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Late menses symptoms: Amenorrhea – Symptoms and causes


Drug Abuse & Addiction Symptoms, Facts on Health Effects & Treatment

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Symptoms, Signs, Causes & Treatment

PMS vs. Pregnancy (Differences and Similarities)

Many women have difficulty figuring out if they are pregnant, have PMS, or are about to start their period. The most common signs and symptoms of early pregnancy, PMS, and the start of your period include mood swings, back pain, increased urination, and tender breasts. These three conditions also share other similar signs and symptoms, but there are unique differences between each. Moreover, there are symptoms that only occur if you are pregnant. Early pregnancy symptoms, PMS, and the start of the menstrual period all have common signs and symptoms like mood swings, back pain, and breast pain. Symptoms and signs between the three conditions that may seem similar, but are slightly different include the following: Pelvic or abdominal cramping before or during your menstrual period is normal; however, the cramping of early pregnancy is mild.
If you are pregnant, nausea and vomiting, or morning sickness, is common. They are not common symptoms of PMS.
Fatigue is common in both, but PMS usually goes away once your period begins.
Food cravings or aversions to certain foods are common in both pregnancy and PMS, but if you are pregnant, the cravings or aversions to foods are more specific and intense.
You may have spotting or bleeding if you are pregnant or suffering from PMS. When the embryo inserts itself into the uterus (implantation bleeding), you may mistake it as your menstrual period. However, implantation bleeding is much lighter (not enough to soak a pad or tampon) than the heaving bleeding experienced at the beginning of your period.
Signs and symptoms that you may have only if you are pregnant include, implantation cramping and bleeding, a white, milky vaginal discharge, and your areolas or nipples darken. The only way to find out if you are pregnant is with a pregnancy test. Home pregnancy test kits are available without a prescription at pharmacies and most grocery stores. Contact a doctor or other health care professional if you think you may be pregnant.

Delayed periods – NHS

Girls usually start their periods between 10 and 16 years of age. Most girls get their first period when they’re around 12.

But everyone develops at different rates, so there’s no right or wrong age to start having periods.

Your periods will start when your body is ready. This is usually about 2 years after the first signs of puberty appear. In girls, the first signs of puberty tend to be breasts beginning to develop and pubic hair starting to grow.

When to see your GP

See your GP if you have not started your periods by the time you’re 16. Your GP can assess whether you’re going through the normal stages of puberty.

It’s also a good idea to see your GP if you have not developed any signs of puberty at all by the age of 14.

You may be advised to “wait and see”. In many cases your periods will start naturally by the time you’re 18.

Your GP may recommend having blood tests to check your hormone levels.

You may be referred to a specialist (usually a gynaecologist – a specialist in women’s health). They’ll try to establish the cause and will be able to recommend any appropriate treatment.

Possible causes of periods not starting

Possible causes of periods not starting include:

  • a normal delay in development – this often runs in families, so if your mother or sister started her periods late, this may be why your first period is delayed
  • a hormonal imbalance
  • being underweight
  • doing a lot of exercise – this can affect girls who do lots of athletics, gymnastics or dance
  • eating disorders
  • severe stress
  • pregnancy – it’s possible to get pregnant before you get your first period as your ovaries can start releasing eggs a few months before your periods start
  • a problem with the ovaries, womb or vagina

Is there any treatment for periods that have not started?

It depends on what’s causing the problem.

Hormone therapy may be recommended if the cause is a hormonal imbalance.

If the underlying cause is an eating disorder, treatment will often involve a combination of therapy and advice about your diet. Read more about treatment for eating disorders.

If doing a lot of exercise is thought to be the cause, you may be advised to do less and, if you’re underweight, to increase your calorie intake. Read more about how to put on weight safely.

If the underlying cause for your lack of periods cannot be treated, you should be able to get NHS therapy or counselling to help you come to terms with what this means for you.

Page last reviewed: 05 August 2019
Next review due: 05 August 2022

Good to know : Irregular Periods Over 40: Do I Need to Worry?

What is Perimenopause?

It is the name given to the transition phase between a woman’s fully reproductive years to menopause, when you have had no period for 12 months straight.  

It can last anywhere between one to ten years and usually starts in your mid 40s, but it can begin much earlier or later. Some women will breeze right through and not notice any changes. Most women, however, will experience some kind of impact, ranging from nuisance to mild discomfort.

Apart from an irregular period, there are many other symptoms of Perimenopause. The most common include:

  • Hot flushes
  • Night sweats
  • Difficulty sleeping
  • Low mood or anxiety
  • Reduced sex drive (libido)
  • Vaginal dryness and discomfort during sex
  • Problems with memory and concentration


Some of these symptoms can be quite pronounced, but oftentimes, women do not notice they have entered perimenopause. This is because changes are happening while your period is still regular and the symptoms can be confused with PMS (premenstrual syndrome). Having an irregular period is therefore a useful signal that your body is moving towards the end of your reproductive years.


What Causes this Change in the Body?


