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

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At July 22, 2020
Reviewed AtSeptember 5, 2023

Patient's Query

Hello doctor,

I missed my period. The last period was more than a month back. I took a urine pregnancy test this week and today early morning, and both results negative. I had intercourse with my partner this past month, but I always used condom protection, and my partner always ejaculated outside. No other symptoms of pregnancy other than a delayed period are noticed. What could be the cause of the delay in my period?

Hello,

Welcome to icliniq.com.

As pregnancy test has been checked twice already and found negative, 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 (polycystic ovarian syndrome), which needs to diagnosed. 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, and if you still do not get your periods, you can take the below-mentioned medication for your withdrawal period. Take tablet Meprate or Deviry (Medroxyprogesterone) 10 mg twice daily after food for five days, wait for withdrawal bleeding in the next 7-10 days. Please get the investigations done for the necessary evaluation of the underlying cause. Alternatively, you can wait and observe to get your next period on time. If that also gets delayed, then you can go for the investigation as advised (in view of the present COVID situation).

Investigations to be done

Ultrasound abdomen and pelvis, complete hemogram, lipid profile, 75g glucose tolerance test, HbA1c (hemoglobin A1c), serum calcium, vitamin D and B12 levels, serum fasting, and postprandial insulin levels, serum follicular stimulating hormone, free testosterone, estradiol, prolactin levels, thyroid profile on 2nd or 3rd day of next menstrual period.

Treatment plan

Tablet Meprate or Deviry (Medroxyprogesterone) 10 mg twice daily after food for five days. Wait for withdrawal bleed in the next 7-10 days.

Patient's Query

Thank you doctor,

I have also had lighter than normal bleeding or 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. Can we still rule out pregnancy in this case, correct? The cause of stress sounds feasible since I have been stuck working at home for the past two months. There are no significant weight loss or gain. 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. I just wanted to rule out pregnancy.

Hello,

Welcome back to icliniq.com.

Sure, as per your description, most probably it is 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. If your previous menstrual cycles were perfectly regular, and if you had unprotected intercourse around the ovulation, which is usually 14 days prior to the upcoming 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 is not pregnancy. Either there is a possibility of delayed ovulation in this cycle due to stress, or maybe there was no ovulation. Then coming to your lighter bleeding or spotting or brownish vaginal discharge, the 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 and the days you had spotting, maybe that can give some clue. I am asking this because some people can have spotted around the time of implantation too, which is called implantation hemorrhage or bleeding, which is usually like 7-9 days after the ovulation time. But in your case, you do not have to worry much also because you had protective intercourse, and pregnancy tests have been negative.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sravanthi Nuthalapati
Dr. Sravanthi Nuthalapati

Obstetrics and Gynecology

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