When you miss a period, your first instinct might be to take a pregnancy test. But maybe you already took a test once, twice, three times even–and it keeps coming back negative. What else could be going on? Why aren’t you getting your period?
A regular period is an important signal of health in the female body. In the menstrual cycle, the lining of the uterus thickens to prepare for pregnancy. If you do not become pregnant during your cycle, the thickened uterine lining sheds, releasing blood, mucus, and tissue through the vaginal opening. While cycles vary, the average menstrual cycle lasts 28 days. If your periods are irregular, it’s important to find out why.
While there are many reasons for a missed period besides pregnancy, let’s look at some of the most common reasons recognized by the medical community.
Trigger Warning: Eating disorders are discussed in this article.
1. Stress
Stress can affect the human body in many harmful ways, even causing hormonal changes that can cause your period to stop. Life is not always easy, and you will face some seasons that are more stressful than others. You might not think you’re that stressed out, but if you’ve stopped having a period, your body might be telling you otherwise. Do not ignore this signal! If you have been under a lot of pressure lately, this may be one way your body is letting you know. Talk with someone who will listen to you and can help you to find the support you need.
2. Birth Control
Birth control methods such as the pill, shot, patch, etc. utilize artificial hormones that cause your body to think it is pregnant. This can cause your periods to become lighter or to stop altogether. You need to contact your physician if you suspect this might be the cause.
The use of emergency contraception (such as Plan B) can also disrupt the regularity of your periods. Emergency contraception uses synthetic hormones to prevent pregnancy. These hormones are found in birth control pills as well, but emergency contraceptives contain a higher dose that can alter your body’s natural hormone levels. The extra hormones can, in turn, affect your menstrual cycle, leading to an earlier or delayed period as well as heavier or lighter bleeding. Often women will take multiple doses of Emergency Contraceptives “to be safe” without realizing that this is disrupting their cycles.
It is important to know that taking emergency contraceptives can also affect your ovulation cycle, making your fertile window (the time of the month you can get pregnant) difficult to identify.
3. An Early Pregnancy
A pregnancy test measures hCG hormones present in your urine. These hormones are present with a pregnancy, but it takes a few weeks for hCG levels to rise enough to be detected with a test. You may just be too early in the pregnancy for your hormone levels to rise high enough to be detected. For this reason, if pregnancy is suspected, it is essential to avoid alcohol or drug use, as well as other high-risk behaviors that could harm a pregnancy.
Some pregnancy tests can detect hCG within the first few weeks after conception. The test may read positive before the first signs of pregnancy develop in some women. It is important to be aware of the following regarding positive pregnancy test readings:
- The presence of hCG alone does not mean that you are really pregnant, or that you have a pregnancy that will continue naturally.
- In addition to a positive pregnancy test, confirmation of pregnancy requires visualization of a gestational sac within the uterus, visualization of a fetus within the gestational sac, and presence of a fetal heartbeat.
- Pregnancy can typically be confirmed via ultrasound by about six weeks gestation, or six weeks after the first day of your last period. It is common before six weeks to see some but not all of the three indicators used to confirm pregnancy. It is not cause for alarm, it may just be too early to visualize. A repeat ultrasound scan is recommended in 1-2 weeks to be able to confirm the pregnancy. Contact Clearway if interested in a pregnancy confirmation appointment.
4. Eating Disorders: Extreme Dieting, Anorexia, Bulimia
According to the National Institute of Mental Health, “There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.”
Eating disorders are very dangerous and can affect the body in many negative ways. For various reasons, these practices can lead to losing your period. Your period may stop to conserve bodily fluids, because of an abnormal change in your hormones, or it may even stop ovulating as a defense mechanism to prevent a pregnancy that your body would have difficulty supporting.
If you are struggling with an eating disorder, you are not alone. Seek help from a medical and/or mental health professional. If you would like help from a spiritual angle, seek help from a local pastor or priest.
If you need recommendations for local counseling services and/or church support, reach out to a Clearway advocate for a resource appointment.
5. Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a disorder of the endocrine system affecting women of reproductive age where small fluid-filled sacs develop on the ovaries. This hormonal imbalance can affect a person’s overall health and appearance, in addition to causing cysts on the ovaries. Among other symptoms such as weight gain, acne, thinning hair, and difficulty getting pregnant, PCOS can also lead to irregular periods of a loss of periods entirely. Early diagnosis can help reduce the risk of long-term complications.
6. Breastfeeding
It is common for menstruation to cease while breastfeeding. While everyone’s body is different, research shows that the majority of people who are fully breastfeeding their babies will be free of menstrual periods for 3-6 months or longer. Known as lactational amenorrhea, frequent nursing inhibits the release of hormones that cause your body’s monthly preparations for a new pregnancy. It is important to note that pregnancies can still occur while breastfeeding, so precautions should be taken to avoid pregnancy during this time.
Understanding Your Body
You could call your menstrual period “the sixth vital sign”–that’s how important it is! If it’s missing, don’t ignore it. Cultivate a healthy lifestyle, including regular exercise, healthy meals, and sufficient rest. Seek medical advice from your provider if you continue to experience irregular periods.
Remember, you can still get pregnant even if you are not having a period or have an abnormal cycle! As mentioned earlier, one possible reason for a missed period and negative pregnancy test is a very early pregnancy.
Miscarriage (Spontaneous Abortion)
The loss of a baby (or fetus or embryo) less than halfway (20 weeks) through a full-term pregnancy. Miscarriage is very common, especially in the first trimester.
The main symptoms of miscarriage include vaginal bleeding or spotting, with or without abdominal pain or cramping. Sometimes there are no obvious signs at all. Lack or loss of pregnancy symptoms can also sometimes be a sign of miscarriage, but like pain and bleeding, that doesn’t necessarily mean there is a problem. If you think you are having a miscarriage, seek immediate attention from a medical provider.
A miscarriage may be diagnosed via a pelvic exam, an ultrasound exam or blood test.
Even though miscarriage is so common, it is rare for a doctor to be able to discover the cause. It’s important to know that your miscarriage is very unlikely to have happened because of anything you did or didn’t do. It can be known with certainty in only a few patients, those with:
- A fetus with abnormalities that prevent it from surviving
- Certain infection or immune system abnormalities
- Abnormalities of shape or function of the female organs
Unfortunately, if you are having a miscarriage, there is no emergency care that will save your pregnancy. The usual treatment is to wait for the natural emptying of the uterus. If bleeding or pain is extreme or prolonged, seek immediate medical attention. If some of the pregnancy tissue remains in the uterus after a miscarriage, your doctor may refer you to a specialist to perform a dilation and curettage procedure (D&C).
If this is your first pregnancy contact your doctor to determine your Rh factor. If you are Rhesus (Rh) negative, you will be given an injection of Rhogam which will prevent Rh problems in any future pregnancies.
Grief after pregnancy loss is normal, and you deserve a safe place to grieve. If you have recently experienced pregnancy loss, consider attending one of our monthly Pregnancy Loss Grief Support Groups. Contact clearpast@clearwayclinic.com to learn more.
Clearway is Here for You
A missed period with a negative pregnancy test can be unsettling, but it’s important to remember that many factors can influence your menstrual cycle. By understanding these potential causes, you can take proactive steps to address any underlying issues and maintain your reproductive health.
If in doubt, always consult with a healthcare professional to ensure you receive the best care possible. If you’ve missed more than one period and are not pregnant, it’s a good idea to seek care from a healthcare provider. They can help determine the underlying cause and recommend appropriate treatment. Early diagnosis and intervention can help manage any potential health issues effectively.
If you think you might be pregnant, you can come to Clearway for a free pregnancy test. If you are pregnant, we also provide confirmation ultrasounds and options information. Schedule your appointment today.
Reviewed by Deana G., BSN RN
This information is to educate you on the possible causes of amenorrhea (lack of menstrual period). It is not a substitute for medical advice.Please contact your doctor for more information.
