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Menstrual Period - Missed or Late

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Definition

  • Late or missed menstrual period
  • Late period: 5 or more days late compared to normal menstrual cycle
  • Missed period: no menstrual flow for more than 6 weeks
  • Teen not using any birth control that stops periods. These products include birth control shots, implants, and IUDs with hormones.

Normal Cause of a Missed Period during the First Year

  • Skipping periods is common during the first 1 to 2 years after they start. This is due to not releasing an egg each month.
  • This is most likely the cause if less than 2 years since the first period
  • Has missed periods in the past or has had only 1 or 2 periods
  • Otherwise healthy
  • No signs of pregnancy such as breast tenderness, breast swelling or nausea

Common Cause of a Missed Period after the First Year

  • Pregnancy is the most common cause

Other Causes

  • Stress
  • Dieting, extreme exercise and weight loss
  • Polycystic ovarian disease
  • Endocrine disorders
  • Birth control products like birth control shots, implants, and some IUDs

Home Urine Pregnancy Tests

  • Home urine pregnancy tests do not cost very much. They are easy to use. Most drugstores sell these tests. No prescription is needed.
  • Urine pregnancy tests are very accurate. They can turn positive as early as the first week after a missed period.
  • It is best to do the pregnancy test first thing in the morning. Reason: hormone levels are higher in the morning urine.
  • Sometimes, a home test is negative even if you think you might be pregnant. In this case, repeat the test. Do the repeat test in 3-5 days. You can also go to a doctor's office for testing.
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When To Call

Call Doctor or Seek Care Now

  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Contact Doctor During Office Hours

  • Home pregnancy test is positive
  • You want a pregnancy test done in the office
  • Sexual intercourse (had sex) within the last 3 months
  • Recent breast swelling, weight gain or nausea
  • Teen acts sick
  • Has missed 2 or more periods and prior periods were regular
  • Recent weight loss
  • Excessive exercise suspected as cause of no periods
  • First period started less than 1 year ago and has missed 4 or more periods
  • Age 15 or older and periods have not started
  • Cause is unknown (not recent onset of menstrual periods or recent stress)
  • You think your teen needs to be seen, but the problem is not urgent
  • You have other questions or concerns

Self Care at Home

  • Pregnancy Suspected or Possible
  • First period started less than 1 year ago and has missed 3 periods or less
  • Recent stress (such as starting at a new school, break-up) causing late period
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Care Advice

Pregnancy Suspected or Possible

What You Should Know About Late Periods if Having Sex:

  • Menstrual periods stop when a woman becomes pregnant.
  • A woman with a missed or late period should think about pregnancy.
  • Here is some care advice that should help.

Pregnancy Test, When in Doubt:

  • If there is a chance that you might be pregnant, use a urine pregnancy test.
  • You can buy a pregnancy test at any drugstore.
  • It works best first thing in the morning.
  • Follow all package instructions.

Call Your Doctor If:

  • You have trouble with the home pregnancy test
  • Pregnancy test is positive
  • Misses 2 periods and pregnancy test is negative
  • Your teen develops any serious symptoms

First Period Started Less than 1 Year Ago

What You Should Know About First Periods in Young Teens:

  • Skipping periods is common during the first 1 or 2 years after they start.
  • It doesn't mean anything serious or cause any harm.
  • A girl can normally go up to 6 months between the first and second periods.
  • Also, a girl can go up to 4 months between the second and third periods.
  • Normal irregular periods can go on for 2 years.

Call Your Doctor If:

  • Misses 4 periods
  • New symptoms suggest pregnancy (such as morning sickness)
  • You have other questions

Recent Stress Causing Late Period

What You Should Know about Stress and Late Menstrual Periods:

  • Stress can disrupt normal menstrual cycles.
  • Try to help your daughter deal with the stress by talking about it.
  • Also, try to avoid or decrease stressors.
  • If this does not help, seek help from a counselor.

Call Your Doctor If:

  • Misses 2 periods
  • Your daughter needs help coping with stress
  • New symptoms suggest pregnancy (such as morning sickness)
  • You have other questions

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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