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General Practice 2023

Ausêance of menstruationção: 8 causes and when to go to the doctor

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Ausêance of menstruationção: 8 causes and when to go to the doctor
Ausêance of menstruationção: 8 causes and when to go to the doctor

The lack of menstruation can happen as a result of several factors, such as intense physical exercise, stress, eating disorders or being an indication of pregnancy, for example. The absence of menstruation is usually related to the decrease in estrogen that can prevent ovulation and the formation of the uterus tissue that sheds during menstruation, so there can be menstrual changes such as lack of flow or irregularity of the cycle.

The lack of menstruation for more than 3 consecutive months also occurs in pre-menopause, in the first cycles after menarche and does not occur again after surgery to remove the uterus and ovaries, not being a worrying situation, in most cases of the cases. Learn about other causes of delayed period.


1. Pregnancy

Pregnancy is one of the main causes of absence of menstruation, since due to the implantation of the embryo in the uterus, hormonal changes occur that prevent a new menstrual cycle.

What to do: To confirm the pregnancy, it is important that the beta-HCG test is performed, as it is also possible to check the week of pregnancy according to the levels circulating hormone. Learn more about the beta-HCG exam.

Furthermore, it is important that the gynecologist be consulted so that an evaluation can be carried out and, if the pregnancy is confirmed, prenatal care can be started.

2. Intense physical exercise

Intense physical activity, as performed by marathon runners, competitive swimmers or gymnasts, leads to increased levels of endorphins and ACTH in the blood, which can interfere with the levels of female hormones related to the menstrual cycle, which may result in a lack of menstruation.

What to do: In this case, the ideal is to reduce the intensity of training to regulate menstruation again. It may also be interesting to consult an endocrinologist or gynecologist so that the hormonal variation is properly monitored and the need for some treatment is evaluated.

3. Stress

Stress can also lead to a lack of menstruation, as it causes an increase in the amount of circulating cortisol, which can interfere with the menstrual cycle.

What to do: To solve this situation, it is recommended to adopt habits that can help you relax, such as regular physical activity and psychoanalysis sessions, for example. See more simple tips to relieve stress.

4. Eating Disorders

Eating disorders such as anorexia or bulimia or having a diet low in vitamins can also cause a lack of menstruation as a result of malnutrition, which interferes with hormone levels.

What to do: It is important that the nutritionist is consulted so that it is possible to improve the relationship with food and to make changes in the diet to guarantee all the necessary nutrients for the person, which can help regulate menstruation. In addition, it is essential that the person has psychological support so that it is also possible to treat the cause of the eating disorder.

5. Thyroid changes

Changes in the functioning of the thyroid gland, such as hyper or hypothyroidism, can also result in a lack of menstruation, as they influence circulating estrogen and progesterone levels. Check out other symptoms of thyroid problems.

What to do: It is important that the gynecologist is consulted so that an evaluation is carried out and the dosage of thyroid hormones is indicated. If any changes are observed, the use of medications to regulate the functioning of the thyroid may be indicated.

6. Use of medication

Some medications, such as corticosteroids, antidepressants, chemotherapy, antihypertensives or immunosuppressants, may have the side effect of not having a period.

What to do: In this case, it is important to consult a doctor to verify if it is possible to suspend or change the medication without causing harm to he alth.

7. Diseases of the reproductive system

The presence of polycystic ovaries, endometriosis, myoma or tumors in the reproductive system can result in changes in the menstrual cycle, since these are situations in which there is a great variation in the levels of female hormones.

What to do: If the absence of menstruation is due to changes in the female reproductive system, it is important to follow the treatment indicated by the doctor, which may involve the use of medication or performing a surgical procedure according to the disease to be treated.

8. Changes in brain functioning

Some brain changes, such as pituitary and hypothalamus malfunction, can also cause the absence of menstruation, because these structures are related to the production and activation of hormones.

What to do: It is important that tests are carried out to help assess the functioning of the pituitary and hypothalamus so that the most appropriate treatment can be initiated.


When to go to the gynecologist

It is necessary to go to the gynecologist when:

  • The girl has no signs of puberty until the age of 13, such as lack of pubic or axillary hair growth, no breast growth, and no rounding of the hips;
  • If menstruation does not come until age 16;
  • If, in addition to the absence of menstruation, the woman has other symptoms such as rapid heartbeat, anxiety, sweating, weight loss;
  • When the woman is over 40 years old and has not had a period for more than 12 months and has already rejected the chance of pregnancy or has an irregular period.

In any of the cases, the woman should go to the gynecologist who may indicate the need for blood tests or an ultrasound to evaluate hormonal values and exclude the existence of any problem or disease, in the ovaries, thyroid or the adrenal glands. See more details about when to go to the gynecologist.

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