At fertile (fit for childbearing) age periods usually occur regularly and in due time. The only natural exception is pregnancy, at which endocrine profile undergoes rapid alteration and periods stop away. In some cases, however, there is a reason to wonder, what if I missed period but not pregnant? This condition can have two physiological backgrounds (pre-menopause or intake of hormonal contraceptives), three interim (stress, diet, climatic change) and 7 pathological causes.
The menstrual cycle (MC) involves hormone-dependent regular changes in the female organism, aimed at the maturation and emergence of the ovum from the follicle and preparation of the endometrial lining to the implantation of the ovum. During fertilization, the mellow mucous lining of the uterus “hospitably” receives the fetus into its thickness, where it begins to grow and develop. There is no menstruation in this period. In case pregnancy does not occur in 2 weeks after ovulation (which happens much more frequently), the proliferated endometrial lining, which has additionally accumulated a good supply of nutritive substances, is naturally rejected from the organism. Periods mark the start of the next cycle.
Anovulation – no period not pregnant
Physiological conditions, associated with absence of ovulation, involve pre-menopause in the first place and intake of hormonal contraceptives in the second. In fact, each woman has a predetermined number of ovules. They never increase in a number. Sooner or later the supply of generative cells runs low, therefore at the decline of regenerative function periods become irregular, there may be anovulatory cycles, as well as cases of missed period but not pregnancy.
The situation is quite different with contraception, in which case ovulation is deliberately decelerated, leading to overdue or very scanty periods.
Six pathological conditions that involve dysmaturity of the ovum and failure of its emergence form the follicle
- Polycystic ovary syndrome (PCOS);
- Corpus luteum cyst;
- Weight loss;
PCOS is characterized by chronic ovulation and is accompanied by obesity, excessive hair-covering (hirsuties), disturbance of carbohydrate metabolism (prediabetes) and scanty periods. In the presence of this disease, conception is rather problematic – infertility is one of the main complaints, reported by women with PCOS.
Corpus luteum cyst is a proliferated neoplasm that appears in the lutein (second) phase of the MC. Sometimes it assumes enlargement of the yellow body (corpus luteum) (“emptied” after the ovum’s emergence) while, in other cases, it involves hemorrhaging. Diagnosis of a cyst can be observed in case the neoplasm does not resolve on its own in 14 days after its origination, which is followed by the occurrence of periods. Before this, there is a delay in menstruation. Complication of this diseases involves abruption of the cyst.
Rapid decrease of body mass also has a negative effect on the endocrine profile, since lipocytes (fat cells) appear to be natural estrogen depositaries. Inadequate decrease of fat cells is fraught with hormonal disruption, particularly – anovulation. In order to define the minimal amount of fat, required for proper functioning of the reproductive system, one should calculate the body mass index (BMI). It equals your weight in kg, divided by the quarter of the height in meters. The BMI norm ranges between 19 to 25.
Psychological or physical exhaustion, as well as climatic changes, may provoke hormonal setback, which in its turn causes missed period.
The other 4 causes of late period not pregnant
Anemia is an insufficient number of erythrocytes (red blood cells) in the blood or low level of hemoglobin. This condition might have various backgrounds, from vitamin deficiency to previous heavy blood loss. Possible delay of periods due to general exhaustion of the organism is common to all various types of anemia.
Adhesive processes in the uterus lead to the endometrial dysfunction. They can result from surgical manipulation (such as abortion) or inflammatory processes in the mucous membrane. The presence of scars on the endometrial lining hinders its normal growth and accumulation of vital components. Therefore, there is nothing to be discharged during the periods.
Such a pathogeny is typical to complications, associated with intrauterine devices (thinning of the mucous membrane of the uterus). They can also impede the natural course of MC.
Adhesive processes in the uterine cervix are notable for a different mechanism of pathological action. In the presence of this anomaly, endometrial lining goes through all stages of development, but its emergence form the follicle is mechanically obstructed by adhesions in the cervical canal.
Thus, the question «is it normal to miss a period?» allows for at least 12 possible answers, 10 of which are negative. For timely manifestation of the disease and receiving qualified medical attendance, it is required to consult a gynecologist in case of reoccurring delay of periods. If stress, acclimatization, and exhausting diets can be neutralized by rest and the rational regimen, PCOS, corpus luteum cysts, and anemia require medicinal treatment, whereas the removal of adhesions may require surgical intervention.