Author: Dr Peter England – Obstetrician and Gynaecologist
When you have no period or menstruation the medical term for this is amenorrhoea.
Pronounce Amenorrhoea as – ei·meh·nuh·ree·uh.
Women of reproductive age are for the most part, used to a period arriving approximately every 26-35 days (average 28-30). An interruption to this regular pattern can be a bit of a shock at times and establishing the cause is important. While pregnancy is the most common cause of having no period, there are many other possibilities.
Let’s start by looking at what amenorrhoea is:
Amenorrhoea literally means “no menstruation”.
This can be primary: meaning no period has ever occurred. Or, more commonly, secondary, meaning missed or absent periods. The duration of having no period can be months to years depending on the underlying problem.
Why have I missed my period?
There are many reasons you may have missed a period, or have amenorrhoea.
Pregnancy:
If you are sexually active with a male partner and you miss your period, pregnancy needs excluding. A simple urine pregnancy test is all you need to do to show if this is the reason for your period not occurring like usual.
Pill Amenorrhoea:
It is quite common on the OCP to miss periods, especially if you have been taking the pill for some time. This is not dangerous, it’s simply that the lining of the uterus becomes very quiet for some women while they are on the pill.
Post-Pill Amenorrhoea:
Usually, when you stop using the pill your periods start occurring regularly. However, some women, after being on the OCP for a few years find it takes up to six months for their periods to return to normal. If you’re planning to become pregnant a good strategy to consider is to stop taking the pill for a few months prior and use condoms to avoid any frustrating wait for your cycle to normalise.
Physical Stress:
Acute illness and overly intense daily exercise can interrupt normal cycles. Particularly for you are a woman engaged in high-level competitive sport, you may find that you stop getting your periods for a while.
Emotional stress:
The menstrual cycle is controlled by your brain through the hypothalamus and pituitary gland. In other words the brain secretes hormones that cause the ovaries to make hormones. Acute mental stress and insomnia etc. can cause short term disruption of your cycle.
Extremes of body weight:
Having too little or too much fat as a percentage of body weight can lead to cessation of menstruation. The mechanisms are quite different, as are possible treatments. Keep in mind, a healthy BMI is 20-25, with up to 30 being slightly overweight. If you are below 20 or over 30 there is a chance your cycle may become irregular.
Does it matter if I miss my period?
The answer is sometimes yes and sometimes no. It depends on the cause. If your cycle becomes irregular, you should report this to your doctor, who will assess the problem. You may need a referral to a gynaecologist.
My daughter has not had her period yet. At what age should I be worried?
The commencement of the first period (known as menarche) marks an important milestone in a young woman’s life. Menstruation can begin as young as 9-10 years of age, more typically around 12-14, and as later as 16 or 17. It depends on family genetics and attaining a critical body weight (in Caucasians, usually around 45-50kg). If a girl, who is otherwise healthy, has not had her first period by 16, you should speak with your family doctor.
If I am on the Pill, can I safely skip my period?
Yes, you can. Many women do this regularly, by skipping the sugar pills and going straight to the next packet starting on the active hormone-containing tablets. It is possible to do this for consecutive packets. However, some women find that in the middle of the second or third packet of active tablets in a row they experience light bleeding. Known as breakthrough bleeding, this is not dangerous, but obviously can be annoying.
If I am not getting regular periods will I have trouble falling pregnant?
Fortunately, after we discuss your history, perform a careful examination and arrange investigations including an ultrasound and blood tests, I can usually work out what the cause for your irregular periods is. Once we know that then there are many effective treatments to ensure ovulation is occurring to allow you a chance to conceive a pregnancy.
The following additional posts may provide more information for you:
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Author: Dr Peter England, Obstetrician and Gynaecologist.
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