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Forum Name: Gynecology

Question: Reasons for absent period


 fitmom - Sat Feb 11, 2006 6:49 pm

I am a 41YO female. I am healthy and do not take any medications. I do have a lot of stress in my life, and sometimes the stress can make my periods become irregular. But I have never had a missed period. I have missed two periods, so last week I took a pregnancy test and it came out negative. What other problems could I be suffering which would cause me to miss a period?

My mother was an ovarian cancer survivor 13 years ago, but then she died 2 years ago from brain cancer..the drs said it was the ovarian cancer that came back and spread quickly. I have researched symptoms of ovarian cancer, but nothing I have found says anything about missing a period.

Could I be starting menopause which would explain the missed periods?

Please help.

FitMom
 Dr. Tamer Fouad - Sat Feb 11, 2006 7:29 pm

User avatar Hello,

The causes of absence of menstruation for less than 3 cycles are similar to the causes of amenorrhea (cessation of menses), with the exception of anatomic or chromosomal etiologies. Hypothalamic, pituitary, or ovarian hormonal dysfunction is less severe or of shorter duration than with amenorrhea.[1]

Causes include pregnancy, ectopic pregnancy (especially if you have had a tubal ligation), use of hormonal birth control methods (such as birth control pills or hormonal injections or implants), recently stopping birth control pills or breast-feeding. Other causes such as rapid weight loss, obesity, excessive exercise or participation in endurance sports, menopause, severe stress or lifestyle change, use of certain medications and hormone imbalance. Other, more serious causes of missed periods include tumors, pituitary disorders, and other glandular problems involving the ovaries, thyroid, or adrenal glands. These problems are rare.

Usually if the period is late and the woman is not pregnant, the cause is hormonal--she is not ovulating regularly for some reason. Weight changes and stress levels can disrupt the menstrual cycle; so can being peri-menopausal, taking some medications, and engaging in heavy exercise.

After excluding pregnancy, the usual recommendation is if you miss more than three cycles or have any symptoms that are worrying you, you should see your doctor to check for the cause of the problem. Usually it does not turn out to be serious and may resolve on its own before you even get in for the appointment.

References:
==========
1. Jonathan S. Berek: Novak's Gynecology, 13th ed. Lippincott Williams & Wilkins, 2002.
 fitmom - Sat Feb 11, 2006 11:22 pm

Thank you for your quick response.

What do you consider "heavy exercise"? I do exercise 5-6 days per week, but I haven't added anything extreme into my routines.

As far as the ectopic pregnancy, I have had no pain to lead me to believe this is the problem. If there is an ectopic pregnancy, would a pregnancy test come out negative? Would I have the normal symptoms of a pregnancy such as breast tenderness or other symptoms that would have been present during past pregnancies?

Fitmom
 Dr. Tamer Fouad - Sun Feb 12, 2006 5:11 am

User avatar Hello fitmom,

I was just going through the list of causes.

An ectopic pregancy should be detected quite accurately with a pregnancy test. So that is hopefuly ruled out in your case. Yes it would be accompanied with all the other manifestations of normal uterine pregnancy.

If you haven't increased your routine workout then that would not lead to stress related anovultion.

Like I said if you experience another missed period you should contact your gynecologist.

Best regards.

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