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First aid

Menstrual period - missed or late

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Does this describe your symptoms?

Definition
  • Late Menstrual Period: 5 or more days overdue compared to usual menstrual cycle
  • Missed Menstrual Period: no menstrual flow for more than 6 weeks

General Information

  • The first day of menstrual bleeding is considered the first day of a new menstrual cycle.
  • Menstrual bleeding typically lasts 3-7 days.
  • Ovulation generally occurs around day 14 of the cycle.
  • The length of the menstrual cycle varies from woman to woman. The range is from 24 to 35 days. The average is 28 days.

Causes

  • Pregnancy is the most important cause. This possibility needs to be considered in any woman who has a missed or late period.
  • Stress
  • Dieting, exercise and weight loss
  • Menopause
  • Polycystic ovarian disease
  • Birth control pills
  • Depoprovera injection
  • Pituitary and other endocrine disorders

Home Urine Pregnancy Tests

  • Home urine pregnancy tests are inexpensive, accurate, and easy to use. Most drug stores sell these tests over-the-counter .
  • Urine pregnancy tests can often diagnose pregnancy during the week after the first missed period (2 weeks after ovulation).
  • Use of a first-morning urine specimen is recommended because the urine HCG concentration is highest in the morning.
  • When a home pregnancy test is negative, but there is still a high suspicion of pregnancy, the woman should either repeat the test in 3-5 days or go to her doctor's office for testing.
  • The urine pregnancy test can sometimes be falsely negative if the urine specimen is very bloody. A small amount of blood (e.g., blood-tinged urine) should not interfere with the accuracy of the test.
  • More information is available at: http://www.4woman.gov/faq/pregtest.aspx.

If not, see these topics

When to Call Your Doctor

Call 911 Now (you may need an ambulance) If
  • Passed out (fainted)
  • Severe abdominal pain
Call Your Doctor Now (night or day) If
  • You feel weak or very sick
  • Abdominal pain and you are pregnant
  • Abdominal pain and you might be pregnant
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • You are pregnant
  • You want a pregnancy test done in the office
  • Recent weight loss
  • Age greater than 45
  • Missed 2 or more periods in a row
  • Missed period has occurred 2 or more times in the last year
Self Care at Home If
  • Missed or late period and you don't think you need to be seen
HOME CARE ADVICE FOR MISSED OR LATE MENSTRUAL PERIOD

  1. Pregnancy test, when in doubt:
    • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
    • Follow the instructions included in the package.
  2. Stress: Stress can interrupt normal menstrual periods. Try to reduce your stress by talking about it with a friend or family member. Try to avoid or decrease stressors. If this is not effective, seek help from a counselor or talk with your doctor.
  3. Call Your Doctor If:
    • Pregnancy test is positive
    • You have difficulties with the home pregnancy test
    • New symptoms suggest pregnancy (e.g., morning sickness, breast tenderness/swelling)
    • You need help coping with stress
    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 1/19/2009

Last Revised: 9/21/2007

Content Set: Adult HouseCalls Online

Portions Copyright 2000-2009 Self Care Decisions LLC; Copyright LMS, Inc.

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