Period Late, Not Pregnant.
“My period is late but I’m definitely not pregnant! What is happening?”
When your monthly period is late it’s common to jump immediately to pregnancy as a possible reason. But what does a late period mean when you’re sure that you’re NOT pregnant?
This article will break down the 6 main reasons (that’s right, there are 6!) that your period is missing or late besides being pregnant – and more often than not it’s actually a combination of the following reasons.
Reason 1 - Stress
The role of stress in our lives is greatly underestimated. In today's society the pressure to be a successful career woman, family member, have the ideal body, eat perfectly and every other pressure that’s put on us is a recipe for hormonal disaster. We’re not meant to live our lives so rigidly, and this commonly causes cycle irregularities.
Additionally, if you’ve experienced acute stress or trauma like the loss of a loved one or financial hardship, you’re highly likely to experience a change in your cycle like a late, light or missing altogether period.
From late cycles to bad PMS symptoms, your stress levels for the month are playing a direct role in the health of your cycle.
Reason 2 - Over Exercising
We all know that exercise is great for us...but what happens when it goes too far?! Today more than ever women are pushing themselves in the gym 5-7 days a week. That’s probably too much for most people.
Like I mentioned in reason #1, stress plays a major role in why your period may be late or missing. Regular exercise, although you may think it’s one of the healthiest things about you, could actually be the culprit.
Are you doing high-intensity workouts like HIIT or CrossFit a lot? Check out this article to understand why women who do a lot of CrossFit are missing and delaying their menstrual cycles often.
Not an intense exerciser? Chronic long walks, dance classes or even daily power yoga classes can, contrary to popular belief, cause over-exercising and be placing unnecessary stress on your body.
So, what’s your weekly exercise look like? Is it possible you’re doing more than your body can handle and delaying your period?
Reason 3 - Recent Weight Loss
Research shows us (all the research for this article linked at the end) that alongside chronic stress and exercise, recent weight loss of as little as 5kg can be the cause of a late or missed period.
Rapid weight loss, which is common in today’s society, is actually a major shock to the body. As a result, the body thinks that it’s in starvation mode and puts a pause on bodily functions that are not 100% required for survival like reproduction.
Have you been on a diet recently?
Reason 4 - Chronic Dieting
For the exact same reason as reason #3, consistently dieting for months or years is likely to cause a hormonal imbalance in your body. This often looks like long cycles, missed ovulation, completely missing your period (known as hypothalamic amenorrhea or hypogonadotropic hypogonadism) and other symptoms like hair loss, weak skin, brittle nails, exhaustion and more.
If you’re seeing issues arise with your period it’s time to lay off the low-fat diets, calorie counting or macro tracking and try fueling yourself fully. This returns missing cycles and regulates late cycles like nothing else.
You may also be eating enough food, but not enough of the right food for you. If you’re under-eating your fat (i.e eating a low fat diet) or protein (it’s very common for people to undereat protein) you may need to revisit your intake. You may also have a micronutrient deficiency such as low iron, copper or zinc to name only 3 of many possible micronutrients.
I recommend working with a nutrition professional who is well versed in women’s hormones or with a missing period coach – like myself!
Reason 5 - Just Stopped Birth Control
If you’ve been on hormonal birth control, like the pill, you might experience a delay in the return of your cycle. While some women can come off the pill and get their cycle back quite quickly, for many other women this takes more time.
Wait up to 3 months for the return of your cycle post-pill. If you still don’t have it, look into some of the reasons listed above to do with stress, exercise and dieting. These are typically the cause for prolonged periods 3+ months after birth control. Again, if you’re fresh off birth control, wait 3 months first and prioritise your nutrition and rest.
Reason 6 - Something deeper…
None of the reasons above clicking for you? There could be a much deeper hormonal issue happening like PCOS or you could be experiencing menopause. Look into these things with your OBGYN or trusted health professional.
Feeling unsure if the above-mentioned stress, exercise or undereating is really what’s making your period late? That’s a really common concern. I personally was in doubt that my lifestyle was the cause of this issue for a long time.
