Missed period? 7 reasons why, plus when to see a doctor

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  • 1 in 5 women are currently suffering from COVID-related menstrual problems.

    The reasons for a missed period can be hard to identify at the best of times. Is it a hormonal problem? Are you eating enough? Are you exercising too much? Or could it be a more serious underlying condition like PCOS or endometriosis?

    But, interestingly, menstrual problems seem to be on the rise. Did you know? Studies have found that 1 in 5 women are currently suffering from COVID-related menstrual problems. Several self-reported surveys indicating that this figure could be as high as 30%.

    That’s basically a fifth of women reporting that their TOTM has become irregular since the beginning of the pandemic. But why? And how?

    According to doctor Sarah Brewer, Healthspan Medical Director, your period would be classified as ‘irregular’ if the length of time between each, plus the duration of bleeding and amount you bleed, vary from bleed to bleed. “Irregular periods are most common in the early teens and again as the menopause approaches,” she shares. “Plus, many women do find their periods are occasionally irregular. Failure to ovulate sometimes occurs in women with otherwise normal menstrual cycles.”

    But if you’re wondering why now – we’ve roped in two doctors to answer all your questions. Keep reading for advice on what to do if your monthly bleeds are all over the place, plus all the reasons for a missed period, too.

    Reasons for a missed period: A woman lies on a sofa clutching her stomach

    Missed period: 7 reasons

    The most obvious reason you’ve missed a period is pregnancy, but once you’ve ruled that out, what else could be the cause? According to doctor Brewer, periods may become irregular as a result of:

    1. Physical stress (eg excessive exercise; stress of lockdown)
    2. Emotional stress (eg stress of COVID-19 pandemic, bereavement, depression)
    3. Significant loss of weight (eg anorexia nervosa)
    4. An over-active or under-active thyroid gland
    5. Polycystic ovaran syndrome (PCOS)
    6. Gynaecological problems, such as an ovarian tumour
    7. Approaching menopause.

    She also shares that an irregular, heavy period that was also late could be due to a miscarriage. “If you think this could be the case, always seek medical advice,” she stresses.

    Why has the pandemic had an impact on our periods?

    According to Narendra Pisal, consultant gynaecologist at London Gynaecology, they’ve been seeing an increasing number of period-related issues in their clinics.

    But why? Short answer: increased stress, anxiety and workload, and less easy access to doctors and GP clinics. “There are several factors responsible. These include anxiety and stress caused by the pandemic and lockdown, increase in the workload for women due to home-schooling and working from home, not forgetting the affect of COVID infection on general and reproductive health,” he shares.

    Missed period: A period pad on a pink background

    What should I do if I’ve missed a period?

    First things first – take a pregnancy test if you have any doubt at all that you could be expecting.

    From there, it’s important to keep a record of when bleeding occurs, doctor Brewer advises. “If your vaginal blood loss is irregular, this may help to tell true irregular periods from regular periods, and establish what is irregular non-menstrual bleeding in-between,” she explains.

    Do note: The doctor explains that irregular bleeding that is non-cyclical (aka, not due to normal menstruation) is known as metrorrhagia. “This will always needs investigating to find out the cause, so do book an appointment with your GP,” she advises.

    6 tips for dealing with missed a period 

    1. Get to know your ‘normal’ cycle

    Keeping a track of your cycle, according to Pisal. “There are loads of smartphone apps that will help,” he shares. We like Clue, Flo and Glow.

    Do note that a ‘normal’ cycle can have anything from 21 to 42 days between bleeds. “That is entirely regular,” Pisal reassures.

    2. Make sure you’re living a balanced lifestyle

    Might sounds obvious, but many menstrual problems could be prevented by better self care. “Make sure you’re getting balanced nutrition, regular exercise and adequate sleep, and try and maintain a healthy body weight,” Pisal recommends. “They’re all important factors in maintaining a regular menstrual cycle,” he continues.

    Rad our guide to self love, while you’re here – it’ll help.

    3. Try and notice a pattern

    So, your period is slightly delayed or slightly early. Don’t panic immediately, shares Pisal. “There’s no cause for concern unless it becomes a persistent pattern,” he shares. “Do keep an eye on things – usually the cycle will return back to normal,” he explains.

    4. Watch out for red flags

    Again, if your periods do become persistently irregular, it’s time to book a GP appointment. Other red flag symptoms include:

    • Prolonged bleeding
    • Heavier flow
    • Bleeding between periods
    • Bleeding after sex.

    5. Practice self care

    Top tip from Pisal: don’t ignore what can feel like boring self-care.

    “This includes having your cervical screening when invited, having your contraception reviewed when appropriate, and looking after yourself during the premenstrual and menstrual period,” he explains.

    6. Maintain a healthy hormone balance

    Sounds scary, isn’t really. Maintaining your hormones essentially means eating well and looking after yourself. For a healthy hormone balance, doctor Brewer advises you aim for:

    • Eat a healthy, low-fat, preferably organic diet
    • Eat at least five portions of fruit and veg a day
    • Eat essential fatty acids, like nuts, seeds, pulses and fish
    • Be mindful of your intake of sugar and salt
    • Avoid convenience, pre-processed foods and additives – eat home-made meals as much as possible
    • Be mindful of your alcohol consumption
    • Be mindful of your caffeine consumption – aim for no more than three caffeinated drinks a day
    • Never skip a meal, especially breakfast
    • Drink plenty of fluids, especially water.

    Final note: don’t be afraid or shy to talk about your concerns, shares Pisal. “Whether that’s on social media, with your line manager, or with your friends and family, breaking the taboo around menstruation is important. It’s time we normalise talking about female health,” he concludes.

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