Causes of Delayed Periods in Women of all age group

Delayed or missed periods is often a worrisome issue among women of reproductive age group. Although most often than not the condition is not worrisome, it’s always better to seek professional help to find out the underlying cause. Delayed periods can be due to many reasons, here are the most common causes of delayed or missed periods:

1. Pregnancy: This is the most common reason of missed periods among reproductive age women. Make sure to do a urine pregnancy test by using commercially available “Pregnancy Kits”. These kits are cheap and easily available at pharmacies, and have a sensitivity of 98%. The doctor will always advise you to rule out Pregnancy in case of missed periods before proceeding for any further management. Please note that these kits show positive result only after at least 1 week of implantation (that is after 1 week of unprotected Intercourse). If the test comes negative after more than 7 days of missed cycle, the Pregnancy is most likely ruled out.
2. Perimenopause: Women above 40 years of age may experience delayed periods near to Menopause. Although this can be normal but one should get examined by a Gynecologist in this case since this age group is also vulnerable to develop many disorders. The average age of Menopause in India is 47 years. Once other conditions are ruled out, only then it’s safe to say that the irregular or delayed periods are a result of perimenopause and needs no active intervention. The most common mechanism understood behind this is insufficiency of ovarian follicles, resulting in delayed periods.
3. Oral Contraceptive pills: Contraceptive pills or hormonal medications control the body hormones and thus regulates the periods. Therefore, it is reasonable that you won’t get your periods while on contraceptive pills. Once you stop taking the pills, you may get your periods after 3-4 days of your last pill. This is what’s called a “withdrawal bleeding”. It should be noted that it is important to take Contraceptive pills or other hormonal medications strictly as per the regime prescribed by the doctor.
4. Breastfeeding: During the lactation period, a hormone called “prolactin” remains raised in the body that helps in formation of the milk. This hormone has an inhibitory effect on other menstruation regulating hormones causing amenorrhea or missed periods. Generally speaking, a lady may not get her periods if she is lactating for an average of 6 months after her delivery, but it should also be kept in mind that this number varies greatly among different women.
5. Polycystic ovarian syndrome: PCOS has been known to be one of the most common culprits of causing delay in periods in young females. Broadly put, pcos develops due to imbalance between female and male hormones ratio in a women’s body, leading to delayed periods, very less or scanty bleeding during periods, facial hair growth, facial acne etc. A recent history of weight gain can be a corroborative finding, although pcos has also been found in thin girls.
6. Stress: prolonged stress causes interruption in release of GnRH hormone (secreted from hypothalamus in brain, this hormone acts as a trigger for release of other menstruation related hormones), thus causing missed periods. The stress can be psychological or can be physical such as any acute illness.
7. Malnutrition: Nutrition deprived or anorexic females frequently develops delayed or irregular cycles. Although the mechanism behind this is not well understood, it has been stated that pituitary gland becomes less functional in anorexic females leading to hormonal imbalances and thus delayed cycles.
8. Thyroid Disease: A deficiency of Thyroid hormone, also known as hypothyroidism medically is very common ailment among women leading to delayed periods. Since thyroid hormone is the major metabolism regulating hormone, its deficiency can disturb a whole cascade of hormone functioning leading to Menstrual issues.
9. Chronic Diseases: Such as diabetes, pituitary and adrenal tumors (both benign and malignant), TB can cause delayed cycles in females.
10. Menarche: If you have just started menstruating, you may experience delayed periods. This is because the “hypothalamic-pituitary axis” is immature in early years of menarche, and it might take a couple of years to experience regular menstruation.