Regardless of age, women can experience irregular or missed periods, but what’s normal?
Dr. Yolanda Kirkham, an obstetrician/gynecologist at Women’s College Hospital and St. Joseph’s Health Centre in Toronto, tells Global News the average cycle can last anywhere between 25 to 40 days, and if you miss your period for three or more months, it’s time to talk to your doctor.
“I always tell women to track their periods, either on a phone app or on a calendar,” she says, adding they should also keep tabs on changes to flow, especially if their period gets heavier.
“There are easy treatments for women … they need to be seeking medical attention.”
Though a missed period can cause panic, Kirkham notes, for the most part, they shouldn’t cause major concern. And if you’re not pregnant, there are five other reasons you may skip a cycle.
Your stress levels change
Stress, from the anxiety that comes from studying for exams to dealing with a loss of a family member, can change a woman’s period — making it irregular, delaying it or causing it to disappear altogether.
“When we think about it, having periods means having babies. It’s a part of our reproduction — if your body doesn’t think you’re in a good space or good time to carry a pregnancy… it will delay the process.”
It could be PCOS
Polycystic ovarian syndrome (PCOS) is a hormonal disorder that can affect up to 10 per cent of women. Kirkham says PCOS leads to more estrogen in the body that can interrupt the usual flow of estrogen, which means eggs won’t get released from the ovaries during a cycle.
“People often gain weight and have unwanted body hair and acne,” she explains. “You can go through three or four months with no period… this even with young girls who are overweight.”
PCOS can be diagnosed with a blood test, she adds, so if you notice other symptoms besides the missed period, talk to your doctor. Nutrition is also important, she adds. If you have PCOS, you should focus on eating a healthy diet and increasing your daily exercise.
Hypothalamic amenorrhea is another cause
Also called “female athlete triad,” this condition is very common for female athletes and it can cause missed periods, Kirkham says. “We see it in ballet dancers and athletes… it’s about energy-level imbalance.”
She explains our bodies tend to prioritize what’s important and if highly competitive athletes are using energy for other things, reproduction is not prioritized. “You almost don’t have enough energy to have periods.”
Kirkham says hypothalamic amenorrhea is also common for people on very restrictive diets or those with eating disorders like anorexia. In this case, a proper diet change is required, as is cutting down on the amount of exercise you do.
Maybe it’s your ovaries
Primary ovarian insufficiency (POI), which was previously called premature ovarian failure, is a condition where women lose the function of their ovaries before the age of 40. It’s rare, Kirkham says, but she does see it in patients.
“I see it in 15-year-old girls who never had a period, essentially their ovaries stop for various reasons.”
This can be caused by types of chemotherapy from childhood cancer, genetics or other autoimmune disorders. A blood test, she adds, is the best way to see if you have POI.
Changes with your pill and other contraceptives
Kirkham says women who begin a new routine of a birth control pill or IUD may experience normal changes in their period flow.
“Sometimes you have to go on the pill to regulate the period. If you go off, you go back to the original problem.”
Other reasons women may miss their periods can include taking certain anti-depressant medication, being obese or having a benign tumour called prolactinoma, which is quite rare. Kirkham says the best thing women can do is to alert their health-care provider as soon as they notice changes.
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