missed period Illustration by Maria Ines Gul

Any period-haver knows the drill when they suspect that their cycle is off: We check the date, fret a little, and maybe run out for a pregnancy test. But if the pregnancy test comes back negative and you fully missed your period, what then? What the heck is going on with your cycle?

Missing a period when you’re not pregnant could mean a number of things. Here are some possible reasons for a disrupted menstrual cycle.

Stress

The stress that can throw off your period isn’t the everyday stress of, say, pulling an all-nighter to meet a deadline or running out of gas on the way to work. The period-stopping kind of stress is intense, acute stress that affects the function of the hypothalamus region of the brain. This causes a chain reaction between the hypothalamus, the pituitary gland, and the ovaries, which ultimately can suppress reproductive hormone levels, and lead to, you guessed it: a disappearing period. The good news about this kind of missed period, however, is that dealing with your increased stress levels (with therapy, for instance, or another coping mechanism) should allow your period to quickly return back to normal. 

Illness

Much like stress, it’s not going to be your garden-variety illness that causes your period to go AWOL, so this winter’s flu, colds, and fevers won’t affect your cycle. But a severe illness like pneumonia, a heart attack, kidney failure, or meningitis can lead to hormone dysfunction, which can result in a missed period. Once the illness is healed or taken care of, your period should become regular again.

Weight Loss or Gain

While there’s no specific amount of weight that you’d have to lose or gain in order to miss your period, drastic weight changes—especially when they happen quickly— can impact your cycle because it can interfere with hormone production and distribution. A higher BMI can actually influence estrogen and progesterone, which are the hormones that run ovulation. (They’re also responsible for puberty, sex drive, and ovulation, so yeah, they’re a pretty big deal!) On the other hand, if a lot of weight is lost, this could mean your body lacks fat or nutrition, which it needs to produce the hormones that run your cycle. 

PCOS

PCOS, or Polycystic Ovary Syndrome, is a condition that has everything to do with hormones. It’s not known exactly why PCOS occurs in some people, but we do know that one of the symptoms is irregular periods or no periods at all. PCOS can cause a hormonal imbalance that prevents the egg from being released or even developed, which stops a period from occurring. Other PCOS symptoms include unpredictable bleeding, skin conditions, unwanted hair, sleep apnea, anxiety, and depression. If you think you have PCOS, it’s definitely something to speak with a healthcare provider about. 

Thyroid Problems

If you know you have issues with your thyroid, that might also be the reason your period went MIA. Both an overactive thyroid gland (called hyperthyroidism) and an underactive thyroid gland (called hypothyroidism) can result in a missed period. Basically, the thyroid releases hormones, and if there are too few hormones produced, it can upset the body’s balance of chemical reactions which leads to irregular periods, or if there are too many hormones produced, it can indirectly prevent ovulation. Long story short: Thyroid issues can usually be solved with medication, so if you think that this is the culprit, again, speak with your doc. 

Perimenopause

Another reason you didn’t have to reach for your tampons/menstrual cup/pads this month? Well, it could be perimenopause. Not to be confused with full-on menopause, this is the transition phase leading to menopause that might happen at a younger age. When your egg supply is dwindling and estrogen levels are uneven, periods can skip and become irregularly until eventually you enter menopause, when you’ll no longer have periods. Think this could be you? Other signs of perimenopause include hot flashes, mood changes, vaginal dryness, and sleep problems. 

Pituitary Tumors

Yes, a pituitary tumor (an abnormal growth that develops in your pituitary gland) sounds scary, but know that most of them are benign and noncancerous. Some pituitary tumors have no effect on the body, some cause the gland to over function, and some cause the glad to not work so well. And if someone develops a large pituitary tumor, it could cause a hormone deficiency that inhibits menstruation. If you think that this might be the case for you, note that other signs of a pituitary tumor include nausea, weakness, feeling cold, sexual dysfunction, and unintended weight loss or gain. 

Medications

Are you on some new meds? That could also be the reason behind your period’s disappearing act. There are so many medications out there that affect our bodies in all different ways, but in general, the categories of meds that can cause periods to stop include antipsychotics, antidepressants, blood pressure drugs, and allergy medications. Your prescriber should be able to tell you more about how the medication interacts with menstrual cycles. 

Change in birth control method 

And speaking about how medication can throw your cycle out of whack, birth control is no different. If you’ve decided to stop taking birth control pills, it’s possible that your period will disappear for a few months. Birth control pills function by stopping your body from making hormones associated with ovulation and menstruation, and because after going off of BC your body needs some time to adjust to producing these hormones again, you might not get your period for around three months. However, if you’ve just gotten off the pill and haven’t had your period for longer than three months, you might want to check in with a doctor.

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