Menstrual Delay

Approved Doctor(s) ; Michael E. Anderson , Jeff Chapa • Jan 11, 2022

Table of contents

What is Menstrual Delay?

A normal menstrual cycle (from the day your period starts to the day your next period starts) is on average 28 days. A normal cycle is considered to be between 21 and 35 days, although this can vary from person to person. If there is a delay of at least 7 days in the menstrual cycle, this is defined as a menstrual delay.

Changes of a few days in the menstrual cycle are considered normal. A few days late or early menstruation is not considered a delayed period, but if it lasts more than 7 days, you should consult a physician.

Since ovulation is not fully regulated in young girls who have just started menstruation, menstrual irregularity for an average of 1-1.5 years is considered an expected condition. For the menstrual cycle to function regularly, this system of the hypothalamus, pituitary, ovaries and uterus must work in harmony with each other. A slight change in this system can alter the menstrual cycle, even if it is not pathological.

Menstrual Delay Diagnosis

When a patient presents to a physician with a complaint of delayed menstruation, a medical history is first taken. When taking a medical history, the duration of the menstrual cycle, how long the bleeding lasts, the amount of bleeding, whether there is pain during menstruation are questioned.

It is also important to ask whether the person has an active sex life and, if so, whether they are protected. An important part of the history taking is the family history. Regular medication use and menopause may also be questioned.

After the medical history, a gynecological examination is performed to look inside the uterus and ovaries. After the gynecological examination, if necessary, some hormone tests such as estrogen, FSH, LH, AMH and a pregnancy test are performed.

If an underlying disease is suspected, MRI or similar imaging techniques are also used. A smear test can be performed if the cause of menstrual irregularities is thought to be a mass in the uterus or cervical cancer, taking into account family history. If necessary, a biopsy of the uterus is taken.

The hypothalamus, pituitary gland, uterus and ovaries, which are the cornerstones of a healthy reproductive system and menstrual cycle, are checked in detail. All examinations, laboratory tests and investigations are evaluated to determine the cause of the menstrual irregularity.

What Causes Menstrual Delay?

Menstrual delay can occur as a result of some minor physiological differences or as a symptom of a serious illness. The cause of menstrual irregularity must be investigated, as it can have many different causes. Some causes of delayed menstruation are as follows;

  • Stress Physical or emotional stress can disrupt hormonal balance and lead to delays in the menstrual cycle. In particular, anxiety, chronic depression, alcoholism or substance abuse can also cause delayed menstruation.
  • Pregnancy If the patient has a sexually active life and her menstrual period is delayed, a pregnancy test should be performed. Menstruation may stop during pregnancy, so the possibility of pregnancy is also evaluated.
  • Hormonal Imbalances: Imbalances of hormones such as estrogen, progesterone, FSH, LH, which play an important role in the menstrual cycle, can also cause menstrual delay.
  • Weight Disorders: Being underweight or overweight than normal body weight can disrupt body balance and cause menstrual delay. Sudden weight gain and loss have the same effect.
  • Excessive Exercise: Too much exercise affects the hypothalamus in the brain and leads to delayed menstruation. For example, this can be seen in long marathon runners and ballerinas.
  • Early Menopause On average, women reach menopause at the age of 45-55. If the patient enters menopause before the age of 40, this is defined as early menopause and menstrual delay occurs in this case.
  • Drugs or Diseases: Some medications or serious illnesses such as systemic diseases, diabetes, cancer can also cause delayed menstruation. The underlying condition underlying the delay in menstruation should be found and appropriate treatment should be provided.

Symptoms of Menstrual Delay

Symptoms of delayed menstruation vary depending on the underlying cause.

