Stress, sleep problems, age-related changes and more can lead to a missed period. Learn all the reasons—besides pregnancy—that can cause you to miss yours.
A missed period can lead to many overwhelming emotions. Disruptions in your menstrual cycle may bring up worries and questions about your health, potential pregnancy, and overall well being. However, there are many different reasons why you might have missed a period, from normal changes in stress levels to age-related changes.
If you’re experiencing a missed period, here are some of the top causes and implications—that aren’t pregnancy.
Is it normal to miss a period and not be pregnant? Yes and no—menstrual cycles can vary from month to month. Only about 13% of women experience a true 28 day-cycle. It’s not uncommon to have a different cycle length for every period! Factors such as stress, diet changes, and age-related shifts can influence your cycle timing each month.
Cycle timing often depends on your various hormone levels and when menstruation occurs. Menstrual cycles are regulated by hormones released by the brain, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and ovaries, estrogen and progesterone. There is a distinct pattern that repeats about every month of these hormones. The fluctuations of LH, FSH, estrogen, and progesterone prepare the uterus for pregnancy. If pregnancy does not occur, estrogen and progesterone will drop, leading to menstruation (which is the shedding of the uterine lining).
There are numerous factors that can affect these hormone levels—which in turn can influence your cycle timing from month to month.
10 causes for missed periods Here are 10 reasons for a missed period—that are completely unrelated to pregnancy.
1. Age and age-related changes Irregular periods are common at a couple of different stages of your life: when you first get your period and during perimenopause.
Irregular periods happen when menstruation begins because the body is adapting to the interaction of hormones regulating the cycle, which can cause irregular periods in the beginning. It takes time for a pattern to develop as the body matures. However, for some women, conditions like PCOS prevent periods from ever becoming regular.
Changes to your period are also common during perimenopause . At this stage in your life, which typically starts between your late 30s to early 40s, the levels of estrogen and progesterone in your body start to fluctuate and decline.
>>MORE: Everything You Need to Know About Perimenopause Periods
Recognizing this new life stage typically involves experiencing perimenopause symptoms —which are often caused by these hormonal changes. If you’re tracking your hormones, which you can do with the Oova perimenopause kit , you can also look for consistent decreases in your progesterone and estrogen levels over time.
2. Stress High levels of stress are another reason why someone might experience a missed period. When we feel stressed, a hormone called cortisol is released. Cortisol plays a role in decreasing the levels of LH and FSH released from the pituitary gland, which can then affect your cycle.
Sometimes women are not consciously aware of the stress in their lives, but see the physiological signs like headaches, muscle tension, digestive issues, cardiovascular problems, or menstrual irregularities.
Illness and injury are other forms of stress that can impact our bodies and our menstrual cycle.
3. Functional hypothalamic amenorrhea Functional hypothalamic amenorrhea (FHA) is a condition where menstruation stops due to disruptions to the hypothalamus (in our brain)—often caused by stress, excessive exercise, or low body weight. This is the common cause of primary and secondary amenorrhea.
Primary amenorrhea: absence of a menstrual period by age 15 for girls with normal growth and secondary sex characteristicsSecondary amenorrhea: cessation of menstrual periods in a woman who previously had a regular menstrual cycle for three consecutive cycles (or six months if you have irregular cycles)You can recover from functional hypothalamic amenorrhea with lifestyle modifications including changes to diet, exercise, and stress management. Depending on the underlying cause and individual factors, menstrual cycles could resume within a few months to over a year.
4. Relative energy deficiency in sport (RED-S) Relative energy deficiency in sport (RED-S) is a condition in which the body does not get enough energy to support exercise and basic bodily functions. This imbalance can lead to low energy levels, bone problems, hormonal changes that could impact your menstrual cycle.
Organizations like the NCAA, United States Naval Academy, and even the International Olympic Committee (IOC) have made statements regarding RED-S and strongly urge athletes who display menstrual irregularity to refer to their healthcare provider for further evaluation.
