your stress-response is activated which can affect the functioning of your reproductive system. To add to this you are more likely to have very little body fat in a case like this too which can also contribute. Regular, moderate exercise is recommended though, you just need to find the right balance

• Medication - Different medicines can affect your period, most commonly, certain types of the contraceptive pill (for example the mini-pill) which can cause your period to stop altogether. However, it is important to be beware of side effects of other types of medication too as these could also upset your periods, such as anti-depressant or anti-anxiety medication, anti-inflammatory medication or those for thyroid disorders

• PCOS – Polycystic ovary syndrome (PCOS) affects how your ovaries work. In many cases this can cause an imbalance in sex hormones and you may fail to ovulate which means your periods could stop

• Hyperthyroidism – Thyroid issues can affect your periods too; an overactive thyroid  (hyperthyroidism) can cause your periods to stop

• Others – Other issues affecting the ovaries can also cause your periods to stop, for example ovarian cancer. If your periods stop suddenly, you experience additional symptoms or are worried, you should pay a visit to your doctor.

Symptoms

So what are the symptoms to look out for if you suspect you’ve missed a period? This may seem obvious but in many cases it can be difficult to differentiate between a missed period and irregular periods that are far apart (oligomenorrhoea). Here we outline what symptoms to look out for.

• No breasts or pubic hair by age 14 – This applies to suspected cases of primary amenorrhea. If you haven’t developed breasts or any pubic hair by age 14 it suggests there could be a problem with your sex hormones and your periods may not start. It is worth seeing your doctor if this is the case

• Frequency – The number of periods you are getting is a big indicator. If you fail to have a period over three cycles and have less than 4 per year it is likely your periods are missing or have stopped altogether

• Duration – The average period lasts for 3 – 5 days. A period lasting for less than 2 days suggests it isn’t a proper period and this could be the result of something else going on such as pregnancy or a side effect of medication

• Pregnancy symptoms – If you’ve missed a period and think you could be pregnant then look out for these tell-tale signs of early pregnancy: period-like cramps but no period, tender breasts, fatigue, nausea, bloating, excessive thirst and frequent urination

• Other symptoms – If you experience other symptoms (such as pelvic pain) alongside your missing period and aren’t pregnant, it is advised you pay a visit to your doctor who can investigate this further.

What can I try at home for missing periods?

If your period is missing and you definitely aren’t pregnant there are some simple home remedies you could which may help

• Manage your diet better – A fresh, balanced diet is crucial for many bodily functions including those of your reproductive system. The intake of fat is crucial in particular. A diet very low in fat can be problematic. We need good fats in our diet to manufacture many hormones including sex hormones, so a low-fat diet can affect your periods. Ensure you are incorporating plenty of oily fish, eggs, avocado, nuts and seeds into your diet

• Manage your body weight and exercise regime – This is interesting as being overweight or underweight, exercising too much, or exercising too little can all be detrimental and cause your periods to stop. These can all upset your balance of hormones so you should aim to get your BMI within the normal range and partake in regular, moderate exercise

• Manage your stress levels – Stress can have a whole-body effect and your periods suffer as a result o this. In times of stress our digestive, immune and reproductive functions can become diminished. So, managing your stress is often a useful first step in getting your periods back to normal

Can any herbal remedies help?

If your periods have stopped and you definitely aren’t pregnant, there are some herbal remedies which could prove useful in certain situations:

• Fermented soy isoflavones – Fermented soy isoflavones can be a useful remedy if a hormone imbalance is suspected to be the root cause of your problem. Soy isoflavones act to gently support your oestrogen levels. Symptoms such as feeling very weepy and emotional, having low self-confidence, being very tired and suffering from skin breakouts can be signs your oestrogen is low relative to progesterone

• Stress Relief drops – If stress is a big factor in your life it could be affecting your periods. Use Stress Relief Daytime drops to help reduce symptoms of stress and mild anxiety.

Please note if you are taking hormonal contraceptives such as the pill, hormone-balancing herbal remedies may not be suitable for you.

Can my doctor help?

If home and herbal remedies don’t help it is worth paying a visit to your doctor who can further investigate the issue. If you suspect you are pregnant or suffer from any additional symptoms other than a missed period it is also worth visiting your doctor in the first instance.