It mainly comes down to hormones, your body’s messengers, which travel through the bloodstream to affect various functions and processes. When a woman enters middle age, her ovaries start to produce less oestragen. They also produce less ovarian follicles making the ovaries become less responsive to Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH), two hormones necessary for reproduction and the regulation of oestrogen, progesterone and testosterone. This decline in oestragen and fluctuating hormones can be the cause of almost any imaginable bleeding pattern. This also includes intermenstrual bleeding, which is separate to irregular menstruation.


What is Intermenstrual Bleeding?


It is bleeding that occurs before or after the period rather than being part of the cycle and is another common change to your body in your 40s. However, it is always prudent to rule out dysfunctional uterine bleeding. For instance, by booking a cervical smear to rule out cervical cancer. Or an ultrasound scan of the pelvis to check the womb for uterine cancer. These diagnoses are the very worst case scenario, but it is useful to know which symptoms are a cause for concern.

When to See a Doctor 

Irregular periods and intermenstrual bleeding are completely normal during perimenopause. However, there are other conditions that might be affecting menstrual bleeding. See your doctor straight away if you notice any of the following situations:

  • Your periods have blood clots or are very heavy
  • Your periods are much longer than normal
  • Spotting occurs between periods
  • Spotting occurs after sex
  • There is no sizeable gap between periods

There are many health conditions that could cause abnormal bleeding ranging from hormone problems to pregnancy and from blood clotting issues to diabetes. Some reasons could be as a result of perimenopause, such as fibroids or polyps, while others could be completely independent, like STIs, cancer or the very harmless cervical erosion.

With regard to irregular periods in your 40s, it is useful to remember that the reason could also be down to lifestyle.

Here is a list of lifestyle habits which could be affecting your period:

  • Significant weight gain or loss
  • Over-exercising
  • Poor diet
  • Smoking
  • Increased stress
  • Hormonal contraception

Your irregular period is most likely nothing to worry about and probably a sign of Perimenopause. However, should you feel your symptoms are a cause for concern or you have any questions at all, please feel free to ring us on 02033 030 316 for confidential advice.

My period’s late but the pregnancy test is showing negative. What’s going on?

When your period is late with no sign of a positive pregnancy test, it can be upsetting and confusing. If your normally regular periods have suddenly become irregular, or stopped, think about whether anything has changed in your lifestyle.

Nine reasons you might miss your period

1. Pregnancy

It is possible to get a false negative on a pregnancy test (where the test says you’re not pregnant even though you are), particularly if you test too early, or don’t follow the instructions exactly. If you’re in any doubt about the results of your pregnancy test, try waiting a few days and testing again.

2. Stress

Severe stress can affect your hormones, which could cause changes to your menstrual cycle, or even stop your periods altogether. Learn more about how stress affects your menstrual cycle, and get tips on what to do about it.

3. Being overweight or obese

Being overweight (with a BMI of 25 or more) or obese (with a BMI of 30 or more) can also affect your hormone balance and menstrual cycle. If you’re finding it difficult to manage your weight, and it’s affecting your periods, your GP may be able to refer you to a dietitian or other local services, who’ll help you lose the weight safely.

4. Sudden weight loss

Being underweight, or losing weight very quickly, can mean that you’re not getting enough calories for a healthy menstrual cycle. If you have a body mass index (BMI) under 18.5, or are suffering from an eating disorder such as anorexia, speak to your GP. She may refer you to a specialist who can help you get back to a healthy weight, which should get your periods back to normal, too.

5. Extreme exercise

Extreme exercising puts your body under stress and reduces your levels of body fat, which can both affect your periods. If you’ve recently been doing lots of strenuous exercise, try stopping for a while to see if your periods return.

6. The contraceptive pill

If you’re taking the pill, it’s perfectly normal for you to have the occasional missed period. Provided your period returns the next time it’s due, there’s no need to worry.

Other types of contraception, such as the progestogen-only pill (mini pill), contraceptive injection and intrauterine system (IUS) can stop your periods altogether. However, your periods should return as soon as you stop using the mini pill or IUS, and within a year of the injection wearing off.

7. Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a condition that can prevent your ovaries from releasing an egg each month. Symptoms of PCOS include:

  • irregular periods, or no periods
  • difficulty getting pregnant
  • extra hair growth on your face, chest, back, bottom or tummy
  • thinning hair on your head
  • unexplained weight gain
  • oily skin or acne

Learn more about PCOS, including how it’s treated.

8. Other health conditions

If you have a long-term health condition, such as thyroid problems, diabetes or coeliac disease, this can also affect your menstrual cycle. Some types of medication, such as antidepressants and epilepsy medication, can also affect your hormones. So if you have any kind of health problem, it’s worth speaking to your GP to see if this could be affecting your periods.

9. The menopause

The menopause is when a woman stops having periods naturally, as part of the ageing process. It usually happens after the age of 45, and is often accompanied by symptoms such as hot flushes, night sweats and difficulty sleeping.

If you are going through the menopause, your periods won’t return, and you won’t be able to get pregnant naturally. However, it’s still worth seeing your GP, who can confirm the menopause and prescribe medication to help with any symptoms you may be experiencing. She can also give you information about other options for having a child, such as adoption or surrogacy.

