Shark week. Aunt Flo’s in town. Red Moon rising. Whatever name you might give it, menstruation makes having a vagina *all the more enjoyable.* However, there are some months when your period fails to show up altogether, and even though we don’t miss the cramping, fatigue, mood swings, and weird food cravings, the absence of our period is worrisome.
We’re used to our period coming like clockwork every month…except when it doesn’t. If you know you’re not pregnant, there are probably a million questions running through your head. You can’t help but ask yourself what’s normal in the realms of periods and which abnormalities require more investigation. Don’t worry, we got you. HelloGiggles spoke with Dr. Alyssa Dweck, OB-GYN, women’s health expert, and author of the upcoming book The Complete A to Z of the V, who shares her knowledge with us about why Aunt Flo might be late — or canceling her visit altogether.
Here are seven reasons why you aren’t getting your period, besides being pregnant, of course.
1You have PCOS
“Polycystic Ovarian Syndrome, or PCOS, results from a hormone imbalance due to infrequent or total lack of ovulation,” Dr. Dweck tells HG. “Typically, testosterone levels are elevated. Symptoms might include irregular or absent menses, difficulty with weight control, hair growth in typically male places (chin, chest or mustache for example) acne and insulin resistance.”
Between 5 and 10 percent of women who are in their childbearing years suffer from PCOS, which equals about 5 million people. Unfortunately, PCOS is the most common cause of infertility. Although many women go undiagnosed, PCOS is certainly treatable and you don’t have to suffer through it alone. Reach out to your doctor immediately if you feel like you might have PCOS.
2You have thyroid irregularities
Your thyroid regulates metabolism and can heavily influence whether or not you get your period. “An underactive or overactive thyroid gland might result in altered menstrual habits, including amenorrhea,” says Dweck. Amenorrhea is a fancy science word for an absence of your period.
It’s estimated that 59 million Americans suffer from thyroid irregularities — and many of them don’t even know it. Some additional signs of having thyroid issues is pain or tenderness in your neck, a lump in your throat when you swallow, and enlargement of the thyroid gland itself, which is a butter-fly shaped gland at the base of your neck.
3Your body mass index (BMI) is really low
A low body mass index, or BMI, can be a result of excessive exercise (we don’t mean light jogging here). BMIs below the 18-19 percent range result in amenorrhea, which, again, is a fancy pants way of saying your period doesn’t show. Dr. Dweck says not to fret, though, because “gaining a few pounds to increase BMI will typically result in the return of your flow.”
Speak to your doctor if you feel like you need to figure out whether your BMI is too low for your body and your overall health.
4You’re feeling under the weather
A minor cold won’t throw your period out of whack, but a gnarly stomach virus or the flu can. Don’t be surprised if your period doesn’t come knocking on your door when you’re in the middle of a stomach bug so severe that you have to cancel work and social plans, including that super cute Tinder date.
Your period should get back on track once you start feeling better again, but if it doesn’t, go see your doc.
5Your sleep schedule has recently changed
Disruption of your circadian rhythm, which can arise from traveling across time zones, for example, takes its toll on your hormones. In that same vein, night shift workers are more likely to report menstrual irregularity when compared to their daytime counterparts since their body has had to adjust to a completely different schedule. After all, we’re meant to be awake during the day.
Speak to your doctor if your period keeps failing to show up consistently, and you might be able to drum up a new sleeping schedule that will help your menstruation flow in once again.
6You’re way too stressed out
Ah, yes…stress, AKA the silent killer, and in this case, the period ruin-er. “A significant life stress, such as a sudden loss or going off to college for example, might cause hormonal havoc…losing your period can result,” Dr. Dweck tells HG.
Stress affects the hypothalamus which *then* affects the pituitary gland which *then* effects the thyroid, adrenal glands, and ovaries. All these parts combined help regulate hormones — and off kilter hormones means off kilter periods. If this sounds familiar, you might want to consider taking a step back and reevaluating whether you should make any major changes to your lifestyle.
7You’re taking medication
A variety of medications can influence your monthly. According to Dr. Dweck, “Select medications that act on the brain might influence menstrual habits and even cause a temporary loss of flow.” Anti-depressants, for example, can increase levels of a hormone that prevents ovulation and the your cycle. Even switching birth control can change things up.
This is definitely something you should talk to your doctor about. Never stop or start taking medications on your own just because you feel like your period is being affected. It’s best to speak to a a medical professional before making any big decisions like that.
As you can see, there are plenty of reasons why your period might not make an appearance. As Dr. Dweck puts it, “If the stars aren’t aligned, periods go awry.”
One missed period is nothing to worry about, but if it becomes a prolonged issue, make sure you follow up with your primary care provider or gynecologist. There are a variety of tests and blood work that can determine what might be ailing you. Be smart and take charge of your health!