Late or missed period

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

Missing a period can bring up so many emotions — worry, relief, confusion. Pregnancy is often the first thought, but there are many other reasons your cycle might be late or stop altogether.

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

What Is a Late Period?

A typical cycle is around 28 days, but anything from 21 to 35 days is normal. A late period is often the first sign of many things, including pregnancy. A period is late if:

• It’s more than 5 days past your expected date

• You miss a full cycle

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

Common Causes of Late or Missed Periods

There are many reasons for menstrual changes, including the role of the hormonal system in regulating cycles. Other symptoms like tender breasts or body hair may accompany menstrual irregularities. Hormone levels are key to diagnosing menstrual issues and there are many reasons for missing periods so evaluation is important. Stress can affect other hormones and impact cycles. Other factors like lifestyle and health conditions can also affect cycles. The timing of your last period is important in determining a late period.

• Pregnancy: the most common reason for a missed period

• Stress: physical or emotional stress can disrupt hormone balance

• Weight changes: significant weight changes can affect ovulation

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

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

• Perimenopause: hormonal changes in your 40s

• Excessive exercise: especially in athletes

• Contraceptive changes: starting, stopping or changing methods

• Chronic medical conditions: like 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 cycles

• Medical condition: long term conditions can cause missing periods

• Health conditions: can disrupt cycles

• Sexually active: you need to consider pregnancy

• Infrequent periods: conditions like breastfeeding can cause them

• Tender breasts: a sign of hormonal changes

Understanding the underlying cause is key to what to do next.

Menstrual Cycle and Age

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

Contraception and Menstrual Cycle

Contraception can have a big impact on your cycle. Hormonal methods of contraception like the pill or IUD are used to regulate cycles and prevent pregnancy. However these methods can also change your period, making it lighter or heavier. See a healthcare provider and monitor any changes in your cycle. If you miss a period while using contraception, take a pregnancy test and see a healthcare provider to determine the cause and manage your reproductive health.

Chronic Conditions and Menstrual Cycle

Chronic conditions like polycystic ovary syndrome (PCOS), thyroid disease and premature ovarian failure can affect the menstrual cycle. Women with these conditions may have irregular periods, heavy periods or absent periods. Managing these conditions with a healthcare provider is key to preventing complications and overall health. Other chronic conditions like diabetes, heart disease and thyroid conditions can also cause changes in the cycle. Monitor your period and see a healthcare provider if you notice any unusual symptoms. A healthcare provider can determine the cause of irregular periods and develop a treatment plan for you, to manage your condition and your reproductive health.

Should You Be Worried About a Missed Period?

It depends on your situation. You should see a healthcare provider if:

• You miss more than one period (and you’re not pregnant) or have missing periods frequently. You need to see a healthcare provider to understand the underlying cause.

• Your periods have become irregular after being regular

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

• You have a known health condition that affects your hormones

• You are under 45 and experiencing early menopause symptoms

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

Other chronic conditions like thyroid disease and Turner syndrome can also affect menstrual health. 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, causing 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.

Early evaluation can give you reassurance and avoid delayed diagnosis of any underlying condition.

How Are Late or Missed Periods Diagnosed?

At Happiher, diagnosis starts with understanding your full health picture. The thyroid, a butterfly-shaped gland at the base of the neck, plays a big role in hormonal regulation which can impact menstrual cycles. In some cases thyroid disease can cause missing periods altogether and requires a full evaluation.

Assessment may include:

• Full 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 finding the cause — not just getting cycles back but supporting your overall health.

Treatment Options for Late or Missed Periods

Treatment depends on the cause and your goals (e.g. symptom management, fertility, hormonal health). Late periods can be due to hormonal imbalances caused by stress, illnesses or medications. You need to understand why late periods happen and see a healthcare provider if your period is late. Irregularities can last a few months especially after stopping hormonal contraception or due to health issues. The time from one period to the next period can vary and minor delays are not a concern. But if your periods stop unexpectedly you need to seek treatment to address the underlying issue.

Options include:

Lifestyle Support

• Stress management techniques: Managing stress is key to hormonal balance. Techniques like mindfulness, meditation and yoga can help reduce stress and overall well-being.

• Nutritional advice and weight support: Proper nutrition is essential for hormonal health. A balanced diet rich in vitamins and minerals can help regulate hormone production. And achieving a healthy weight is important. Inadequate body weight and malnutrition can disrupt hormone production and cause irregular menstrual cycles. So weight gain can play a big role in getting periods back.

• Exercise adjustments: Exercise is good for hormonal health but find a balance. Over-exercising can cause hormonal imbalances while moderate exercise can help with weight and reduce stress.

Hormonal Therapy

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

• 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 like delayed or irregular periods

Fertility Support

At Happiher we tailor every plan to your health needs, priorities and life stage.Understanding the reproductive system and its role in fertility is key as factors like obesity, stress and hormonal imbalances can affect 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 be unsettling especially if pregnancy isn’t the reason. Whether it’s a single missed period or a cycle change, seeking advice can give you clarity and a plan to move forward with confidence. Menstrual periods can stop altogether due to various health conditions like Polycystic Ovary Syndrome (PCOS) or external factors like stress so see a healthcare provider.

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, confidential consultations

• Full hormonal and pelvic health assessments

• Personalised, realistic treatment plans

• 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 making you feel heard and supported. We know the average age of menopause is 51 years old and perimenopause often starts in the 40s or 50s so it’s essential to address any menstrual health concerns early.

Final Thoughts

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

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