Your period is late, but the test is negative: what to do?

Every girl or woman may experience menstrual irregularities.

At some point in her life, cycle disturbances probably occurred in every woman. Irregular periods, which many women are accustomed to considering as something ordinary, are actually a signal of problems with women’s health.

What is NMC in gynecology? This is a disrupted menstrual cycle that happens to women at different periods of their lives.

Irregular menstruation - delays or a shorter cycle, indicate disturbances in the physical or mental state of the woman. The monthly cycle is a kind of biological clock of the body. A disruption in their rhythm should alert you and cause you to consult a doctor so that diseases can be identified in a timely manner. Below we will talk about why the menstrual cycle fails and what a woman should do in such a situation.

A little about menstruation and the menstrual cycle

The first menstruation or menarche occurs in girls around 12–14 years old, and the further south the child lives, the earlier her periods begin. Menstruation ends around 45–55 years of age (this period is called premenopausal).

Menstruation is the shedding or desquamation of the functional layer of the uterine lining in response to decreased progesterone production. This is why gynecologists like to repeat that menstruation is the bloody tears of the uterus due to an unfulfilled pregnancy. To understand this definition, it is worth remembering the physiology of the menstrual cycle. As you know, a woman’s monthly cycle is divided into 3 phases:

• In the first, follicular phase, estrogens are produced, the action of which causes the maturation of follicles. From these follicles the main or dominant follicle is released, from which a mature egg is subsequently released.
• The second phase is the shortest (about a day), it is during this period that the main follicle ruptures, and the mature egg is released “free”, ready to meet the “live animals” and fertilize.
• In the third phase, the luteal phase, the synthesis of progesterone by the corpus luteum, which arose at the site of the ruptured follicle, begins. It is progesterone that prepares the endometrium for implantation of a fertilized egg. If conception does not occur, the corpus luteum slowly “dies” (regresses), progesterone production drops and endometrial rejection begins, that is, menstruation.

Then estrogen production gains strength again and the cycle repeats.

From all that has been said, it becomes clear that the menstrual cycle is called cyclic changes that occur in the body after a strictly defined time.

Causes of menstrual irregularities

The main reason for the disruption of the menstrual cycle is hormonal imbalance. This happens in various diseases and conditions. The hereditary factor also plays an important role - if ancestors on the female line had disruptions in the cycle or other disorders, it is quite possible that this will affect the nature of menstruation in women in subsequent generations.

Lack of sleep, stress, excessive physical activity, psychological fatigue, change in time zone or climatic conditions can lead to irregular periods. It is not uncommon to experience menstrual problems in those who regularly stay awake at night. Brain tumors and neuroviral infections can also lead to menstrual irregularities.

Disturbed hormonal cycles are also observed in many diseases. Most often this happens against the background of pathologies of the endocrine and genitourinary systems, such as:

• genetic and hormonal pathologies of the ovaries;
• inflammation of the uterus and appendages;
• infectious lesions of the pelvic organs;
• diabetes;
• diseases of the thyroid gland, adrenal glands;
• obesity, etc.

Functional disorders of the endocrine system, manifested in the accumulation of estrogen with a simultaneous deficiency of progesterone, also cause menstrual irregularities. The cycle can be disrupted due to any infectious and non-infectious diseases, acute or chronic.

How can a gynecologist help?

Heavy and prolonged bleeding with clots can signal endometrial hyperplasia, which occurs mainly in women over 45 years of age, as well as diseases that occur in women of childbearing age.

It happens that menopause occurs prematurely, even before the age of 40. The cause may be damage to the ovaries during abdominal surgery, thyroid disease, diabetes, as well as an abnormal reaction of the immune system, which itself destroys ovarian cells by producing antibodies against them.

The doctor will find out the cause of the disorders and prescribe treatment that eliminates the pathology. For women in menopause, hormone replacement therapy (HRT) is indicated to reduce the severity of unpleasant symptoms. She is also selected and prescribed by a gynecologist.

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Any woman can experience menstrual irregularities

Failures can be associated not only with diseases of the pelvic organs, but also with disorders in the endocrine, nervous, and immune systems. It should also be remembered that sometimes they signal the development of certain infectious diseases or pathological conditions:

• ectopic pregnancy;
• neoplasms in internal organs;
• malignant or benign neoplasm in the uterus or on its surface;
• STD;
• tuberculosis.

