Nobody loves having periods, but when *that* time of the month doesn’t come, it can be quite worrying.
You may not know this, but not everyone has a menstrual cycle that functions like clockwork.
While some girls have the privilege of being able to accurately predict when their next period is going to come due to their extremely regular cycles, many of us actually experience some variation in our menstrual cycles.
These variations are usually a difference of a few days, with the average length of a menstrual cycle ranging from 28-35 days.
A delayed menstrual cycle occurs when your menstrual period deranges from this average duration of 28-35 days. While some people do have longer menstrual cycles of up to 45 days, any cycle that is delayed or out of the norm should be checked out by your doctor.
What causes a delayed menstrual cycle?
Causes for a delayed menstrual cycle will depend on 2 main things:
1. Your age
2. Whether you’re sexually active or not
The most important cause of a delayed menstrual cycle that cannot be missed is pregnancy.
If you are of a reproductive age group (after puberty and before menopause) and sexually active, the first thing to do with a delayed menstrual period is to do a urine pregnancy test.
Girls at the ‘extremes’ of their reproductive age also may tend to experience a delayed menstrual cycle.
What do we mean by this?
Adolescent girls who recently underwent puberty or are within the first few years of getting their first period may also experience some delays in their monthly menstrual period.
On the other end of the spectrum, older women in their late 40s or early 50s may also experience delayed menstrual cycles as they approach menopause.
Several other factors can also contribute to a delayed menstrual cycle:
– Weight gain or loss
– Over exercise
What does a doctor do for someone with a delayed menstrual cycle?
If you experience any delays, irregularity or changes in your menstrual cycle, you should see a doctor to get it checked out.
The first thing your doctor will do is to take a detailed history of your condition, which may include personal questions such as your sexual history.
It is also important for the doctor to have an idea on your usual menstrual patterns as well as your general lifestyle.
Next, a physical examination on the abdomen and vaginal area is carried out to look for any clues for the cause of your delayed menstrual period. The doctor will also look for signs such as excessive hair growth, acne or obesity.
After taking the history and performing the physical examination, your doctor may then order some investigations to find out what is causing your delayed menstrual period.
What type of investigations are required?
As mentioned, the most important thing to rule out with a delayed menstrual cycle is pregnancy.
Once a pregnancy is ruled out, other types of tests can then be conducted to further investigate the cause of the delayed menstrual period.
One of the tests that may be done is a hormonal blood test. This will ascertain if there are any hormonal abnormalities resulting in the abnormal menstrual period.
An ultrasound may also be arranged to look for any abnormalities.
It is also important for all women to have an up-to-date PAP smear.
What should I do for my delayed menses?
The first thing you should do if you experience delayed menses is to seek a doctor’s opinion as early as possible.
Also, as mentioned above, doing a urine pregnancy test is one of the basic steps that you can do on your own as well.
If you are pregnant, then your doctor will refer you to a gynaecologist or a hospital for further testing.
If you are not pregnant, then further tests will be conducted to determine the causes of the delayed cycle.
After which you may be prescribed with some medications to help.
Dr Michelle Chia is the resident doctor at DTAP Clinic Bencoolen, specialising in women’s health. She has extensive experience in managing a variety of women’s health, general gynaecology issues and antenatal care for pregnancy.