What to do if your periods have stopped

If you miss more than three periods in a row, and pregnancy tests are negative, see your GP. She’ll ask you some questions about your medical history, and may arrange for you to have some tests, such as a blood test, to find out exactly what’s causing your missed periods. If necessary, she’ll refer you to a specialist who’ll make sure that you get the care you need.

More information:

Park Avenue Women’s Center: OB-GYNs

Polycystic ovary syndrome (PCOS) is a common condition among women of childbearing years, affecting about 1 in 10, or about 10 million women worldwide. Hormonal imbalance is the main culprit of this syndrome, but environmental and genetics can also play a role.

A common symptom of PCOS is missed or irregular periods. While some women may relish the idea of not getting their period every month, they won’t like the symptoms. PCOS can lead to pelvic pain, headaches, and infertility. So if you suspect you have PCOS, you should see your OB/GYN.

While there is no cure for PCOS, there are many treatments to help you minimize or eliminate the symptoms.

What is PCOS and what causes it?

The exact cause of PCOS is unknown. But some factors that are thought to contribute or play a role in the condition are an excess of androgen, a male hormone, and excess insulin, which can lead to excess androgen.

When your body has too much androgen, it can affect your regular monthly cycle. This hormonal imbalance prevents the egg from developing or releasing properly.  As a result, women with PCOS often miss their periods or have delayed or irregular periods.

PCOS can affect all women, usually between the ages of 15 and 44, but women who are obese and women who have a close relative with PCOS are at higher risk for developing this syndrome.

In addition to missed or delayed periods, other common symptoms include:

  • Acne
  • Thinning hair or hair loss on the scalp
  • Weight gain or difficulty losing weight
  • Skin tags
  • Skin discoloration
  • An increase in facial and body hair, also called hirsutism
  • Sleep issues
  • Infertility

PCOS is the most common cause of infertility. About 70-80% of women with PCOS experience fertility issues. Fortunately, it’s also very treatable.

PCOS diagnosis and treatment

There is no single blood test or other types of tests that provide a positive diagnosis for PCOS. Instead, the providers at Park Avenue Women’s Center conduct a series of tests to rule out other conditions and identify markers for PCOS. These tests can include:

  • A physical exam
  • A pelvic exam
  • A pelvic ultrasound
  • Blood tests to check your hormone levels and maybe cholesterol levels

If other conditions have been ruled out and you have at least two of the following symptoms, your provider will discuss PCOS treatment options with you:

  • Irregular periods
  • High levels of androgen, as noted in blood tests or by symptoms such as excessive hair growth or acne
  • Small fluid-filled sacs, or follicles, on one or both ovaries

Treatment options can include lifestyle changes, medications, or both. Lifestyle changes include losing weight, watching your diet, and exercising more regularly. Medication options include anti-androgen medicines, hormonal birth control pills, or a hormonal birth control device such as an IUD.

For women who want to get pregnant, birth control pills are obviously not an option. Treatment options for women with PCOS who want to have a baby, include:

  • Clomid, a medicine that helps you ovulate
  • In vitro fertilization
  • Surgery to help restore ovulation

For more information about diagnosis and treatment of PCOS, call us at Park Avenue Women’s Center, located on Manhattan’s Upper East Side in the Yorkville neighborhood. You can also book an appointment online through this website.

Types, Symptoms, & Treatment in Akron, Ohio

Simple modifications in lifestyle can help eliminate or reduce the severity of symptoms, including:

  • Exercising 3 to 5 times each week
  • Eating a well-balanced diet that includes whole grains, vegetables and fruit, and a decreasing salt, sugar, caffeine and alcohol intake
  • Getting adequate sleep and rest

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Amenorrhea is characterized by absent menstrual periods for more than three monthly menstrual cycles. There are two types of amenorrhea:

Types of Amenorrhea

  • Primary amenorrhea: Menstruation does not begin at puberty.
  • Secondary amenorrhea: Normal and regular menstrual periods that become increasingly abnormal and irregular or absent. This may be due to a physical cause typically of later onset.

Amenorrhea can occur for a number of reasons as part of the normal course of life, such as pregnancy, breastfeeding or menopause. Or, it may occur as a result of medications or a medical problem including:

  • Ovulation abnormality
  • Birth defect, anatomical abnormality or other medical condition
  • Eating disorder
  • Obesity
  • Excessive or strenuous exercise
  • Thyroid disorder

If at least three consecutive menstrual periods are missed or if you’ve never had a menstrual period and are 16 years or older, it is important to see a healthcare professional. As with any condition, early diagnosis and treatment is very important.