Some girls believe that tampons also provoke changes in the cyclicity of menstruation, but this opinion is incorrect. They are the same means of hygiene during menstruation as pads and menstrual cups.

Why are constant delays in menstruation dangerous?

Constant delays in menstruation indicate hormonal disorders, lack of ovulation, and abnormal changes in the structure of the endometrium. Pathology can arise due to serious, even dangerous diseases: tumors of the uterus, endocrine glands, polycystic ovaries. The cause of a missed period is an ectopic pregnancy.

It is necessary to establish a diagnosis as early as possible, to find out the degree of danger of the processes, since they lead, at a minimum, to infertility and early menopause. Diseases associated with delayed menstruation cause breast tumors, cardiovascular problems, diabetes, weakened immunity, premature aging, and changes in appearance. For example, if the delay occurs due to polycystic ovary syndrome, then the woman experiences a sharp increase in weight, up to obesity, hair appears on the face and chest (as in men), acne, and seborrhea.

Timely treatment of diseases that cause prolongation of the cycle often helps to avoid infertility, ectopic pregnancy, miscarriage, and prevent the appearance of cancer.

What is considered a menstrual disorder?

• Delay of menstruation by more than 10 days.
• Shortening the cycle by 5-7 days.
• Increase or decrease in the volume of menstrual flow.
• Accompanying menstruation with deterioration of well-being and/or severe pain.
• Discharge of blood outside of menstruation (minor bleeding during ovulation is part of the norm).
• Complete cessation of menstruation before menopause.
• Uterine bleeding during menopause.

In order for a change in a cycle to be called a violation, it must be repeated over several cycles. Situational, that is, single changes (increasing or shortening the cycle by 5-7 days) are not violations and are considered a type of norm.

What to do if your period is late?

If you experience regularly recurring delays in menstruation or the period of delay exceeds the maximum permissible physiological limits of five days, you should consult a doctor. After determining the reasons, the woman will be prescribed appropriate treatment. Most often, therapy is carried out using hormonal pills. However, under no circumstances should they be taken independently, without medical advice. This is extremely dangerous for a woman’s health and can disrupt the entire hormonal system, which means it can lead to serious health problems.

Among the most common hormonal drugs, doctors prescribe the following:

1. Duphaston. Used if a delay in the menstrual cycle is caused by insufficient levels of progesterone in the body. Only a doctor should adjust the dose based on the research conducted. If there is no pregnancy and the delay does not exceed 7 days, then postinor is prescribed for a period of 5 days. After this time, menstruation should begin two or three days later.
2. Postinor. It is a drug used for emergency contraception. This remedy is used if it is necessary to induce a menstrual cycle as quickly as possible. However, it is recommended only for regular menstruation, since its use can provoke cycle disorders, and if used very frequently, lead to infertility.
3. Pulsatilla. Another hormonal drug that can be prescribed for delayed menstruation. This is the safest remedy that does not lead to weight gain and does not affect the nervous system. However, it should not be taken by girls with irregular cycles.
4. Progesterone is an injectable hormone. Used to induce menstruation, dosage selection is carried out strictly individually. An increased intake of progesterone in the body can cause a lot of side effects, including excess hair growth, weight gain, and menstrual irregularities. More than 10 injections are never given. The effect is based on stimulating the work of the glands located in the mucous membrane of the uterus. The drug has a number of contraindications, including: uterine bleeding, liver failure, breast tumors, etc.
5. Non-ovlon, a drug that stimulates the onset of the menstrual cycle, can prevent acyclic bleeding. It contains estrogen and gestagen. Most often, if there is a delay, two tablets are prescribed every 12 hours. However, before using it, it is mandatory to consult a specialist, since the drug has side effects and can disrupt the functioning of the reproductive organs.
6. Utrozhestan. It is a drug that suppresses estrogen and stimulates the production of progesterone, which determines its therapeutic effect. In addition, it has a stimulating effect on the development of the endometrium. The drug can be administered vaginally, which is its undoubted advantage, however, this drug also has some contraindications.
7. Norkolut causes menstruation because it contains norethisterone, which is similar in action to the action of gestagens. And their lack often provokes failures in cycles and their delay. The course of treatment should not exceed five days; it is not used during pregnancy, as it risks miscarriage and bleeding. It has a large number of contraindications and side effects, so a preliminary consultation with a doctor is necessary.