  • If the patient's delay in menstruation is due to pregnancy, she will develop pregnancy symptoms. Nausea, vomiting, dizziness, weight gain, cessation of menstruation.
  • Fatigue
  • Lower abdominal pain
  • Low back pain
  • Sudden mood swings are observed.
  • If the delay in menstruation is caused by a disease, symptoms of the disease are observed alongside the delay in menstruation. Examinations, tests and imaging methods are evaluated, the cause of the delay in menstruation is found and treatment is prescribed.

Menstrual Delay Treatment Methods

After a detailed examination of the patients who come to the doctor with the complaint of menstrual delay, a treatment method should be applied depending on the cause of the menstrual delay. Conditions such as pregnancy, hormones, physiological problems are investigated and a treatment plan is made according to the problem.

If the reason for the delay in menstruation is due to the thyroid gland, drug treatment is started, or if there is a delay in menstruation due to a cause such as polycystic ovary syndrome, the diet is regulated, and if there is excess weight, a diet program is prepared accordingly.

In case of delayed menstruation caused by any disease, appropriate treatment is applied. There is no obvious gynecological problem or disease;

  • A balanced diet is provided. Whole grain foods, fruits, vegetables, lean proteins and healthy fats are consumed. Foods rich in iron, calcium, magnesium, vitamins B and D are consumed to maintain hormonal balance.
  • Drink plenty of water to support the body's natural balance.
  • Regular physical activity to improve blood circulation and reduce menstrual cramps. Light exercise such as walking, yoga, swimming or cycling.
  • Stress management should be ensured. Hormonal balance can be improved by reducing stress through breathwork, meditation and mindfulness.
  • Good quality sleep is important for the body's balance. Regular sleep also affects hormones and prevents delayed menstruation. It is important to sleep between 7-9 hours a day.
  • It is also beneficial to relax oneself with self-care practices during menstruation. Routines such as warm baths, light exercises, soothing herbal teas, self-massage have a relaxing effect.

Which Months Does Seasonal Menstrual Delay Occur?

Seasonal changes affect many mechanisms in the body, including the menstrual cycle. Seasonal transitions have an impact on metabolism and mood. It has been observed that periods of decreasing and increasing sunlight can also change the length of the menstrual period.

It has been suggested that ovarian activity is higher in summer. Sunlight helps increase FSH secretion, which helps regulate the body's reproductive functions. This is why menstrual delays are more common as we move into the winter months. Changes in lifestyle, inactivity, and changes in diet in winter also lead to delayed menstruation.

How Many Days Does Menstrual Delay Due to Stress Last?

When the hypothalamus and pituitary gland, which play an important role in the menstrual cycle, are affected by stress, menstrual delays can occur. Sudden traumas in a person's life, intense sadness and depression, anxiety, etc. disrupt the hormone balance and delay menstruation.

The duration of delayed menstruation due to stress may differ from person to person. Generally, there is a delay of a few days, but this can last longer as the stress level increases.

How Many Days Does a Menstrual Delay Occur?

A delay of at least 7 days outside of one's own menstrual cycle is referred to as a delayed period. In people who have just started menstruating, it may take 1.5-2 years for ovulation to become regular. Irregularities in these people are considered normal.

At the same time, it is normal for people who have entered menopause to have irregular and delayed menstrual cycles due to rare ovulation. If the menstrual cycle of women of reproductive age is delayed for 7 days or more, this is not considered normal and they should consult a doctor.

Menstrual Delay and White Discharge

If there is a white discharge with menstrual delay, it can be considered as an early pregnancy period. Vaginal discharge in early pregnancy is a thin whitish discharge. If there is an increase in discharge with menstrual delay, the possibility of pregnancy increases.

If the white discharge is thick and milky, it may suggest a vaginal yeast infection. Vaginal yeast infections can also cause delayed menstruation. Cheesy, milk-cut discharge with an intense odor can be treated with antibiotics.

What Causes Menstrual Delay Without Pregnancy?

