Menstrual Period - Missed or Late

Symptoms

DEFINITION

• Late Menstrual Period: 5 or more days overdue compared to usual menstrual cycle
• Missed Menstrual Period: no menstrual flow for more than 6 weeks

General Information

• The first day of menstrual bleeding is considered the first day of a new menstrual cycle.
• Menstrual bleeding typically lasts 3-7 days.
• Ovulation generally occurs around day 14 of the cycle.
• The length of the menstrual cycle varies from woman to woman. The range is from 24 to 35 days. The average is 28 days.

Causes

• Pregnancy is the most important cause. This possibility needs to be considered in any woman who has a missed or late period.
• Stress
• Dieting, exercise and weight loss
• Menopause
• Polycystic ovarian disease
• Birth control pills
• Depoprovera injection
• Pituitary and other endocrine disorders

Home Urine Pregnancy Tests

• Home urine pregnancy tests are inexpensive, accurate, and easy to use. Most drug stores sell these tests over-the-counter .
• Urine pregnancy tests can often diagnose pregnancy during the week after the first missed period (2 weeks after ovulation).
• Use of a first-morning urine specimen is recommended because the urine HCG concentration is highest in the morning.
• When a home pregnancy test is negative, but there is still a high suspicion of pregnancy, the woman should either repeat the test in 3-5 days or go to her doctor's office for testing.
• The urine pregnancy test can sometimes be falsely negative if the urine specimen is very bloody. A small amount of blood (e.g., blood-tinged urine) should not interfere with the accuracy of the test.
• More information is available at: http://www.4woman.gov/faq/pregtest.htm.

See More Appropriate Topic (instead of this one) If

• ABDOMINAL PAIN, FEMALE
• Questions about EMERGENCY CONTRACEPTION
• VAGINAL BLEEDING, ABNORMAL

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE FOR MISSED OR LATE MENSTRUAL PERIOD

1. Pregnancy test, when in doubt:
   • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
   • Follow the instructions included in the package.
2. Stress: Stress can interrupt normal menstrual periods. Try to reduce your stress by talking about it with a friend or family member. Try to avoid or decrease stressors. If this is not effective, seek help from a counselor or talk with your doctor.
3. Call Your Doctor If:
   • Pregnancy test is positive
   • You have difficulties with the home pregnancy test
   • New symptoms suggest pregnancy (e.g., morning sickness, breast tenderness/swelling)
   • You need help coping with stress
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.