Menstrual delay is a problem that most women experience at some point in their lives due to various reasons. The menstrual cycle is 28 days for most women. However, there may be periods when this cycle is shorter or longer. In some women, the cycle can be between 21 days and 40 days. Cycles that do not comply with a certain time cycle, appear early or late in different months, and whose duration varies, may be related to various diseases or mental changes. The treatment plan for delayed menstruation, which should be taken seriously, is made by determining the underlying cause of the disorder.
What is Menstrual Delay?
The normal menstrual cycle in healthy women is 28 days from the start of the last bleeding. However, between 21-40 days can be considered normal. It's also normal for the cycle to change a few days at a time. The occurrence of bleeding outside of this cycle is called menstrual delay.
During a normal menstrual cycle, an egg is released from one of the ovaries of women. The egg, which is not fertilized by a sperm, is expelled from the body along with the blood and tissues. This bleeding lasts an average of 5 days.
Then the cycle repeats itself monthly. In some periods, this cycle may be disrupted due to moods such as stress, various external factors or diseases. In this case, abnormal bleeding occurs outside the cycle.
What Causes Menstrual Delay?
Some common causes of delayed menstrual bleeding are:
Pregnancy, Extreme stress, Sudden weight loss, Being overweight, Exercising too much during the day, Using birth control pills, Menopause or early menopause, Polycystic ovary syndrome ,Uncontrolled diabetes, Heart diseases, Overactive thyroid gland.
Long-term stress due to any factor can affect hormones, causing delay in menstruation and a more painful menstrual period than normal. Stress is one of the reasons for the delay as well as the early bleeding. Exercises such as meditation, yoga, swimming, and running can help reduce stress. However, excessive exercise during the day also increases stress levels. In this case, as the fat level will decrease, ovulation may be delayed or stopped.
Menopause is a natural part of aging in women. It is usually seen between the ages of 45-50. Menstrual delay can be seen in women approaching the menopause period. This is because estrogen levels start to drop and ovulation becomes irregular. After menopause, bleeding stops completely.
Excessive and sudden weight loss is among the causes of delayed menstruation. Reducing the daily calorie intake negatively affects the production of hormones necessary for ovulation. Menstrual delay can be seen especially in individuals with a body mass index of 18.5 and below.
On the contrary, excess weight is one of the important reasons for the irregularity of the menstrual cycle. Overweight women produce too much estrogen. Excess estrogen can delay menstrual bleeding. Especially women with a body mass index of 30 and above are included in this risk group.
Using birth control pills may cause a missed bleeding in the cycle. This condition is considered normal for most women. Especially progesterone-only pills cause delay in menstruation. With the discontinuation of the pills, the menstrual cycle is expected to progress in its normal course.
Polycystic ovary syndrome is a common and treatable disease that affects reproductive hormones in women. This disease causes fluid-filled cysts to form in the ovaries. These cysts, which are mostly small and harmless, generally do not cause any discomfort or pain, but they can cause disruption of the menstrual cycle.
Celiac disease, which is an autoimmune disease, causes destruction in the digestive system due to gluten allergy. Hyperthyroidism and hypothyroidism can also affect hormones and cause delay in menstruation. In such cases, the cycle is expected to return to normal following appropriate treatment.
What are the Symptoms of Menstrual Delay?
A common symptom of delayed menstruation is that the bleeding does not come within 35-40 days following the previous bleeding. However, different symptoms can be seen in menstrual delays due to many diseases. Common symptoms seen in women with menstrual delay are as follows:
• Excessive hair growth,
• Headache,
• Pain in the groin area,
• Pimples appearing in different parts of the body, especially on the face,
• Excessive weight gain or loss.
What are the Diagnostic Methods?
Menstrual delay can be a symptom of different diseases, especially if it is seen for a long time. For this reason, it is beneficial for women to apply to a health institution for diagnosis and treatment. In gynecology or endocrinology examinations, the medical history of the patients and their families, emotional problems such as stress, weight changes, frequency of exercise are listened to. The age of women is also an important factor. Patients are directed to different departments in case of menstrual delays caused by a medical condition.
Before the examination, it is helpful to note the start and end dates of the menstrual bleeding. If no disease is suspected during the diagnosis process, it may be desirable to monitor the menstrual cycle for a certain period of time.
In addition to blood tests, methods such as ultrasound, MR and tomography are also used for diagnosis. Blood tests provide information about whether there are abnormal levels of hormones. Imaging methods are used for any disorder in the pituitary gland or reproductive system.
How Is Menstrual Delay Treatment Worked?
For the treatment of menstrual delay, the causes of the delay are determined first. Women need to make changes in their living conditions in case of delay in menstruation caused by factors affecting hormones such as stress or nutritional disorders.
If the reason for the delay in menstruation is polycystic ovary syndrome, it may be recommended to use progesterone-containing birth control pills in the treatment. However, birth control pills can also be the reason for the delay. In this case, it is expected that the cycle will return to its normal course by stopping the pills.
In cases of early menopause, hormone replacement therapy (HRT) or birth control pills are used. Medication can be applied in case of menstrual delays due to the overactive thyroid gland producing too much hormone.