Dysmenorrhea is characterized by severe and frequent menstrual cramps and pain associated with menstruation. The cause of dysmenorrhea is dependent on if the condition is primary or secondary. With primary dysmenorrheal, women experience abnormal uterine contractions resulting from a chemical imbalance in the body. Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis. Other possible causes may include:

  • pelvic inflammatory disease (PID)
  • uterine fibroids
  • abnormal pregnancy (i.e., miscarriage, ectopic)
  • infection, tumors, or polyps in the pelvic cavity

Any woman can develop dysmenorrhea, but those who are at increased risk include:

  • Smokers
  • Those who consume excessive alcohol during their period
  • Women who are overweight
  • Women who started menstruating before the age of 11

Dysmenorrhea Symptoms

The most common symptoms may include:

  • Cramping or pain in the lower abdomen
  • Low back pain or pain radiating down the legs
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Weakness
  • Fainting
  • Headaches


Menorrhagia is the most common type of abnormal uterine bleeding and is characterized by heavy and prolonged menstrual bleeding. In some cases, bleeding may be so severe that daily activities are disrupted.

Other types of this condition, also called dysfunctional uterine bleeding, may include:

  • Polymenorrhea: Too frequent menstruation.
  • Oligomenorrhea: Infrequent or light menstrual cycles
  • Metrorrhagia: Any irregular, non-menstrual bleeding as in bleeding which occurs between menstrual periods
  • Postmenopausal bleeding: Any bleeding that occurs more than one year after the last normal menstrual period at menopause

Menorrhagia Causes

There are several possible causes of menorrhagia, including:

  • Hormonal imbalance
  • Pelvic inflammatory disease (PID)
  • Uterine fibroids
  • Abnormal pregnancy; i.e., miscarriage, ectopic (tubal pregnancy)
  • Infection, tumors or polyps in the pelvic cavity
  • Certain birth control devices; i.e., intrauterine devices (IUDs)
  • Bleeding or platelet disorders
  • High levels of prostaglandins (chemical substances used to control muscle contractions of the uterus)
  • High levels of endothelins (chemical substances used to dilate blood vessels)
  • Liver, kidney or thyroid disease

Menorrhagia Symptoms

Typical symptoms of menorrhagia are when a woman has soaked through enough sanitary napkins or tampons to require changing every hour, and/or a woman’s menstrual period lasts longer than 7 days in duration. Other common symptoms include spotting or bleeding between menstrual periods, or spotting or bleeding during pregnancy.

A diagnosis can only be certain when the physician has ruled out other menstrual disorders, medical conditions or medications that may be causing or aggravating the condition.

Other diagnostic procedures may include:

  • Blood tests
  • Pap test
  • Ultrasound: An imaging technique that uses high-frequency sound waves to create an image of the pelvic organs.
  • Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of the reproductive organs.
  • Laparoscopy: A minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
  • Hysteroscopy: A visual examination of the canal of the cervix and the interior of the uterus using a hysteroscope inserted through the vagina.
  • Biopsy (endometrial): Tissue samples are removed from the lining of the uterus with a needle or during surgery to determine if cancer or other abnormal cells are present.
  • Dilation and curettage (D&C): A common gynecological surgery that consists of widening the cervical canal with a dilator and scraping the uterine cavity with a curette – a spoon-shaped surgical tool used to remove tissue.

Your doctor may suggest a psychiatric evaluation to rule out other possible conditions, or ask you to track your symptoms in a journal to better assess the timing, severity, onset and duration of symptoms.

A specific treatment plan will be determined by your doctor based on factors such as:

  • Your age, overall health and medical history
  • Extent of the condition
  • Possible cause of the condition
  • Current symptoms
  • Your tolerance for specific medications, procedures or therapies

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Treatments for menstrual disorders

Discussing your menstrual disorder symptoms with your doctor can help determine what type of treatments can best reduce or relieve your symptoms, including:

  • Diuretics
  • Prostaglandin inhibitors
  • Hormone supplements
  • Oral contraceptives
  • Tranquilizers
  • Vitamin or mineral supplements
  • Dietary modifications
  • Antidepressants
  • Regular exercise
  • Surgery

For more information about menstrual disorders, schedule an appointment for a pelvic exam or Pap test.

90,000 Signs and diagnosis of endometriosis. Main symptoms, diagnostic methods

11 January 2021

Endometriosis is a chronic disease characterized by pathological proliferation of the endometrium outside of it. It is diagnosed mainly in reproductive age – in 10% of women. Most often, endometrial cells are detected in the ovaries, cervix, and intestines. The difficulty in diagnosing endometriosis is that it can proceed without symptoms.

Causes of endometriosis

Researchers suggest that the pathological proliferation of endometrial cells is due to the fact that its particles during menstruation fall from the fallopian tubes into the abdominal cavity. This movement is typical for 90% of women. The likelihood of endometriosis is higher:

  • In women who have not given birth.
  • With prolonged exposure to estrogen – early menstrual cycle (up to 11-13 years).
  • Late menopause, short and irregular periods.
  • In case of insufficient weight in combination with high growth (from 170 cm).

The likelihood of endometriosis decreases during lactation, after childbirth, in women with the onset of menstruation after 14 years. Statistically, it is less likely to be found with adequate intake of omega-3 fatty acids.

