Every woman is different — including their periods. Some happen regularly and others are hit or miss and for some it’s unpredictable. On average, a woman get their period every 21 to 35 days and it usually lasts about 2 to 7 days. Is your period irregular — and if so, does it need attention? Many women are worried about a late period, but know you’re not pregnant? Did you know that a delayed or a missed period happen for many reasons other than pregnancy? Common causes can range from normal physiological conditions, stress or obesity, anxiety related issues, lifestyle changes or hormonal imbalances.

However, every woman needs to understand, you may be different: you may have more or fewer and a missed or irregular period must be looked at in terms of what is normal for you, says Manjula Deepak, Senior Consultant Gynecologist, Cloudnine Group of Hospitals, Bengaluru (HRBR). “The causes and treatment differ according to the age group of women and hence it is important to stop a comparison of our conditions.”

The expert explains it in detail:

What causes a delayed period?

Amenorrhea is when menstruation is absent during the reproductive years, between puberty and menopause. It is not a disease, and it does not mean that a person is infertile, but it can be a sign of a health problem that needs some attention. It can occur in healthier women during breastfeeding or may signal other gynecological conditions, like hormonal imbalance, excessive exercising, eating disorders, stress, drug usage, PCOS, endometriosis, fibroids, endocrine disorder like thyroid, pituitary gland, premature ovarian failure.

Amenorrhea usually happens when the ovaries stop making enough of the female hormone. Primary amenorrhea refers to the absence of menstruation in someone who has not had a period by age of 16 years. The most common causes of primary amenorrhea relate to hormone levels, although anatomical problems also can cause amenorrhea. Such conditions are rare and constitutes to less than 0.1 of the individuals. Secondary amenorrhea refers to the absence of three or more periods in a row by someone who has had periods in the past. Pregnancy is the most common cause of secondary amenorrhea, although problems with hormones also can cause secondary amenorrhea.

A range of factors, including those below, can cause an irregular period.

You’re stressed out: If you’re under a lot of stress, your body can stay in fight-or-flight mode, which can make you temporarily stop ovulating. This lack of ovulation, in turn, can delay your period.

Changes in body weight (Increase/ Decrease in weight): Severe changes in body weight can impair with period’s timing. Extreme increases or decreases in body fat can lead to a hormonal imbalance that causes your period to come late or stop entirely.

You have PCOS: Polycystic ovary syndrome (PCOS) is a set of symptoms caused by an imbalance of reproductive hormones. People with PCOS don’t ovulate regularly. As a result, your periods may be lighter than normal, arrive at inconsistent times, or disappear altogether. Besides delayed period you may also notice excess or course facial and body hair, acne on the face and body, thinning hair, weight gain or trouble losing weight, dark patches of skin, often on the neck creases, groin, and underneath breasts, skin tags in the armpits or neck.

You’re in perimenopause: Perimenopause is the time leading up to your menopausal transition. It typically starts in your mid-to late 40s. Perimenopause lasts for several years before your period stops completely. For many, missed periods are the first sign of perimenopause. You may skip a period one month and be back on track for the following three you may skip your period three months in a row and find that it arrives unexpectedly, often lighter or heavier than you’re used to.

You’re in early menopause: Early menopause, also known as premature ovarian failure, happens when your ovaries stop working before you turn 40. When your ovaries aren’t working the way they should, they don’t produce enough hormones. You will begin to experience the symptoms of menopause. Late or missed periods may be an early sign.

Chronic diseases: Chronic diseases such as diabetes, tuberculosis, liver disorders also can affect your menstrual cycle. These are linked to hormonal changes, so even though it’s rare could cause your period to be irregular.

Thyroid issues: An overactive or underactive thyroid gland could also be the cause of late or missed periods. The thyroid regulates your body’s metabolism, so hormone levels can be affected as well. Thyroid issues can usually be treated with medication. After treatment, your period will likely return to normal.

Contraceptives / Birth Control medicines: Medicines such as birth control pills, Intra-Uterine Devices may cause lighter, less frequent, more frequent, or skipped periods or no periods at all UTERINE CAUSES Thickening of endometrium, polyps, uterine fibroids, uterine cancer, Endometrioses, Adenomyosis can also be a cause.

Diagnosis of a Missed/Delayed Period

*A detailed history

*Family History

*Examination of the patient

*Lab Investigations — follicular stimulating hormone, luteinizing hormone, thyroid stimulating hormone, estrogen, Testosterone prolactin, Beta HCG

*Ultrasound

Many things can cause irregular period, from routine lifestyle changes to underlying medical conditions. If your period is regularly late, make an appointment with a gynecologist to determine the cause. Irregular periods aren’t always a sign of a problem, but it is important to understand the underlying causes of delayed /missed periods. It is a myth to state that a delayed period indicates infertility and conception related issues. Timely medical intervention is advisable. A gynecologist will be able to determine the cause of your irregular periods and help you develop the best treatment plan for you.