Delayed Periods: Psychological and Hormonal causes, consequences and possible treatment

Dr. Rinku Sengupta Dhar: One of the most common complexities which women deal at some points of their lives are irregular periods, especially during adolescence, perimenopause or menopause. Delayed periods in the reproductive age can happen for many reasons.

Most of the time there is no worrying cause. As long as you are sure you are not pregnant and you feel well in yourself there is no need for concern if you miss one or two periods. However, if you don’t have a period for 3-6 months, or have other symptoms then you should consult a doctor.

Sometimes periods in teenage girls start later than in others. If your periods haven’t started by the time, you are 16 (or 14 if you have not started developing in other ways such as getting pubic hair and breasts) then a Gynaecologic review will be needed.

Meanwhile, let’s check out couple of reasons that cause delayed period and possible solution for same.

Physiological Causes of Delayed period

 There are certain times when it is normal not to have periods. These include:

Before puberty. Girls start to go through puberty from around the age of 9 years and their periods start a year or two later. Up until that point girls do not have periods.

During pregnancy. If you are pregnant, your periods will normally stop until after the baby is born.

During breastfeeding. If you are fully breastfeeding, you will normally not have a period until you stop. You may find you have a bleed if you drop a feed, or start to breastfeed less.

After menopause. The menopause is the time in your life when your ovaries stop producing eggs and you stop having periods. The average menopause is around the age of 51. You will be classed as having gone through the menopause a year after your last period.

However, after ruling out the physiological causes of Delayed periods, we need to know the pathological causes to understand the consequences and the individualized treatment. These are the following —

1.Hormonal causes of Delayed periods

Stress, PCOS, Thyroid Disorders, Benign Tumour in Pituitary Gland, Congenital Adrenal Hyperplasia

Premature menopause,  

2.Genetic causes
3. Drugs like Antipsychotic drugs ,oral contraceptive pills ,contraceptive injections and intrauterine devices

Consequences of Delayed Periods

Delayed periods in reproductive age needs attention to first rule out unwanted pregnancy.

Once pregnancy is ruled out a detailed history, examination, investigations and often a pelvic ultrasound is done for diagnosis. Treatment is tailored as per the evaluation.

If Delayed periods persist due to PCOS— endometrial thickening and heavy irregular bleeding can follow. Often Hormonal therapy needs to be started. Women who have delayed periods due to PCOS may also have obesity and metabolic disturbances.

Dr. Rinku Sengupta Dhar is a Senior Consultant, Obstetrics and Gynecology at Rosewalk Healthcare in New Delhi

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