Symptoms of endometriosis

Most often, women consult a doctor when pain appears – aching, sharp or throbbing. With the involvement of organs located in the immediate vicinity of the uterus, patients note frequent urination, which is accompanied by pain.Some of them complain of stool disorders (constipation, diarrhea), chronic fatigue. There is a possibility of uterine bleeding, intestinal colic.

Important! Endometriosis cannot be diagnosed using laboratory tests.

Basic examination methods:

  • Ultrasound – makes it possible to identify endometrioid ovarian cysts.
  • MRI is a more informative method of examination, but it is not always advisable due to its high cost.
  • Histology. Samples taken by biopsy (laparoscopic surgery) are subject to examination.

Mostly, the diagnosis of endometriosis is based on the patient’s symptoms and the results of ultrasound examination. Indications for laparoscopy: infertility, large endometrioid ovarian cysts, severe pain, significantly impairing the quality of life, in the absence of the effect of pharmaceutical drugs.

Endometriosis increases the likelihood of miscarriage, ectopic pregnancy, early birth, ovarian cancer, and cardiovascular disease.To detect the disease at an early stage, we recommend visiting a gynecologist at least once a year for a preventive examination.

Why are your periods delayed?

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Regular periods are one of the signs of good health, so whenever there is a delay, we get worried.A delay in your period can be associated with the onset of pregnancy, but there are many other reasons why your period may be late.

The duration of the menstrual cycle is on average 28 days, while bleeding usually lasts 3-5 days. The first couple of years after the onset of menstruation may be irregular, but over time it will stabilize. After establishing a regular cycle, delayed periods can be caused by excessive stress .The fact is that during stress in the body, the level of adrenaline and cortisol rises – hormones that suppress functions that are not vital, including reproductive function.

Menstrual Tracker & Calendar

You can follow your cycle with the WomanLog calendar. You can download the calendar at the links below:
You can follow your cycle with the WomanLog calendar.

In women of childbearing age who are sexually active, a delay or cessation of menstruation can be a sign of pregnancy .The onset of pregnancy can also be indicated by such specific symptoms as morning sickness, increased sleepiness, frequent urge to urinate, etc. You can determine the presence of pregnancy using a special test.

The test results will be more accurate and reliable if done a week after your period should have started.

A sudden increase or loss of weight can also negatively affect your cycle, since in both cases hormonal imbalance occurs.In addition, changes can be expected when starting or stopping hormonal contraception , as well as after changing hormonal contraceptives.

Another possible cause of irregular periods is violation of the daily rhythm , for example, when traveling long distances across several time zones. Changes in the endocrine system , increased body temperature , fear of pregnancy or approaching menopause can also disrupt the menstrual cycle.

Doctors advise you to monitor your cycle by making notes on the calendar. Thus, you can notice any changes and, if necessary, consult a doctor in time.

You can follow your cycle with the WomanLog calendar. You can download the calendar from the links below:

Download on the App Store

Get it on Google Play

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https: // www.nhs.uk/conditions/stopped-or-missed-periods/





https: // www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940



Luteal phase support with assisted reproduction

Review Question

Many different interventions, dosing and management of the luteal phase have been studied.We have compared seven different methods and have prepared a complete overview on this topic.


After ovulation, the luteal phase of the menstrual cycle begins and continues until the next menstruation. The remains of an ovulated egg in the ovary are known as the ‘corpus luteum’ or corpus luteum. The corpus luteum produces hormones, including progesterone. Progesterone stimulates the proliferation of the lining of the uterus in preparation for implantation.

During the implementation of assisted reproduction, the female pituitary gland is desensitized by drugs, which makes it possible to control the stimulation of the ovaries.This promotes the formation of more mature eggs that can be harvested and fertilized outside the woman’s body. Ovarian hyperstimulation causes a luteal phase defect, since the corpus luteum is unable to produce enough progesterone.

Since low progesterone levels can reduce the likelihood of implantation, support for the luteal phase is necessary. This can include oral, vaginal, or intramuscular progesterone, human chorionic gonadotropin (hCG) (which stimulates the production of progesterone), or gonadotropin-releasing hormone (GnRH) agonists.GnRH agonists stimulate the production of GnRH, the hormone responsible for follicle-stimulating hormone (FSH), and luteinizing hormone (LH), which promotes ovulation and the development of the corpus luteum. GnRH agonists are thought to restore LH levels and naturally support the luteal phase.

Research characteristics

We found 94 randomized controlled trials comparing different luteal phase support regimens in a total of 26,198 women.We observed that the primary outcome was a live birth or ongoing pregnancy. Other outcomes were clinical pregnancy, ovarian hyperstimulation syndrome (OHSS), miscarriage, and multiple pregnancies. The evidence is current to August 2015.

Main Findings

HCG or progesterone obtained during the luteal phase may be associated with a higher rate of live birth or ongoing pregnancy compared with placebo or no treatment, but the evidence is mixed.The addition of GnRH to progesterone appears to improve outcomes. HCG may increase the risk of OHSS when compared to placebo. Moreover, hCG, with or without progesterone, is associated with a higher incidence of OHSS than progesterone alone. Neither estrogen supplementation nor the route of progesterone administration is associated with improved outcomes.

