First of all, take a deep breath…and then take a pregnancy test! If it’s negative, or if there’s no way you could be pregnant, then consider the following common causes of missed periods:
Polycystic ovarian syndrome (PCOS): This is the most common endocrine (glandular) disorder in women of childbearing age – the involved glands being the ovaries. This problem is essentially caused by an imbalance in the female (oestrogen and progesterone) and male hormones (testosterone) in the body, and usually manifests as irregular or infrequent periods. A combination of blood tests and ultrasound scans are used to help make the diagnosis. PCOS can have potential long-term health implications, so it is important to see your doctor should you think that your period cycles are abnormal.
Thyroid imbalance: This is again a glandular issue, with the thyroid gland, situated in the front of the neck, being either under- or overactive. Thyroid function tests are usually included as part of the tests ordered to investigate irregular period cycles.
Stress: Your period cycles are ultimately controlled by your brain, so outside influences such as stress, major life events, and even overseas travel can have an impact on the axis filtering down to the ovaries. This is the situation in which you might miss one or two periods, and then find that your cycles go back to normal again.
Exercise/weight changes: Similar to emotional stress, when our bodies are put under physical stress, they recognise that now might not be a good time to get pregnant – thereby resulting in less frequent, or no, periods. Extreme weight loss and exercise can be the culprits, but even an increase in exercise from your usual amount can be enough to turn your periods off. If you miss your period for more than a few months, you should see your doctor, as there are other health implications to missed periods in this situation, including osteoporosis.
Hormonal contraceptives: Less frequent periods are a common (and often welcome!) side-effect of most hormone-containing contraceptives. Hormonal contraceptives work by altering your normal female hormone levels to a steady state, rather than the fluctuating levels that are normal over a natural cycle. In addition, they thin the lining of the womb, which is what comes away when you bleed during your period. When using hormonal contraceptives, it’s okay to not have a period every month, and this is why we often use them to treat women who have heavy or painful periods.
Chronic illness, or recent severe illness: Again, this is a form of stress on your body, and some women with chronic illnesses like diabetes, coeliac disease, inflammatory bowel disease and kidney disease will have irregular periods. Some of these conditions cause problems with low body weight and malnutrition, contributing to the overall picture of less frequent periods. Similarly, women who have had recent severe illnesses may find that their periods stop while their bodies recover.
Menopause: The average age of menopause in women in Australia is around 51-52 years, with about 10% of women undergoing menopause before the age of 45. There may be a family history of early or premature menopause, a history of known chromosomal abnormalities or chronic illness, or a history of medical treatments such as pelvic surgery or chemotherapy. Menopause is usually accompanied by other symptoms such as hot flushes, mood disturbances and vaginal dryness. Hormone replacement therapy is generally recommended for women who undergo early menopause, with some important exceptions, such as a history of breast cancer.
In summary, our bodies are amazingly susceptible to a range of inside and outside influences – and it’s quite common to miss one or two periods over the course of a year. For more information regarding periods, PCOS and menopause, see the excellent women’s health website, https://jeanhailes.org.au/. If you are concerned about your menstrual cycle, or are unsure about what might be causing your missed periods, then you should see your doctor for advice.