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Date of last update: 10/14/2017.

Forum Name: Gynecology

Question: Missed/late period


 rgunn - Tue Mar 15, 2005 9:31 pm

I have been on the pill for two years, and about six months ago I got my period super late, and then when I did get it I could have filled a bucket with the amount of blood, however it is late again, and I don't think I could possibly be pregnant because I take my pill at the exact same time every single night, like not even a minute later, also I don;t not have any symptoms, other than nauseas but I think that's just coming because I am so stressed out. Is there anything else it could be that I am missing my period, for instance I have started taking vitamins, exercising more frequently etc. so i am just wondering if that is it?
thanks let me know
 Dr. Tamer Fouad - Wed Jan 11, 2006 5:46 am

User avatar Hello,

Please understand that with the perfect use of contraceptive pills there is still a chance of pregnancy, albeit minor.

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:
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1. Jonathan S. Berek: Novak's Gynecology, 13th ed. Lippincott Williams & Wilkins, 2002.

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