“I’m late.” “I haven’t got off yet.” These words can be a source of emotion and/or concern for a large number of people, who usually associate it with a possible pregnancy.
However, the truth is that although possible pregnancy is a possibility, in a vast majority of cases there are many other factors that can explain why you have not yet menstruated. In this article we will review fifteen possible causes of why this has not yet happened.
What is menstruation?
Menstruation is the name given to the biological and natural process by which a woman’s body expels unfertilized eggs and the mucous lining of the uterus (or endometrium) is expelled from the vagina as a bloodstream.
This process usually occurs once a month and lasts up to about a week, forming part of a continuous cycle from female puberty to climacteric, when the female reproductive system loses its function to conceive.
Different reasons why the rule does not go down
The menstrual cycle usually follows a certain timeline that allows an estimate of when the period will arrive, but this does not mean that it is identical and always appears on the same dates.
There are a large number of factors that can alter this and make the period or menstruation not appear when it should in principle . Below we will look at fifteen possible causes that can explain why a woman does not get her period.
This is the option that most people think about when menstruation does not appear in the usual period. And indeed it is one of the options to take into account, even though a delay or even the absence of a period does not have to mean being in a state. To check this, it is necessary to take a pregnancy test at least fifteen days after the last sexual relations , as before that it could give a false positive.
2. Lactation period
Some women who have just given birth may think that since they have already given birth they will quickly start to menstruate again. But the truth is that this is not the case because during lactation hormones such as prolactin , which is very important in increasing and allowing the secretion of breast milk , inhibits estrogen and other hormones responsible for the menstrual cycle. It is therefore not unusual for there to be no menstruation until the end of the breastfeeding period.
3. Late Puberty
Many young teens are very concerned about the fact that they haven’t gotten their period yet, even though most people their age have already started having periods a while ago. It is necessary to remember that each person has his or her own evolutionary rhythm and some girls have a late puberty, so that menarche or first menstruation can appear even later than 15 years old.
This need not imply anything bad, although in some cases there could be some basic problem. Usually, unless there is some kind of organic cause, this does not require any treatment, although if the doctor considers it necessary, hormone therapy may be used.
4. First rules
It is also important to bear in mind that having your first period does not necessarily imply a totally regular cycle: it is not impossible that during the first years, because the reproductive system is still developing , there are alterations in the menstrual cycle.
5. Menopause (normative or premature)
Another reason why the rule stops coming is because of the possible arrival of menarche and climacteric. In other words, the arrival of the menopause. This generally occurs from the age of 45 (in fact, it usually appears from the age of 50), but in some cases the so-called premature or early menopause can occur in which the end of the menstrual cycle arrives before the age of 45.
Usually before the imminent cessation of menstruation there is usually a period when the menstrual cycle acts irregularly . This is a normative biological process, which does not require any treatment.
6. Feeding and/or starvation problems
Menstruation is strongly linked to the state of health of the body, and is profoundly altered by aspects such as the presence of sufficient nutrients in the body. If the human body is in a situation where it does not have enough nutrients, menstruation will not occur. An example of this is found in women with eating disorders, especially in anorexia (in which amenorrhea is in fact one of the most frequent symptoms).
In addition, other circumstances or diseases in which the body cannot process nutrients properly and becomes anaemic can cause a woman to stop or delay her menstruation. Menstruation also stops in people who are extremely hungry because they lack food resources.
7. Sudden weight changes
Not only can the presence or absence of nutrients in the body affect menstruation, but also sudden weight gain or loss. This is because even if you have enough nutrients, a sudden change in weight and especially in body fat can generate changes in the body’s levels of oestrogen , varying the menstrual cycle.
8. Hormonal imbalances
Menstruation is a biological process that depends on the hormones in a woman’s body. Alterations in these hormones or the presence of others that inhibit or alter them can generate changes in the menstrual cycle including their advancement, delay or even cessation. These imbalances may be normative, related to psychosocial stress, or linked to hormonal, thyroid, ovarian or brain problems. The treatment of these problems will return the cycle to its normal functioning .
9. Taking or Stopping Birth Control
As we have said and being something deeply related to the previous point, hormones are the key to the existence and maintenance of the menstrual cycle. In this sense, the taking of certain contraceptives or the cessation of their consumption may cause the period not to decrease in the usual period.
10. Use of other drugs or medical treatments
The use of different drugs, not necessarily contraceptives, can cause an altered or delayed menstrual cycle. Examples of these are some psychopharmaceuticals . If this effect occurs, it is advisable to go to the doctor first to check whether it is really a possible side effect of the medication and if so, to assess (depending on the case) possible alternatives.
Problems with menstruation may also occur with certain non-pharmacological medical treatments, such as surgery on certain areas of the brain or reproductive system or radiation therapy.
11. Stress and anxiety
So far we have talked about mainly organic elements, but we cannot forget the importance of psychosocial factors in menstruation. The presence of continuous stress or anxiety is another of the main reasons why menstruation can be delayed. An example would be work stress . Another example may be somewhat paradoxical, but more common than it appears: it is common for the anxiety experienced due to the delay in the period to generate even greater delay.
In view of this, it is advisable to use relaxation techniques, such as breathing or progressive muscle relaxation, and to avoid becoming obsessed with the subject.
12. Extreme physical activity
Sportswomen, especially high-performance women, may have irregular or delayed menstrual cycles due to their high level of physical activity. This is because very intense physical exercise causes a drop in oestrogen levels. In this case it may be advisable to consult doctors specialised in sports .
13. Ovarian disorders
Another of the main causes of a delay in the arrival of the period is the presence of problems in the reproductive system, one of the most frequent parts being the ovary. Polycystic ovarian syndrome or endometriosis are examples of this, and treating these causes (for example with contraceptives) can make the cycle more regular.
14. Medical conditions
Not only gynecological problems can cause delays in menstruation, but also other medical problems such as different infections (both genital and other types), metabolic problems such as diabetes, obesity or thyroid disorders . Certain tumours may also be affected. A specific treatment of the cause will be required, so that the symptomatic improvement can generate a recovery of the usual cycle (although it depends on the cause it will not always be possible).
15. Psychological pregnancy
One reason that menstruation may disappear in a woman is the disorder known as pseudocyesis or psychological pregnancy. In this case we are dealing with a person who begins to manifest all the typical symptoms of pregnancy, including the cessation of menstruation, despite the fact that there is not really a developing fetus . It can appear in depressed women, with great desire to be a mother or extreme fear of becoming pregnant, in people who have suffered abuse or in various types of situations. The treatment of this type of condition is often delicate and complex, requiring psychological treatment in most cases.
Conclusion: why don’t I get my period?
Like any other biological process, menstruation depends on many factors and processes carried out by the body in a relatively parallel way. There is no single reason why we do not get our period, but knowing the main ones is useful to know what to do depending on the symptoms and clues we get through our habits and through the characteristics of our own body.