Defining a “Missed Period”

Often during conversations about periods, I hear my patients have “missed” a period…or even, a few periods. What exactly is a “missed” period? Typically, periods follow a monthly schedule, arriving every 28-35 days, but sometimes your cycle might skip over the menstrual phase – the phase when you bleed. If you were expecting your period but it never arrived, know that sometimes this is natural, but it’s important to explore the potential factors that contributed to a change your cycle.

Common Reasons for Missed Periods

Let’s talk about reasons why Aunt Flo might skip a visit. In general, teenagers and young people experience missed periods more frequently, especially athletes or dancers who perform strenuous exercise and don’t consume enough calories in exchange. There are a variety of other causes for a missed period, ranging from stress, exercise, or weight fluctuations. Each of these factors affects hormone levels, and when a body decides to halt ovulation, it can cause bleeding to temporarily stop.

1. Stress: When the hypothalamus in the brain is affected by stress, it sends messages to the ovaries to halt ovulation and therefore stops the menstrual phase of one’s cycle.
2. Exercise: Similarly, strenuous exercise can cause the brain to send mixed messages to the reproductive system, urging the body to stop ovulating. This is especially common for individuals who are not eating enough – therefore, it’s important to ensure they are intaking enough calories if exercising often.
3. Weight: With sudden weight loss or gain, the body will likely work to keep up with the hormonal imbalances, interfering with hormone levels that otherwise kickstart ovulation.

When You Should Visit a Doctor

It’s important for your child get familiar with their body and cycle, so that when they notice something unusual like a missed period, you know to consult a primary care doctor or OB/GYN (yes, they should see both of these docs regularly). Help your child track their cycle with a tool like the U by Kotex® period calculator, and share that record with the doctor. I recommend seeing a doctor immediately if your teen experiences one of the following.

• A missed period while sexually active
• A missed period for several consecutive months
• More than three missed periods in one year
• A period that consistently shows up less than every 35 days
• A period that seems heavier, lasts longer or feels more painful than usual 

A doctor can help determine if the missed periods are a sign of a more serious condition like Polycystic ovary syndrome or chronic diseases like diabetes. Overall, missing a couple periods throughout one’s life can be a normal result of life experiences, however, if you notice frequent missed periods, it’s always a good idea to call your doctor. They are here to help you keep periods healthy and manageable!

Author Summary: Dr. Jessica Shepherd is an OB/GYN, women's health expert and the founder of Her Viewpoint, an online women's health forum that focuses on addressing taboo topics in a comfortable setting. She currently practices at Baylor University Medical Center in Dallas, TX.