Quality of evidence

The evidence for most comparisons was of low or very low quality. The main limitations in evidence were poor reporting of research methods and inaccuracies due to small sample sizes.

Ovulation in a woman: what is it when it happens?

Ovulation – what is it?

How to determine and when ovulation occurs?

When ovulation occurs

How to understand if ovulation occurs or not?

The most successful period for the birth of an embryo is ovulation, which is why, if she wants to get pregnant, a woman needs to know exactly when ovulation occurs.

What is ovulation in women?

Ovulation is a phenomenon in which an egg is released from the follicle.This process takes approximately 15-20 minutes. The egg is then ejected from the ovary and picked up by the fallopian tube. After that, the egg cell gradually moves along the fallopian tube, if on the way it meets a sperm, then fertilization will occur, and the process of embryo formation will start. The egg cell retains the ability to be fertilized for about one day. If fertilization does not occur, the egg dies, and after 14 days the next menstruation comes.

Ovulation: how to tell when it is happening?

Even during fetal development, a lot of germ cells are laid in the ovary of a future girl – gametes, which remain immature and mature only at the end of puberty – the period of puberty.

With the regular activity of the female reproductive system, every month ovulation occurs at the same time: in the middle of the menstrual cycle.

In the life of every healthy woman, there are menstrual cycles in which the ovaries do not ovulate. This phenomenon occurs only a couple of times a year and is a variant of the norm. With age, there are more such cycles. By the time of menopause, ovulation occurs less and less. Menopause is the complete extinction of a woman’s reproductive function, the ovaries do not work at all, and ovulation stops.

When does ovulation occur?

Depending on the physiological and anatomical characteristics of a woman’s body, the menstrual cycle can last 28 – 32 days. Ovulation occurs on days 14-16, in the middle of the cycle, provided that menstruation comes without delay each time. Sometimes ovulation can happen ahead of schedule, about 12 days, this is early ovulation. Also, late ovulation may occur, occurring later than the 18th day of the cycle.

The life of the ovum is short-lived – only a day.During this time, she must be fertilized with sperm for the further development of pregnancy.

How to determine if ovulation is occurring?

To determine ovulation in a woman’s arsenal, there are several simple, but informative methods.

Calendar method. The easiest one, in which, using a regular calendar, a woman can determine the middle of the cycle. To do this, from the beginning of menstruation, you need to count 14 days with a 28-day menstrual cycle.

Basal temperature (BT).The woman determines the basal temperature with a simple thermometer, immediately after the end of sleep: every day for 3 months. The data are recorded in the measurement diary, on the basis of which the basal temperature graph is built. 2 days before ovulation, BT indicators rise from 36.6-36.9 to 37.0-37.3 and remain at an elevated level almost until the beginning of menstruation. After this, the basal temperature decreases to normal values.

Test strips. Also, to track ovulation, women are increasingly using test strips that determine the content of luteinizing hormone – a pituitary hormone that acts on the follicle and causes ovulation in the urine.

Ultrasound examination of the small pelvis. An ultrasound will help a woman get the most accurate information about the ovulation taking place.

signs of ovulation and specific features of menstrual cycles

The female body, after puberty, prepares to constantly perform its most important function, which is to create a new life. In the ovaries of a woman, many eggs mature throughout her life. Ready for fertilization, the egg matures around the middle of the cycle, and this period is usually called ovulation.However, many women are asking quite a logical question. How many days after ovulation does your period come? This is what this article is about.

Menstrual cycle

Before answering the question of how many days after ovulation menstruation comes, you should understand in more detail what the menstrual cycle is. Many different factors affect the possibility of an unplanned pregnancy. The most important of them is the lack of information in women about the structure of their own body, the characteristics of ovulation and the menstrual cycle.If a woman understands the work of the entire female reproductive system, then it will be possible to speed up not only the process of conception, but also to avoid unwanted pregnancy. Also, a woman should know how many days after ovulation her periods come.

With all the variety of such information that is available to modern women, not everyone understands what this process is all about, as well as when it starts. Many do not even understand what they have at one time or another during the period of the menstrual cycle.

In simple terms, the menstrual cycle is the time that separates the periods. The duration of this cycle is individual for each of the fair sex. Typically, a normal cycle lasts 21 to 35 days. But there are also women whose duration is about 45 days. From the point of view of specialists, such a cycle duration is already considered a pathology.

Division of the cycle

The cycle is considered to be from the first day of the onset of menstruation until the beginning of the next.Menstruation can be delayed for a couple of days, while this will not be considered a pathology. The menstrual cycle is divided into two main parts:

  1. When menstruation has come, a follicle in the ovary begins to ripen in a woman’s body. Subsequently, a new egg cell ready for fertilization comes out of it. Typically, your period lasts from 2 to 7 days.
  2. When this egg is released, it is customary to talk about the second phase of the cycle, which is called luteal. During this period, the female body begins to actively prepare for pregnancy.The endometric layer on the uterus becomes the most loose and soft, thus preparing to take on the fertilized egg.

