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Q. What could be the cause of the delay in my period?

Answered by
Dr. Sravanthi Nuthalapati
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jul 22, 2020

Missed period. Last period was more than a month back. Took a urine pregnancy test on this week and today early morning. Both results negative. Had intercourse with partner this past month but always used condom protection and partner always ejaculated outside. No other symptoms of pregnancy other than delayed period. What could be the cause of the delay in my period?

Dr. Sravanthi Nuthalapati

Obstetrics And Gynaecology
#

Hello, Welcome to Icliniq.

As pregnancy test has been checked twice already, and found negative so definitely pregnancy is ruled out, and also as you have used contraceptive method

The delayed Periods can be mostly due to stress or underlying Hormonal disturbances or sometimes a Lifestyle related problem called PCOS, which needs to evaluated.

I would like to know if you have had any recent weight gain, or weight loss, any unwanted facial hair growth, scalp hair fall, acne issues, or any secretions from breast, or headaches that you have experienced in the recent past, As these can provide some clue towards the underlying cause.

I would advise you to just wait for 3-4 days more & if you still don't get your periods, you can take the below mentioned medication for your withdrawal period.

Please get the investigations done for the necessary evaluation of the underlying cause. Alternatively, you can wait and observe you get your next period on time, if that also gets delayed then you can go for the investigation as advised ( in view of present COVID situation).

Please feel free to consult me once you have the reports.


Investigations to be done:

- Ultrasound Abdomen and Pelvis,
-Complete Hemogram,
-Lipid Profile,
-LFT/RFT,
-75g Glucose Tolerance Test (F/1hr/2hr).
- HbA1c
-Serum Calcium, Vitamin D & B12 levels.
-Serum Fasting & Post Prandial Insulin levels.
-Serum FSH, LH, Free Testosterone, Estradiol, Prolactin levels, Thyroid profile (T3, T4, TSH, Anti TPO) on 2nd/3rd day of next menstrual period..

Treatment plan:

- Tablet Meprate or Deviry 10mg Twice daily after food for 5 days,
- Wait for withdrawal bleed in next 7-10days.
- To get the blood tests on Day 2 or Day 3 menses.

Preventive measures:

-Reduce weight.
-Maintain menstrual diary ( keep tracking, if Delayed by more than 45 days, please consult your Gynaecologist).
-Regular excercises at least one hr daily.
- Avoid Sedentary lifestyle.
- Dietary modifications.

Regarding follow up:

- Follow up with the reports.


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Hi Doctor, Much appreciated for the quick reply. I have also had lighter than normal bleeding/brown vaginal discharge several days ago for two days, but my vaginal discharge has now returned to normal (white). No other symptoms that you have described otherwise. We can still rule out pregnancy in this case correct?

The cause with stress sounds feasible since I have been stuck working at home for the past two months. No significant weight loss/gain (+-4 lbs). I would say that my lifestyle is quite different now since working from home (daily exercise and healthier diet). I will try to follow up with a local physician if I experience other symptoms. Just wanted to rule out pregnancy.

Kind Regards.

Dr. Sravanthi Nuthalapati

Obstetrics And Gynaecology
#

Sure, As per your description, most probably it's stress related as you have no other symptoms, so definitely you can Wait and watch and see how your menstrual pattern is before you could investigate.

Now Regarding your pregnancy doubt---> If your previous menstrual cycles were perfectly regular, and if you had Unprotected intercourse around the Ovulation, which is usually 14days prior to the upcoming coming period, then the urine pregnancy test should have been positive.

Ideally one can get positive testing on urine just by the day of missed periods. And you tested it today also which was negative, so definitely this isn't pregnancy. So rest Assured. Either there is a possibility of delayed ovulation in this cycle due to stress, or may be there was no ovulation.

Coming to your lighter bleeding or spotting or brownish vaginal discharge, possibility is that it could have been the spotting around the time of ovulation, which can happen due to the various Hormonal fluctuations around the time of ovulation. If you had provided some timelines of your sexual activity & the days you had spotting, may be that can give some clue.

Why I am asking this is because, sometime some people can have spotting around the time of implantation too, which is called as implantation hemorrhage or bleeding, which is usually like a 7-9days after the Ovulation time. But in your case you don't have to worry much also because you had a protective intercourse & pregnancy tests have been negative.

Hope this was helpful for you.


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