Naturally, the use of hormonal drugs to induce menstruation is not a safe method. They must be taken correctly, as they can cause irreparable harm to health.

Symptoms of menstrual irregularities

Too scanty or, conversely, abnormally heavy periods have their own characteristic symptoms. It is well known that any disturbances in the human body never go away without a trace, and a disruption in the menstrual cycle can be recognized by the following signs:

• disturbance in the regulation of bleeding;
• copious discharge with the presence of clots;
• significant delay;
• very scanty menstruation;
• painful attacks of various types;
• premenstrual syndrome.

In the case of normal menstruation, the woman does not feel any significant symptoms. In some cases, a nagging pain in the lower abdomen may appear, which does not particularly disturb the general rhythm of life. If the menstrual cycle is disrupted, the pain syndrome can become too severe, the pain can radiate to the hip and lower back.

The intensity of the syndrome is determined by the following indicators:

• loss of ability to work – it’s hard to sit, do usual work, there is a constant desire to lie down;
• number of painkillers taken;
• In adolescents, menstrual irregularities are often caused by excessive emotional stress that arises from the expectation of bleeding.

Inflammatory diseases of the uterus

Inflammatory diseases of the uterus and ovaries lead to disruption of the production of hormones that are responsible for the processes of maturation of eggs, follicles, and endometrium. As a result, they are often the cause of delay. At the same time, the volume and nature of the discharge changes, pain appears in the lower abdomen, lower back, and other symptoms.

Often, inflammatory processes are the cause of infertility, tumors of the reproductive system, and mammary glands. Inflammatory diseases occur due to infection due to improper hygienic care of the genitals, unprotected sexual intercourse, traumatic damage to the uterus during childbirth, abortion, and curettage.

Irregular periods during adolescence

In teenage girls, menstrual irregularities are quite common. This is due to physiological reasons. That is, the hormonal background has not yet been established and the duration of both the cycle itself and menstruation may be different each time. The norm is considered to be the formation of a cycle over 1 – 2 years.

Pathological factors and causes of irregular periods include:

• traumatic brain injuries;
• infectious lesions of the brain and its membranes;
• tendency to colds;
• vegetative-vascular dystonia;
• obesity;
• sclerocystic ovaries and genital infections.

Of no less importance is the craze among girls for dieting, which leads not only to significant loss of body weight, but also to hypovitaminosis and menstrual irregularities. In addition, the regularity of the menstrual cycle is also affected by the girl’s character (too emotional, impulsive or aggressive).

The following also play a role in cycle disruption:

• early and promiscuous sexual intercourse;
• bad habits;
• malformations of the reproductive system.

An disrupted menstrual cycle in girls can result in a complication such as juvenile uterine bleeding. In this case, periods last more than a week and are heavy, which leads to anemia in the child (see iron supplements for anemia). Typically, juvenile bleeding is provoked either by an infectious process or by nervous strain.

How can a gynecologist help?

If menstruation is long and heavy, then girls over 18 years of age are prescribed special hormonal medications that will need to be taken throughout the year. Heavy bleeding can lead to anemia, so you should not hope for self-healing. As a result, two pathologies will have to be treated: hormonal imbalance and anemia.

The doctor prescribes hormones

A visit to the doctor is also necessary in case of irregular, infrequent menstruation. They can be caused by:

• diseases of the thyroid gland or hypothalamus;
• polycystic ovary syndrome;
• malformations of the reproductive system (for example, hypoplasia of the ovaries, uterus);
• certain medicines (mostly steroids, which are used, for example, to treat asthma).

You should also consult a gynecologist if there is no menstruation or the bleeding stops very quickly. In the latter case, this may be the result of carefully hidden anorexia or bulimia from others, or an unwanted pregnancy.

Diagnosis of a disrupted menstrual cycle

Many women who have problems with menstruation put off visiting the doctor because they are afraid of prescribing hormone therapy. In fact, hormones are indicated only in some cases, and careful diagnosis is necessary to select an adequate treatment regimen.