If fertilization has not occurred, then the level of hormones sharply decreases, which provokes detachment of the endometrium from the uterus. This is called the next period. Normally, the second phase should last 14 days. The difference may be 1-2 days. Thus, answering the question of how many days after ovulation menstruation comes, the answer will be: 14-15.

Features of the process

Approximately in the middle of the menstrual cycle, an egg, ready for fertilization, begins to mature in the dominant follicle. When it is ripe, the walls of the follicle begin to rupture, thus releasing the egg cell to freedom. During the exit from the follicle, the egg is drawn into the fallopian tube, in which it must subsequently meet with sperm. On the inner surface of this tube there are special villi that move the egg towards the uterus.

The egg cell lives for about 12 to 36 hours. If fertilization does not occur during this period, then it will die, after which it will be excreted with menstrual blood. Thus, we can conclude that the break after the release of the finished egg for fertilization is usually called ovulation.

If a woman tracks the period of ovulation, then she can significantly increase the chances of successful fertilization. The population does not pass at the same time. The specific time of the onset of this favorable period will depend both on the duration of the menstrual cycle and on the hormonal background at a certain moment.

For example, if a woman’s menstrual cycle is 28 days, then ovulation occurs at about 13 or 14 days. That is, each is individual. So how long after ovulation will your period go? You can easily calculate that this will happen in another 14 days. However, it also happens when the egg comes out only on the 18th day of the menstrual cycle. Please note that it is late ovulation that can provoke a delay in menstruation. That is, the cycle shifts a little. Speaking about how long after ovulation menstruation will come, it should be borne in mind that in this case the numbers will be slightly different.

Favorable days for conception

You can calculate the onset of a favorable period for conception using several methods:

  1. Determination of ovulation using a temperature graph. As you know, every month during ovulation due to changes in hormonal levels, the basal temperature increases by about 0.4 degrees. To determine the onset of ovulation using this method, you have to suffer a little: for 2-3 months, a woman must measure her rectal temperature every morning without getting out of bed.Based on the data, the resulting graphs can be used to detect the onset of ovulation.
  2. There are also special tests to determine ovulation. They look exactly the same as a simple pregnancy test. The test reacts to the presence of the so-called luteinizing hormone. The ovulation period occurs throughout the day, after you have found two strips on the test.
  3. Ultrasound. This method is the most reliable for determining the onset of ovulation. For this, a specialist carries out a daily examination of the ovaries.When the follicle reaches a size of 20 mm in diameter, it is sent back, ovulation occurs within a couple of days.

What will happen after?

So, we continue to consider how many days after ovulation are menstruation. If during its entire period the egg has not been fertilized, then it, along with the flow of fluid, enters the uterus, and then is excreted from the female body together with the dead endometrium during the next menstruation.

If fertilization has occurred, then the egg, when fused with the sperm, forms a zygote, starting its path towards the uterus.This journey usually takes 5 to 7 days.

It is important to note that several eggs can mature during the entire menstrual cycle. And if everyone is fertilized, then triplets or twins will be born. However, only one sperm is capable of merging with the egg.

How long does your period go after ovulation?

And now it’s worth answering the main question of this article. A fertilized egg in the uterus is implanted into the endometrium. This stage will be decisive in the development of pregnancy.If the female body at this time rejects the zygote, preventing it from gaining a foothold, then it dies and comes out with the next menstruation.

This introduction lasts for 40 hours, after which an embryo is formed, the female body is actively preparing for pregnancy. The hormonal background also changes, in parallel with this, the immune system decreases.

So how long after ovulation does your period start? If fertilization has not occurred, then menstruation comes 14-15 days after.The longest cycle will indicate late ovulation.


So, we figured it out when menstruation goes after ovulation. In this case, you should pay attention to the fact that they do not have to come day after day every month. In some cases, women experience a delay of several days. And there is nothing wrong with this phenomenon. You need to worry only if the duration of the menstrual delay is more than 5 days. Moreover, the reason will not always lie in the onset of pregnancy.

Taking hormonal drugs

In spring, a common cause of late ovulation is the use of hormonal drugs. The use of emergency contraceptives, as well as an abrupt interruption of hormone therapy, can provoke a delay of about 2 weeks.


What other reasons are there for the delay in menstruation? In addition to the onset of pregnancy and the use of hormonal contraceptives, the absence of menstruation can contribute to cysts on the ovaries. Also, the cause of this phenomenon is often the inflammatory process, which is diagnosed in the pelvic organs.

A delay is often observed in the case of diseases of the endocrine system. Those people who suffer from diabetes mellitus, have problems with the work of the adrenal glands, thyroid gland or pituitary gland, often observe an irregular menstrual cycle.


Those women who have experienced a spontaneous or medical abortion can observe their period only 30-40 days after the procedure. If this happens, do not worry, this is the absolute norm, since the female body needs time to recover from an abortion.

Other causes

There may be a delay in menstruation. For example, this should include a radical change in climate, too active sports, especially if a woman has dramatically lost weight.

