Why won’t my period start?
Short answer: A missed or late period can result from pregnancy, hormonal changes (stress, weight change, thyroid or pituitary problems, PCOS), recent contraception use, breastfeeding, or natural life stages like perimenopause. If pregnancy is excluded and you miss three or more consecutive cycles, see a healthcare provider for evaluation.
Explanation
Menstrual bleeding requires a coordinated hormonal cycle: reliable ovulation and normal levels of estrogen and progesterone. Anything that disrupts the hypothalamic‑pituitary‑ovarian axis can delay or stop periods—common causes include pregnancy, anovulation (no ovulation), polycystic ovary syndrome (PCOS), low body weight or rapid weight loss, intense exercise, chronic stress, thyroid disease, high prolactin, and certain medications (e.g., some antipsychotics, chemotherapy). Recent use or stopping of hormonal contraception can also alter timing. Structural problems (e.g., uterine scarring) or primary ovarian insufficiency are less common. Basic evaluation typically begins with a pregnancy test, medical and menstrual history, medication review, and targeted blood tests (pregnancy test/β‑hCG, TSH, prolactin, and possibly FSH/LH or progesterone) and pelvic ultrasound if indicated.
Tips
- Take a home pregnancy test if sexually active and begin with that simple check.
- Track cycle length, recent weight or exercise changes, stress, and medication history.
- Review current medications and recent stopping/starting of contraception with your clinician.
- Address reversible lifestyle causes: normalize weight, reduce excessive exercise, and manage stress.
- See a healthcare provider if you miss three consecutive cycles, have severe pain or heavy bleeding, or other concerning symptoms.
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