In addition to a gynecological examination, smear and general blood and urine tests, the following may be prescribed:

• Ultrasound of the pelvic organs and thyroid gland;
• hormone analysis;
• hysteroscopy;
• studies to identify chromosomal pathologies;
• PCR, etc.

The doctor decides exactly what tests are needed after a detailed questioning, in which he can find out the presence of a genetic predisposition, features of the patient’s lifestyle and other nuances that affect the frequency and intensity of menstruation. You may also need to consult doctors of other specialties (endocrinologist, therapist) and additional studies (computed tomography, skull radiography, etc.).

Diagnostics of NMC

On your first visit to the clinic, you talk with the doctor, show him the results of previous studies (if you have them), tell him details about your health, lifestyle, and the presence of chronic diseases. Next, the doctor conducts an examination in a gynecological chair. During the examination, a smear is taken for cytology (PAP test), flora, as well as colposcopy to obtain a complete picture of the condition of the genital organs. You will also undergo ultrasound diagnostics and donate blood. You can bring a container of urine with you to your initial appointment and submit it to the laboratory for testing on the same day.

Laboratory results will be available in a few days or a week. Once you receive all the results by email, you can schedule a follow-up consultation to receive a doctor’s opinion and prescribe a treatment plan.

Treatment of menstruation disorders

Often the irregularity of the cycle is short-lived, but it is necessary to consult a doctor. He will conduct an examination, prescribe a list of tests and help determine the factor contributing to the development of this condition. A failure caused by hypothermia, stress, moving or overexertion does not require serious treatment or the use of medications.

During heavy workloads and sports, it is important to provide the body with rest, walk less, but also not lie down for several days in a row. When the climate changes, you can take vitamins; over time, the body will get used to the changes and will not react sharply to changes in temperature and humidity.

If the disturbances are caused by a diet, you must immediately stop it and start eating a balanced diet. Lack of nutrients provokes vitamin deficiency, the treatment of which begins with the use of vitamin and mineral complexes.

Indications for visiting a doctor if your menstrual cycle is irregular

For any irregularities in the menstrual cycle, it is advisable to consult a gynecologist. This will help you avoid serious consequences and not worry about your condition, thereby aggravating the situation. But in some cases it is necessary to undergo an examination:

• If a teenage girl did not have menarche until she was 15-16 years old.
• A year and a half passed after the first menstruation, and the monthly cycle was still not established.
• Your periods are too long and too heavy.
• The nature of menstrual flow, its color, and smell have changed (this may be a sign of endometrial disease).
• Ovulation is accompanied by painful sensations.
• The discharge is very scanty, and menstruation comes with a significant delay.
• Bleeding is a concern during the period between menstruation (even a single case requires examination).

Even if all these changes do not cause discomfort or cause complaints, you should not ignore them. Menstrual irregularities are often a sign of illness, and timely treatment can avoid complications and life-threatening conditions.

List of reasons that may cause a delay in menstruation

A delay of 2 to 5 days in the “red days of the calendar” should not be a cause for concern, since this is considered a very real phenomenon for every woman. If pregnancy is excluded, then such disorders of the female body can be caused by many factors. Their careful analysis allows us to determine the cause of a gynecological or non-gynecological nature.

So, we list the top 15 reasons for missed periods:

1. Polycystic ovary syndrome;
2. Uterine fibroids;
3. Endometriosis;
4. Inflammatory diseases;
5. Hormonal contraceptives;
6. Diagnosis of the uterine cavity, abortion or miscarriage;
7. The period after childbirth;
8. Puberty;
9. Menopausal disorders;
10. Great physical activity;
11. Stressful conditions;
12. Environmental climatic conditions;
13. Body weight abnormalities;
14. Intoxication of the body;
15. Taking certain medications;
16. Hereditary predisposition.

As follows from all of the above, the reasons for regularly recurring delays of critical days are multifaceted. Biological clocks can go wrong even in nulliparous women, who often confuse the symptoms of menstrual irregularities with pregnancy. An inconsistent menstrual cycle should not be considered a particularly dangerous, serious illness, but it is still worth paying close attention to the frequency of your critical days.