Late or missed period

Late or Missed Periods: What They Mean and When to Seek Help

Missing a period can bring up a whole range of emotions — from worry to relief to confusion. While pregnancy is often the first thought, there are many other reasons your cycle might be delayed or stop altogether.

If your period is late or missing, and it’s causing you concern, it’s important to know you’re not alone — and that expert, compassionate advice is available. As a private gynaecologist in London, I help women navigate menstrual changes with clear information and tailored care.

When Is a Late Period Considered Late?

A typical menstrual cycle is around 28 days, but anything from 21 to 35 days can be normal. A late period is often the first sign of various conditions, including pregnancy. A period is generally considered late if:

• It hasn’t started more than five days after your expected date

• You miss a full cycle altogether

Occasional variations happen, especially with stress, illness, or travel. But persistent delays or missed periods deserve attention.

Common Causes of Late or Missed Periods

There are many potential reasons for menstrual changes, including the role of the hormonal system in regulating cycles. Other symptoms, such as tender breasts or body hair, may accompany menstrual irregularities. Hormone levels are crucial in diagnosing menstrual issues, and there are many reasons for missed periods, emphasizing the need for evaluation. Stress can affect other hormones, impacting menstrual cycles. Other factors, such as lifestyle and health conditions, can also influence menstrual cycles. The timing of the last period is relevant in determining a late period.

• Pregnancy: the most common reason for a missed period

• Stress: physical or emotional stress can disrupt hormonal balance

• Weight changes: significant changes in body weight can affect ovulation

• Polycystic Ovary Syndrome (PCOS): a common hormonal condition causing hormonal imbalance and symptoms like body hair

• Thyroid disorders: overactive or underactive thyroid gland and thyroid hormones can impact cycles

• Perimenopause: hormonal changes can cause irregularity in your 40s

• Excessive exercise: particularly among athletes

• Contraceptive changes: starting, stopping, or switching methods

• Chronic medical conditions: such as diabetes or coeliac disease

• Medications: certain psychiatric or chemotherapy medications

• Premature ovarian insufficiency: early menopause or premature menopause before age 40

• Chronic diseases: can affect menstrual cycles

• Medical condition: long-term conditions can lead to missed periods

• Health conditions: can disrupt menstrual cycles

• Sexually active: important to consider pregnancy

• Infrequent periods: conditions like breastfeeding can cause them

• Tender breasts: a symptom of hormonal changes

Understanding the underlying cause is key to choosing the right next steps.

Menstrual Cycle and Age

A woman’s menstrual cycle can change significantly throughout her life. During puberty, it’s common for menstrual cycles to be irregular as the body adjusts to new hormonal patterns. It may take some time for the cycle to become regular. As women approach menopause, typically in their late 40s to early 50s, cycles may become less frequent and more irregular, accompanied by symptoms like hot flashes and night sweats. Women with polycystic ovary syndrome (PCOS) may experience irregular periods throughout their reproductive years. It’s essential to be aware of these changes and consult a healthcare provider if you notice unusual symptoms such as heavy periods, light periods, or absent periods. Managing these changes with professional guidance can help maintain overall health and well-being.

Contraception and Menstrual Cycle

Contraception can have a significant impact on your menstrual cycle. Hormonal birth control methods, such as the contraceptive pill or an intrauterine device (IUD), are often used to regulate menstrual cycles and reduce the risk of pregnancy. However, these methods can also cause changes in your period, such as making it lighter or heavier. It’s important to discuss your contraceptive options with a healthcare provider and monitor any changes in your menstrual cycle. If you experience a late or missed period while using contraception, taking a pregnancy test and consulting your healthcare provider is crucial to determine the cause and ensure your reproductive health is managed effectively.

Chronic Conditions and Menstrual Cycle

Chronic conditions like polycystic ovary syndrome (PCOS), thyroid disease, and premature ovarian failure can significantly affect the menstrual cycle. Women with these conditions may experience irregular periods, heavy periods, or absent periods. Managing these conditions with the help of a healthcare provider is essential to prevent complications and maintain overall health. Additionally, chronic conditions such as diabetes, heart disease, and thyroid conditions can also lead to changes in the menstrual cycle. Monitoring your period and consulting a healthcare provider if you notice any unusual symptoms is crucial. A healthcare provider can help determine the cause of irregular periods and develop a treatment plan tailored to your needs, ensuring you manage your condition effectively and maintain your reproductive health.

Should You Be Concerned About a Missed Period?

It depends on your situation. You should seek advice if:

• You miss more than one period (and you’re not pregnant) or experience missing periods frequently. It's important to seek medical advice to understand the underlying causes.