If a person experiences a delay in menstruation without being pregnant, it can generally be due to the following conditions;

  • Stress
  • Hormonal imbalances
  • Unbalanced nutrition
  • Birth control pills
  • Thyroid
  • Polycystic ovary syndrome
  • Breastfeeding
  • Ovarian cysts and fibroids
  • Cervical cancer
  • Menopause

Which Antibiotics Cause Menstrual Delay?

One of the side effects of antibiotic use is delayed menstruation. Although it varies from person to person, antibiotics can cause menstrual delay in some women. Although not all antibiotics cause menstrual delay, some types can cause it.

Some types of antibiotics such as Tetracyclines, Macrolides, Fluoroquinolones, Sulfonamides, Metronidazole, Chloramphenicol, Rifampin can affect the menstrual cycle in women and cause menstrual delay. Patients with delayed menstruation can change medication in consultation with their doctor.

What is Good for Menstrual Delay?

If the delay in menstruation is caused by any gynecological problem or disease, the treatments applied by the physician will be good. Here are some methods that are good for menstrual delay not caused by disease:

  • Yoga and exercises that help to relax the abdominal muscles
  • Consuming foods rich in vitamin C
  • Drinking herbal teas such as chamomile, thyme, sage, rosemary, cinnamon that help menstruation to come
  • Stress-reducing meditation, breathing exercises
  • Consume plenty of fruits and vegetables
  • Taking a warm shower
  • Avoiding caffeinated and carbonated drinks

Delayed Menstruation while Protected

The rate of pregnancy in women who have unprotected sex is very low. The important point here is the method by which the person is protected. It is normal for a woman who is protected with birth control pills to experience a delay in menstruation. In particular, birth control pills containing only progesterone cause menstrual delays. After stopping the pills, the menstrual cycle is expected to return to normal.

If hormonal spirals are used in spiral contraception, this also leads to a delay in menstruation. This is not the case with copper spirals, but menstrual delays may occur in the first 3-6 months after the spiral is inserted.

Is There a Menstrual Delay with a Spiral?

If a hormonal spiral is used for contraception, menstrual delay may occur. The hormonal spiral contains progesterone and provides protection by releasing progesterone into the uterus. Protection is higher than with copper spirals, but menstruation is delayed. When the spiral is removed, menstrual delays become regular.

Does Fibroids cause Menstrual Delay?

Fibroids are benign tumors in the uterus and if the fibroid is located close to the cervix, it can cause a delay in menstruation if it closes the cervix. Because the cervix is closed, bleeding cannot spill out and menstruation is delayed. Menstrual blood that cannot pass through the cervix accumulates in the uterus and causes pain in the lower abdomen.

Does discharge cause menstrual delay?

In women, the discharge during the normal menstrual cycle is transparent, odorless and looks like egg white. If the color and smell of the discharge changes, this can be considered a sign of infection or fungus. Discharges caused by infection also cause delayed menstruation.

Vaginal infections can occur for many reasons. It can be caused by bacterial infections, fungal infections, parasites or sexually transmitted infections. Infections can cause inflammation in the vagina and surrounding tissues, leading to delayed menstruation. If menstruation is delayed with discharge, a doctor should be consulted and appropriate treatment should be taken.

Does the morning-after pill cause menstrual delay?

The morning-after pill is used to prevent pregnancy after unprotected sex. It is not suitable for continuous use and should be drunk as soon as possible after unprotected intercourse. Because they contain high amounts of hormones, morning-after pills cause menstrual delay.

There are varieties containing only progesterone or estrogen and progesterone. Progesterone-only morning-after pills are more effective. The main side effect of these pills is menstrual irregularity. Menstrual delays may occur and these irregularities may last for several months.

Does Menstrual Delay Cause Abdominal Swelling?

Menstrual delay shows symptoms in many organs in the body. Delayed menstruation is accompanied by breast tenderness, headache, weakness, lower back pain and back pain, as well as abdominal swelling. Abdominal swelling due to delayed menstruation can be an important symptom of the underlying cause.

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