Why Your Period Might Be Missing

It’s a strange situation to say the least – your periods have been normal, regular and predictable. Now you’re scratching your head and wondering, “why haven’t I started a new period yet?”

Depending on your circumstances, there could be a few different causes! Chatting with your health care provider can be a benefit to make sure you know about all of your options and how to go about accessing them.

1. You’re pregnant. If you’ve been sexually active throughout the last cycle with exposure to sperm, we can’t rule this one out. While you’re not fertile throughout your entire cycle (more content to come on this in the future), if you’re not already aware of your fertility status, or tracking your cycle with details around body temperature and cervical mucus, it’s possible that you’re pregnant.

I say this even for folks who use birth control – birth control failure can occur, and if you’ve missed a few doses or used it incorrectly (human error can happen with condoms) you might still be at risk. If you’ve been baby-dancing and hoping for this result, congratulations! Get to peeing on a stick and planning an appointment with your health care provider for some bloodwork and birth planning.

If keeping a baby isn’t in your game plan, there are pathways to help an infant get to a home. If carrying and having a baby isn’t your choice, abortion is an option – speak with your provider about medical and surgical options. Abortion is reproductive healthcare and access to it is not up for debate on this platform.

2. Hypothalamic amenorrhea. If you’ve been struggling with overexercising, undereating and a significantly high stress level, it’s possible that you’ve been affected by hypothalamic amenorrhea (especially if a lack of periods has occurred for several months). In this situation, the brain has shifted into survival mode and as a result shuts down the feedback processes that stimulate a normal menstrual cycle. Stress hormone levels are too high to allow resources to be used for menstruation.

This concern requires a multi-facted approach, including medical monitoring, nutrition therapy and mental health counselling. In order to bring periods back, cessation of exercise, increased energy and nutrient intake and stress reduction are essential. If this situation is where you’re at, you deserve support and recovery.

3. Your birth control. Contraceptives have a few different modes of action depending on their types. Most oral contraceptives are a combination of estradiol and progestin (not a real progesterone) that prevent ovulation, thicken cervical mucus and change the uterine environment to impact sperm function. If the type you’re taking prevents ovulation, your body isn’t stimulated to release an ovum and therefore doesn’t need to have a period when fertilization doesn’t happen. You could take your active pills consistently and not have a period (often considered as a mode of treatment for those with endometriosis or adenomyosis).

Other types of birth control, including the Mirena IUD, don’t necessarily prevent ovulation as a main mechanism but can have a secondary effect on ovulatory function. As a result, periods can lighten or stop for the duration of use. You can always take a peek through the medication pamphlet for information about period changes, or visit the Planned Parenthood website for birth control options.

4. You’re in puberty. While the body is preparing for regular periods, the ovaries and brain are basically learning how to communicate. This means that periods might not be regular for the first several cycles. The ovary is ever-changing in its development of follicles for ovulation, and throughout puberty the function of the ovary is pretty new.

It can take some time for periods to become regular and predictable and we give a little bit of wiggle room to consider them normal – anywhere between 21 to 45 days is considered a normal cycle length for folks in puberty. This is a great time to ask questions and read lots about the human body during this transition, and I love the book Red Moon Gang to open up inclusive conversation about period products, period positivity and how periods actually work!

5. You’re in menopause. It’s a myth that menopause is the stage of zero eggs left in the ovary. Menopause can be viewed as more of a transition, where there are follicles remaining in the ovary but no ovum that are viable for ovulation. The hormones involved in ovulation fluctuate, resulting in changes to cycle length and possibly skipped periods.

It’s expected that the menstrual cycle and fertility has an end, so this shouldn’t be a time of shame or blame – your body is doing exactly what is expected! Check out Dr. Jen Gunter’s “The Menopause Manifesto” – it’s an incredible book for all menstruating bodies to dispel myths about menopause and the health changes as we age.

Not sure that you fit these categories? Chat with your healthcare provider – there are other conditions that can impact how the body experiences a menstrual cycle, including but not limited to thyroid issues, Crohn’s and colitis, and more.