It’s a misconception that missing periods due to stress, over-exercise or undereating are only for people with chronic eating disorders. Missing and late periods happen in all women from time to time due to these reasons – it’s a natural protective mechanism of the female body. Sometimes we just have busy or stressful months and this is our body helping us get through. However this natural mechanism should'’t be prolonged as there are health effects associated with prolonged missing periods.
If you’re experiencing a missing period for more than 3 consecutive months, this is called hypothalamic amenorrhea and it’s important that you address it not just because your period is what allows you to reproduce, but hypothalamic amenorrhea is linked to endometriosis, heart health and more. If you’re having consistent long or late periods, the reason could be linked to the same causes for hypothalamic amenorrhea (reasons 1-4).
Resources to learn about how to return your period:
Get the plan and accountability you need to recovery your missing period.
Learn all the details about coaching here.
What happens once you buy
When you sign up, I’ll send you some documents to you’ll fill out in preparation for our first call.
It will be a full health history form to help me get to know your background, lifestyle and menstrual cycle. Then you’ll schedule your call with me.
Before our session, I will review your intake form. This is important so that I can come into the call with a good understanding of where you're at.
In that first call I will ask any clarifying questions and dive into what I’m seeing based on your responses and get your feedback and input. Then together we will come up with a recovery plan.
Not everyone needs a plan though, some people just need accountability and support on their current plan, and in that case we are here to support and serve. No problem.
After that first call, you can email me at any time within the next month with questions or updates.
Research and Articles
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Zimmerman, Y et al. “The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysis.” Human reproduction update vol. 20,1 (2014): 76-105. doi:10.1093/humupd/dmt038.
Sirakov, M, and E Tomova. Akusherstvo i ginekologiia vol. 54,5 (2015): 34-40.
Palmery, M et al. “Oral contraceptives and changes in nutritional requirements.” European review for medical and pharmacological sciences vol. 17,13 (2013): 1804-13.
Khalili, Hamed et al. “Oral contraceptives, reproductive factors and risk of inflammatory bowel disease.” Gut vol. 62,8 (2013): 1153-9. doi:10.1136/gutjnl-2012-302362.
Baker, James M et al. “Estrogen-gut microbiome axis: Physiological and clinical implications.” Maturitas vol. 103 (2017): 45-53. doi:10.1016/j.maturitas.2017.06.025.
Kalyan, Shirin, et al. “Competing Factors Link to Bone Health in Polycystic Ovary Syndrome: Chronic Low-Grade Inflammation Takes a Toll.” Nature News, Nature Publishing Group, 13 June 2017, www.nature.com/articles/s41598-017-03685-x.
Leonetti, H B et al. “Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss.” Obstetrics and gynecology vol. 94,2 (1999): 225-8. doi:10.1016/s0029-7844(99)00266-5.
Merz, C Noel Bairey, et al. “Hypoestrogenemia of Hypothalamic Origin and Coronary Artery Disease in Premenopausal Women: a Report from the NHLBI-Sponsored WISE Study.” Journal of the American College of Cardiology, Elsevier, 1 Feb. 2003, www.sciencedirect.com/science/article/pii/S0735109702027638.
Emma O'Donnell, Jack M. Goodman, Paula J. Harvey, Cardiovascular Consequences of Ovarian Disruption: A Focus on Functional Hypothalamic Amenorrhea in Physically Active Women, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 12, 1 December 2011, Pages 3638–3648, https://doi.org/10.1210/jc.2011-1223.
Khosla, Sundeep et al. “The unitary model for estrogen deficiency and the pathogenesis of osteoporosis: is a revision needed?.” Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research vol. 26,3 (2011): 441-51. doi:10.1002/jbmr.262.
Clarke, Bart L, and Sundeep Khosla. “Female reproductive system and bone.” Archives of biochemistry and biophysics vol. 503,1 (2010): 118-28. doi:10.1016/j.abb.2010.07.006.
Vegeto, Elisabetta et al. “Estrogen anti-inflammatory activity in brain: a therapeutic opportunity for menopause and neurodegenerative diseases.” Frontiers in neuroendocrinology vol. 29,4 (2008): 507-19. doi:10.1016/j.yfrne.2008.04.001.
