Menstrual Period - Missed or Late
- Late Menstrual Period: 5 or more days overdue compared to usual menstrual cycle
- Missed Menstrual Period: no menstrual flow for more than 6 weeks
- The first day of menstrual bleeding is considered the first day of a new menstrual cycle.
- Menstrual bleeding typically lasts 3-7 days.
- Ovulation generally occurs around day 14 of the cycle.
- The length of the menstrual cycle varies from woman to woman. The range is from 24 to 35 days. The average is 28 days.
- Pregnancy is the most important cause. This possibility needs to be considered in any woman who has a missed or late period.
- Dieting, exercise and weight loss
- Polycystic ovarian disease
- Birth control pills
- Depoprovera injection
- Pituitary and other endocrine disorders
Home Urine Pregnancy Tests
- Home urine pregnancy tests are inexpensive, accurate, and easy to use. Most drug stores sell these tests over-the-counter.
- Urine pregnancy tests can often diagnose pregnancy during the week after the first missed period (2 weeks after ovulation).
- Use of a first-morning urine specimen is recommended because the urine HCG concentration is highest in the morning.
- When a home pregnancy test is negative, but there is still a high suspicion of pregnancy, the woman should either repeat the test in 3-5 days or go to her doctor's office for testing.
- The urine pregnancy test can sometimes be falsely negative if the urine specimen is very bloody. A small amount of blood (e.g., blood-tinged urine) should not interfere with the accuracy of the test.
- More information is available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/pregnancy-tests.cfm.
When to call your doctor
Call 911 Now (you may need an ambulance) If
- Passed out (fainted)
- Severe abdominal pain
Call Your Doctor Now (night or day) If
- You feel weak or very sick
- Abdominal pain and you are pregnant
- Abdominal pain and you might be pregnant
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- You are pregnant
- You want a pregnancy test done in the office
- Recent weight loss
- Age greater than 45 years
- Missed 2 or more periods in a row
- Missed period has occurred 2 or more times in the last year
Self Care at Home If
- Missed or late period and you don't think you need to be seen
HOME CARE ADVICE FOR MISSED OR LATE MENSTRUAL PERIOD
- Pregnancy test, when in doubt:
- If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
- Follow the instructions included in the package.
- Stress: Stress can interrupt normal menstrual periods. Try to reduce your stress by talking about it with a friend or family member. Try to avoid or decrease stressors. If this is not effective, seek help from a counselor or talk with your doctor.
- Call Your Doctor If:
- Pregnancy test is positive
- You have difficulties with the home pregnancy test
- New symptoms suggest pregnancy (e.g., morning sickness, breast tenderness/swelling)
- You need help coping with stress
- You become worse
Author: David A. Thompson, M.D.
Last reviewed: 9/15/2011
Last revised: 8/16/2011 8:17:58 AM