Reasons for delayed periods other than pregnancy
Last reviewed: 05.12.2024
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Delayed periods not related to pregnancy can be the result of a variety of conditions and diseases in women of childbearing age. Delayed menstruation is the absence of periods for five days after they are supposed to start.
More often than not, the first item in the list of the most probable causes of delayed periods besides pregnancy is hormonal imbalance. They mean violations of hormonal regulation of the menstrual cycle.
Such disorders are caused by improper use of oral hormonal contraceptives that suppress the natural menstrual cycle, especially multiphase contraceptives.
Eating disorders - anorexia nervosa, exhaustion, significant weight loss, as well as excessive physical exertion cause a response in the form of decreased estrogen synthesis in the ovaries - hypoestrogenia. Obesity, on the contrary, is accompanied by hyperestrogenemia, because in addition to the glands of internal secretion (adrenal cortex and sex glands), sex steroids, in particular estrogen, can be synthesized by cells of white adipose tissue.
Because of elevated cortisol levels, prolonged stress can lead to estrogen deficiency.
Non-pregnancy-related delayed menstruation can be caused by the hormone prolactin - in the case of a brain tumor such as prolactinoma of the pituitary gland.
Thyroid hormones - thyroid hormones - are not related to gonadosteroids, but they do help control the menstrual cycle, and delayed periods can occur in women with inadequate thyroid function - hypothyroidism or early stage autoimmune thyroiditis.
Also among the endocrine diseases associated with menstrual irregularities are type 2 diabetes and chronic adrenal insufficiency.
Reasons for delayed periods except pregnancy after 30
In addition to all of the above, non-pregnancy related delayed periods in women after 30 can be due to:
- chronic form of oophoritis - inflammation of the ovaries;
- secondary ovarian hypofunction to neoplasms in the hypothalamus, pituitary gland, or skull base;
- inflammation of the uterine mucosa - endometritis and other uterine inflammatory diseases;
- inflammation of the uterine appendages - acute or chronic adnexitis;
- the presence of adhesions in the uterus - asherman syndrome, which can be a consequence of abortion, cesarean delivery, surgical interventions on the uterus;
- - early menopause in women in their 30s. Why it happens, read here.
Reasons for delayed periods other than pregnancy after 35
In women after age 35, non-pregnancy-related delays in the onset of menstruation tend to occur:
- If there is a polyp in the uterus - fibrotic, cystic or glandular endometrial polyp;
- due to cystic ovarian change, resulting in decreased estrogen production;
- due to incomplete follicular maturation due to multifollicular ovarian structure.
Delayed menstruation can be caused by primary ovarian failure, known as depleted ovarian syndrome, which can be idiopathic or etiologically related to chromosomal or autoimmune diseases, as well as chemotherapy and radiotherapy. The syndrome is manifested by the ovaries ceasing to function normally in women younger than 40 years of age. Sometimes primary ovarian failure is mistaken for premature menopause, but in the case of early menopause menstruation stops, while in this syndrome there are delays and irregularity of the menstrual cycle - with the possibility of pregnancy.
Reasons for delayed periods except pregnancy after 40
To all the named etiologic factors for women in this age category must be added:
- - glandular cystic hyperplasia of the endometrium;
- - polycystic ovarian syndrome;
- Hormone-producing (estrogen-secreting) ovarian tumors (granulosa cell tumor and thecoma).
Quite often the cause lies in the onset of early menopause in women, which is preceded by a transitional period known as perimenopause, at which time delayed periods begin.
Read also: Causes of menopausal conditions: uterine bleeding, discharge and ointment, hot flashes
Thus delayed menses except pregnancy is a violation of the menstrual cycle, and to identify its cause and avoid consequences, you should consult a gynecologist in time.