5. Medicine and pharmaceutical drugs Medicine and pharmaceutical drugs can affect your body’s hormone levels, which can alter your menstrual cycle timing, and therefore lead to a missed period. Medicine and pharmaceutical drugs that can cause period irregularity include:
Hormonal contraceptives Anticoagulants Antidepressants Antipsychotics Chemotherapy Thyroid medications Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Anticonvulsants 6. Chronic disease Chronic diseases can play a role in altering or suppressing the menstrual cycle, causing a missed or late period. Examples of diseases that might cause a missed period include:
PCOS Cushing's disease Diabetes Eating disorders Kidney disease Liver disease Autoimmune diseases (e.g. multiple sclerosis, rheumatoid arthritis) Cancer 7. Breastfeeding If you’re breastfeeding and experiencing a missed period, there’s a good chance your period might not have returned just yet. About 70% of women see a return in their menstrual cycle after six months of lactation, but only about 33% see their period return within the first six weeks (about one and a half months) of lactation.
Breastfeeding can delay periods because the hormone prolactin (the major hormone involved in milk production) suppresses the hormones involved in ovulation and menstruation.
>>MORE: 7 Signs of Ovulation While Breastfeeding
8. Sleep Disrupted, inefficient, and too little sleep can contribute to irregular menstrual cycles. Sleep plays a crucial role in maintaining hormonal balance. Irregular sleep patterns can specifically disrupt the production of estrogen and progesterone, leading to missed or irregular periods. Women have found it helpful to stay consistent with their sleep schedules to help maintain a regular menstrual cycle.
9. Diet changes Women are particularly sensitive to both carbohydrate and calorie restriction. Such restrictions can trigger alarms in the body that shut down aspects of the menstrual cycle, causing period loss and heightened inflammation.
Gretchen Spetz MS, RDN, LD, a registered dietitian nutritionist, emphasizes that fats are essential to the production and regulation of estrogen and progesterone. Inadequate fat intake may therefore result in irregular or heavy periods, PMS symptoms, or lack of ovulation .
10. Tracker inaccuracies Most period-tracking apps allow women to track their menstrual cycles and get predictions for their period dates. However, many apps provide predictions based on a textbook 28-day cycle. In reality, menstrual cycles vary from woman to woman and month to month.
There is a solid chance that your menstrual cycle is completely “on time” and the app you might be using just be off!
If you’re looking for the most accurate way to track your period, it’s best to track your hormone levels over time . Oova is different from other cycle-tracking products because Oova utilizes a smart sensor to analyze hormone levels through your pee. This allows for more precise and personalized insights into your menstrual cycle. By tracking hormones like estrogen and progesterone, you can use your data to better understand your menstrual cycles, ovulation timing, and fertility status.
Understanding your whole menstrual cycle on a hormonal level empowers you to use that knowledge to your advantage and take control of your reproductive health. An easy way to get started is by using Oova’s Fertility Hormone Kit.
When to call your provider about a missed period If you experience any of the following symptoms, it might be time to consult your doctor regarding irregular menstrual cycles:
Not having a period for 90 days Sudden irregularities in a menstrual cycle Getting your period more than every 21 days or less frequently than every 35 days Your periods last longer than one week Unusually heavy menstrual bleeding Bleeding between periods Having severe menstrual pain Missed period treatment What can you expect from your doctor when you call them about a missed period and other cycle irregularities?
First, your doctor might have you get some imaging and blood work done to ensure no underlying conditions. If there are any underlying conditions, your doctor may work with you to address those first—which should then help your cycle and period get back on track.
If all other conditions are ruled out, they suggest hormone replacement therapy , lifestyle changes (e.g. stress management, diet changes, exercise changes), speaking with a dietician nutritionist, combined oral contraceptive , cognitive behavioral therapy, or a progesterone withdrawal challenge.
Missed periods: the bottom line A missed period can definitely cause a heightened level of anxiety, but there are numerous reasons why you might not get a period that aren’t pregnancy. From overexercise to stress, a missed period can be a sign of something else that’s going on in your life that you may need to address.
One of the best ways to manage a missed period is to try to understand the underlying cause—and arming yourself with the knowledge about what you might be experiencing is the first step to managing your health. Trust that your body is prioritizing its needs to maintain a regular cycle while remaining attentive to its cues.
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