Why Am I Missing My Period?

Imagine: No cramps. No bleeding. No wondering when “Aunt Flo” is coming to town. Not having a period might sound like a nice break, but in reality, it’s not. Granted, having a period may not always be convenient, but it is a natural process that ensures the body’s reproductive systems are operating properly.

Menstrual cycles can be irregular, but the absence of your period can be cause for concern. If you’re 16 or older and have never had a period, this is called primary amenorrhea. If you’ve had periods in the past, but haven’t had one in six months, this is secondary amenorrhea.

A variety of factors can lead to amenorrhea. If you’re pregnant or breastfeeding, it’s normal to not have a regular period. But in other cases, a lack of a period can be a sign of an underlying condition. While a missing period is the first symptom something is not quite right, you may have other signs as well, such as frequent headaches, changes in vision or cramping but no bleeding.

Possible Causes of Amenorrhea

• Polycystic ovary syndrome (PCOS): One of the most common causes of amenorrhea, PCOS is a group of symptoms that arise due to a hormone imbalance when the ovaries produce more male hormones than normal. PCOS can cause cysts to develop on the ovaries. Your body builds up excess estrogen and you can have too much of the androgen hormone, resulting in acne, excess facial hair and weight gain—particularly around your stomach.
• Birth control: Amenorrhea also can be caused by birth control pills, which inhibit ovulation. Some women who get a birth control injection also find they don’t have a period, but this typically resumes if they stop taking the injection. Intrauterine devices (IUDs) also may make periods lighter, or even stop temporarily. Other medicines, like antipsychotic or antidepressants may have a similar effect.
• Structural issues in the reproductive organs: If you’ve had a delivery or a dilation and curettage (D&C) procedure to remove tissue from the uterus, scarring that occurred during that time can affect your body’s ability to have periods. Other structural issues, such as an abnormality in the vagina, or conditions in the thyroid or pituitary gland can affect menstrual cycles.
• Premature menopause: Depending on your age, doctors may replace those hormones, particularly if they need to maintain your bone and heart health.
• Weight extremes: Rapid weight loss through diet or gastric bypass surgery also can lead to amenorrhea. Low body fat (less than 15 percent to 17 percent) and excess exercise can lead to missing periods as well. Women who are obese also are more likely to have missing periods.

Concerns with Amenorrhea

Other than pregnancy or breastfeeding, the lack of a period can signal serious issues such as hormone imbalances, infertility problems or even other underlying conditions like prediabetes or abnormal cells in the uterus.

If you are missing your period, the first step is to talk with your doctor to find out what is causing the amenorrhea and, depending on what that cause is, developing an action plan to treat it.