• Your periods have become irregular after being regular

• You experience additional symptoms (pelvic pain, unusual discharge, hot flushes)

• You have a known health condition affecting your hormones

• You are under 45 and experiencing signs of early menopause

• You are trying to conceive and notice changes in your cycle

Other chronic conditions, such as thyroid disease and Turner syndrome, can also affect menstrual health. Additionally, the body's ability to maintain regular cycles can be influenced by factors like stress, weight changes, and hormonal disruptions.

• Primary ovarian insufficiency (POI) is a condition where the ovaries stop functioning normally before the age of 40, leading to irregular periods and fertility issues. The causes of POI are not well understood, but it is linked to the functionality of ovarian follicles, where egg maturation occurs.

Prompt evaluation can provide reassurance and avoid delayed diagnosis of any underlying condition.

How Are Late or Missed Periods Diagnosed?

At Happiher, diagnosis begins with understanding your full health picture. The thyroid, a butterfly-shaped gland located at the base of the neck, plays a crucial role in hormonal regulation, which can significantly impact menstrual cycles. In some cases, thyroid disease can cause missed periods altogether, necessitating a thorough evaluation.

Assessment may include:

• Detailed cycle and symptom review

• Pregnancy test

• Blood tests for hormone balance (FSH, LH, oestrogen, prolactin, thyroid function)

• Pelvic ultrasound to assess the uterus and ovaries

• MRI scan in rare cases if a pituitary or ovarian issue is suspected

We focus on identifying the cause — not just restoring cycles but supporting your overall health.

Treatment Options for Late or Missed Periods

Treatment is entirely dependent on the cause and your personal goals (e.g., symptom management, restoring fertility, supporting hormonal health). Late periods can result from hormonal imbalances due to factors like stress, illnesses, or medications. It's important to understand why late periods happen and seek medical advice if your period is delayed. Irregularities can last a few months, especially after ceasing hormonal contraceptive methods or due to health issues. The timeline from one period to the next period can vary, and minor delays are usually not concerning. However, if your periods stop unexpectedly, it's crucial to seek treatment to address any underlying issues.

Options include:

Lifestyle Support

• Stress management strategies: Managing stress is crucial for maintaining hormonal balance. Techniques such as mindfulness, meditation, and yoga can help reduce stress levels and support overall well-being.

• Nutritional advice and healthy weight support: Proper nutrition is essential for hormonal health. A balanced diet rich in vitamins and minerals can help regulate hormone production. Additionally, achieving a healthy weight is important. Inadequate body weight and malnutrition can disrupt hormone production, leading to irregular menstrual cycles. Therefore, weight gain can play a significant role in restoring regular menstrual periods.

• Adjustments to exercise routines: Regular exercise is beneficial for hormonal health, but it's important to find a balance. Over-exercising can lead to hormonal imbalances, while moderate exercise can help maintain a healthy weight and reduce stress.

Hormonal Therapy

The hormonal system, particularly the hypothalamic-pituitary-ovarian (HPO) axis, plays a crucial role in regulating menstrual cycles, especially in young individuals. It often takes years for this system to mature, resulting in initial irregularities in menstruation for preteens and teens.

• Regulation of cycles with the combined pill, progestogen therapy, or hormonal IUS

• Thyroid or other hormonal treatments if a hormonal imbalance is found, which can cause symptoms such as delayed or irregular periods

Fertility Support

At Happiher, we tailor every plan around your health needs, priorities, and life stage.

Understanding the reproductive system and its role in fertility is crucial, as factors like obesity, stress, and hormonal imbalances can adversely impact menstrual cycles and overall reproductive health.

• Ovulation induction if you’re trying to conceive

• Specialist fertility advice if needed

Living with Irregular Cycles

Missing a period can create uncertainty, particularly if pregnancy isn’t the reason. Whether it’s a single missed period or an ongoing cycle change, seeking advice can give you clarity and a plan to move forward with confidence. Menstrual periods may stop altogether due to various health conditions like Polycystic Ovary Syndrome (PCOS) or external factors such as stress, so consulting a healthcare professional is advisable.

You deserve to feel in tune with your body — not confused by it.

Why Choose Happiher for Menstrual Care?

If you’re looking for expert advice about late or missed periods in London, Happiher offers:

• Private, compassionate consultations

• Comprehensive hormonal and pelvic health evaluations

• Personalised, realistic treatment planning

• A focus on fertility preservation if appropriate

• Locations across London: Chelsea & Westminster, The Lister, and The Wellington Hospital

Our approach is empathetic, evidence-based, and entirely focused on helping you feel heard and supported. We understand that the average age of menopause is 51 years old, and perimenopause often begins in the 40s or 50s, making it crucial to address any menstrual health concerns promptly.

Final Thoughts

A late or missed period isn’t something to panic about — but it’s also not something you should ignore if it keeps happening. Whether you’re worried, curious, or just seeking answers, expert support is close at hand.

At Happiher, we’re here to help you understand what’s happening and take control of your menstrual health — with clarity, compassion, and clinical excellence.