Gibson, J H et al. “Determinants of bone density and prevalence of osteopenia among female runners in their second to seventh decades of age.” Bone vol. 26,6 (2000): 591-8. doi:10.1016/s8756-3282(00)00274-x.
Karen K. Miller, Ellen E. Lee, Elizabeth A. Lawson, Madhusmita Misra, Jennifer Minihan, Steven K. Grinspoon, Suzanne Gleysteen, Diane Mickley, David Herzog, Anne Klibanski, Determinants of Skeletal Loss and Recovery in Anorexia Nervosa, The Journal of Clinical Endocrinology & Metabolism, Volume 91, Issue 8, 1 August 2006, Pages 2931–2937, https://doi.org/10.1210/jc.2005-2818.
Karen K. Miller, Ellen E. Lee, Elizabeth A. Lawson, Madhusmita Misra, Jennifer Minihan, Steven K. Grinspoon, Suzanne Gleysteen, Diane Mickley, David Herzog, Anne Klibanski, Determinants of Skeletal Loss and Recovery in Anorexia Nervosa, The Journal of Clinical Endocrinology & Metabolism, Volume 91, Issue 8, 1 August 2006, Pages 2931–2937, https://doi.org/10.1210/jc.2005-2818.
Misra, Madhusmita et al. “Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1.” The Journal of clinical endocrinology and metabolism vol. 93,4 (2008): 1231-7. doi:10.1210/jc.2007-1434.
Schulze, U.M., Schuler, S., Schlamp, D. et al. Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation. Child Adolesc Psychiatry Ment Health 4, 20 (2010). https://doi.org/10.1186/1753-2000-4-20.
Catherine M. Gordon, Kathryn E. Ackerman, Sarah L. Berga, Jay R. Kaplan, George Mastorakos, Madhusmita Misra, M. Hassan Murad, Nanette F. Santoro, Michelle P. Warren, Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 5, 1 May 2017, Pages 1413–1439, https://doi.org/10.1210/jc.2017-00131.
Gordon, Catherine M et al. “Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.” The Journal of clinical endocrinology and metabolism vol. 102,5 (2017): 1413-1439. doi:10.1210/jc.2017-00131.
“Too Much of a Good Thing - Exercise Associated Amenorrhea.” Epigee.org, www.epigee.org/exercise-associated-amenorrhea-late-period.html.
Black, Ryan. “Endocrine Society Releases Guidelines for Functional Hypothalamic Amenorrhea.” HCP Live, 23 Mar. 2017, www.mdmag.com/conference-coverage/endo-2017/endocrine-society-releases-guidelines-for-functional-hypothalamic-amenorrhea.
Gordon, Catherine M et al. “Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.” The Journal of clinical endocrinology and metabolism vol. 102,5 (2017): 1413-1439. doi:10.1210/jc.2017-00131.
Catherine M. Gordon, Kathryn E. Ackerman, Sarah L. Berga, Jay R. Kaplan, George Mastorakos, Madhusmita Misra, M. Hassan Murad, Nanette F. Santoro, Michelle P. Warren, Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 5, 1 May 2017, Pages 1413–1439, https://doi.org/10.1210/jc.2017-00131.
Bearden, Caroline Young. “Clinical Nutrition: Functional Hypothalamic Amenorrhea - Today's Dietitian Magazine.” Today's Dietitian, Aug. 2017, www.todaysdietitian.com/newarchives/0817p12.shtml.
Barbieri, Robert L, and David A Ehrmann. “Patient Education: Polycystic Ovary Syndrome (PCOS) (Beyond the Basics).” UpToDate, Mar. 2020, www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics.
Harrar, Sari. “Polycystic Ovary Syndrome (PCOS): How Is It Diagnosed?” EndocrineWeb, www.endocrineweb.com/conditions/polycystic-ovary-syndrome-pcos/polycystic-ovary-syndrome-pcos-how-it-diagnosed.
“Polycystic Ovary Syndrome.” Womenshealth.gov, Office on Women's Health, 1 Apr. 2019, www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.
