Delayed menstruation is usually considered the first sign of pregnancy. However, a missed period could be a symptom of other conditions.
What can cause a delay in menstruation?
Polycystic ovary syndrome (PCOS). It is a hormonal and metabolic disorder, and its exact cause is unknown. Impaired insulin resistance and high levels of androgens play a role in the development of PCOS. Symptoms include a very short or, conversely, a very long menstrual cycle, long delays between periods (or none at all), infrequent or no ovulation, obesity (four out of five women with PCOS have obesity), acne, increased hair growth (on the face, chest, abdomen, hips) [1].
Thyroid disease. Hormones related to the thyroid gland are instrumental to a woman's reproductive health. If hormone levels are within a normal range, the thyroid functions adequately. But if this balance is disturbed (such as in hypo- and hyperthyroidism), there can be serious issues, including delayed menstruation and irregular cycles [2].
Anorexia nervosa. It is an eating disorder that leads to dramatic weight loss. A lack of body fat and nutrients can disrupt hormone production, contribute to menstrual cycle failure, and inhibit ovulation [3].
Active training. Constant and excessive physical activity or intense training can lead to delays in menstruation or its complete absence, an issue not uncommon among female professional athletes [4]. Your period can also be affected by a sudden engagement in arduous training.
Stress. Stress can also be to blame for delayed or skipped periods. Prolonged or severe stress can lead to hormonal imbalance. For example, it may interfere with the production of gonadotropin-releasing hormone (GnRH) by the hypothalamus, an important indicator of ovulation and menstruation [5]. In addition, stress can increase the risk of other conditions, such as obesity and anorexia.
How do I find out if a delay is due to pregnancy or something else?
The easiest way to find out is by taking a quick pregnancy test. Just keep in mind that if fertilization is very recent, your HCG levels might not be high enough for a home pregnancy test to detect, and therefore the result may not be reliable. To be sure you are pregnant, your best bet is a blood test.
In addition, you can look for other signs of pregnancy, such as:
enlargement and tenderness of the mammary glands;
nausea and vomiting;
frequent urge to urinate;
changes in taste;
aversion to certain foods and smells;
irritability and tearfulness;
fatigue [6].
