What a missed period could mean if you're not pregnant

The average length of a menstrual cycle is 28 days, but anything from 24 to 35 days is considered normal. Skipping right past this time frame can cause you a lot of stress, especially if you're not trying to get pregnant.

But while pregnancy is one of the main reasons for a loss of menses, it's not the only culprit when your period comes up missing. Here are some other common reasons you might be missing your period.

• Stress.

• Infection.

• Pelvic organ issues such as polycystic ovary syndrome (PCOS).

• Hyperprolactinaemia (a condition where the hormone prolactin is too high).

• Some medications.

• Increased amount of exercise.

• Weight gain or loss.

• Eating disorders.

• Hormonal changes.

• Thyroid disorders such as hypothyroidism (underactive thyroid gland).

• Pituitary gland disorders.

• Breastfeeding.

• Approaching menopause.

• Changes in diet.

• Some forms of hormonal contraception.

When should you worry about absent periods?

If you've taken a pregnancy test and it comes back negative, the next thing to do is track how often this is happening. "The occasional missed period is not unusual," says Dr Karen Morton, consultant gynaecologist and founder of Dr Morton's. But if periods become generally infrequent or stop altogether, Morton says it's time to pay closer attention to what is going on.

When to see your GP

Morton recommends speaking with your GP if your periods are fewer than every three months. And if you're trying to conceive, Morton suggests medical intervention if your cycle is longer than 32 days.

Additionally, you should see your doctor if:

• You have not had a period for nine months but your periods have always been infrequent.

• You have hot flushes and you're under the age of 45.

• You have lost weight or your BMI is 19 or less.

• You feel unwell.

• You've not had a period for six months after stopping the contraceptive pill.

Gynaecologist, Dr Tami Prince, tells patients that if their periods have consistently been regular and then become irregular, it's time to look for causes. On the flip side, she says women often tell her they've always had irregular periods. But just because a period has always been irregular doesn't mean it's normal. That's why Price recommends that you be evaluated if you're having irregular periods.

What are the possible health consequences?

In the short term, skipping periods shouldn't cause you harm. However, if it goes on for a longer time, it may cause some problems. Price says the major potential long-term consequences of irregular periods, particularly if you have PCOS are:

• Infertility.

• An increased risk of endometrial hyperplasia (which occurs when the lining of the uterus becomes too thick).

• An increased risk of insulin resistance or type 2 diabetes.

• A higher risk of heart disease.

• In rare cases, irregular periods - could signal womb cancer.

Missed periods and fertility

If your future plans include trying to get pregnant, you might be wondering what your missed periods mean for your fertility. Unfortunately, there's not a simple answer to this question.

Dr Angela Jones, a gynaecologist, says it really depends on why you're not getting a period. Some of the more common reasons for missing your period, such as recent weight loss or gain, or medications, are reversible.

But, if you're dealing with things like PCOS, which causes ovulatory dysfunction, Jones says steps will need to be taken to manage this in order to help you ovulate regularly.

After all, if you aren't ovulating, you can't get pregnant. This may be a reason to see a specialist. However, it's important to remember that even if you're not ovulating regularly, you can still get pregnant. So if you don't want to conceive, it's essential to use reliable contraception every time you have sex.

Tips to make your periods more regular

Once the cause of the irregularity is found, Price says treatment is tailored to that cause, whether it is treating infection, decreasing stress, stopping breastfeeding, or correcting hormonal imbalances. Here are some other changes you can try to get your period back on track:

Focus on your lifestyle

Jones frequently tells patients that leading a healthy lifestyle which includes a good diet and exercise, minimising stress, and getting an adequate amount of rest, are all good things to help ensure you will have and/or maintain a regular cycle.

Change your contraception

If the current birth control method you're using is causing you to skip your period, speak to your GP. If you're using a hormonal coil such as the Mirena®, periods usually become lighter, less painful and often stop.

Gain weight if you're underweight

Meet with a dietician to create a plan for gaining weight. If you're missing your period due to a low body weight, talk with your GP and dietician about healthy ways to put on weight.

Lose weight if you're overweight

Excess body fat can cause your periods to become irregular. Meet with your GP or practice nurse, who may be able to refer you to a dietician to discuss ways to lose weight. Even losing 5% of your body fat can help get your cycles back on track. This can be particularly helpful if you're dealing with PCOS.

Exercise

Make sure you're getting the right amount of exercise. Excessive exercise has been shown to cause problems to cause menstrual irregularities, so cutting back on the amount you're doing might help regulate your period.