In addition, obesity can cause disturbances in the normal rhythm of menstruation. If women over 40 years old have delays in their periods, then this may be a symptom of the onset of menopause. The function of the ovaries begins to fade away gradually, which provokes a delay in menstruation.

Now you know how long after ovulation your period comes. If a woman observes her menstrual cycle for some time, then in the future she will be able to determine the onset of ovulation, as well as the period of approaching critical days, without any complications.


Progesterone is a steroid hormone, the main function of which is to prepare a woman’s body for pregnancy. It is produced by the corpus luteum of the ovaries.

It is recommended to take the test on the 21st-23rd day of the menstrual cycle.

Russian synonyms

Progestin, gestagen.

English synonyms

P4, pregn-4-ene-3.20-dione.

Research method

Electrochemiluminescence immunoassay (ECLIA).

Detection range: 0.159 – 1910 nmol / l.


Nmol / L (nanomole per liter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

  • Do not eat for 2-3 hours before the examination, you can drink clean non-carbonated water.
  • Stop taking steroid and thyroid hormones 2 days before the study (in consultation with your doctor).
  • Eliminate physical and emotional stress during the day before the study.
  • No smoking within 3 hours prior to examination.

General information about the study

Progesterone is a steroid hormone whose main function is to prepare a woman’s body for pregnancy.

Each month, estrogen causes the inner lining of the uterus – the endometrium – to grow and renew itself, while luteinizing hormone (LH) promotes the release of an egg in one of the ovaries. In place of the released egg, the so-called corpus luteum is formed, which produces progesterone. Progesterone, together with a hormone secreted by the adrenal glands, stops the growth of the endometrium and prepares the uterus for the possible implantation of a fertilized egg.

If fertilization does not occur, the corpus luteum disappears, the level of progesterone falls and menstrual bleeding occurs.If the fertilized egg attaches to the wall of the uterus, the corpus luteum continues to produce progesterone. After a few weeks, the placenta takes over the function of the corpus luteum to produce progesterone, being the main source of this hormone during pregnancy.

What is the research used for?

  • To identify the causes of infertility.
  • To determine if the patient has ovulated.
  • For the diagnosis of ectopic or pathological pregnancy (together with a test for chorionic gonadotropin).
  • For monitoring the condition of the fetus and placenta during pregnancy, if there are complications.
  • To determine the effectiveness of progesterone injections to maintain early pregnancy.

When is the study scheduled?

  • When asking if ovulation is proceeding normally (sometimes twice during the menstrual cycle).
  • When stimulating ovulation.
  • For symptoms of ectopic pregnancy and threatened miscarriage, such as abdominal pain and bleeding.
  • With the administration of progesterone during pregnancy.
  • Periodically during pregnancy with an increased risk of termination to monitor the condition of the fetus and placenta.
  • When a non-pregnant patient has uterine bleeding.

What do the results mean?

Reference values ​​

Cycle phase, pregnancy

Progesterone, nmol / L



0.181 – 2.84


0.385 – 38.1


5.82 – 75.9


1st trimester

35 – 141

2nd trimester

80.8 – 264

3rd trimester

187 – 681


Interpretation of the test results depends on the reason for its performance, as well as on the characteristics of the patient’s menstrual cycles or her pregnancy.Progesterone levels usually begin to rise when the egg leaves the ovary, then rise over the course of a few days, and then either continue to rise with pregnancy or fall off, signaling the onset of menstruation.

If the progesterone concentration does not change during each month, it is possible that the patient is not ovulating or her menstrual cycle is irregular.

When progesterone levels do not rise properly in early pregnancy, an ectopic or abnormal pregnancy can be assumed.If a series of analyzes did not show its increase over time, then it is possible that the patient has problems with the viability of the fetus and placenta.

Causes of increased progesterone levels:

  • ovarian cyst,
  • pathological pregnancy, as well as cystic drift or chorionic carcinoma,
  • rare forms of ovarian tumors,
  • congenital adrenal hyperplasia.

Causes of low progesterone levels:

  • toxicosis in late pregnancy,
  • decreased functional activity of the ovaries,
  • no menses,
  • ectopic pregnancy,
  • threatened miscarriage.

What can influence the result?

Taking food supplements and pharmaceuticals that change the concentration of estradiol and progesterone.

90,000 when prescribed, efficacy, prices for radiation therapy for uterine tumor in Moscow

Cancer of the uterus develops from cells in the mucous membrane. It is one of the most common cancers that typically affects women between the ages of 60 and 70. Cervical cancer is the second most common tumor after breast cancer in women.About 20% of all recent malignant tumors are cervical cancer.

Key points:

  • Risk factors: being overweight, longer estrogen production, and genetic predisposition.

  • Symptoms: Discomfort occurs in the late stage, including unusual bleeding, such as between periods or after menopause. Later, pain in the vaginal area is added, as well as urinary tract infections.

  • Prognosis: With early detection, the chances of recovery are high. If metastases have already formed, then the prognosis worsens.

  • Treatment: The best treatment option is surgery, in which the uterus is removed. Radiation and chemotherapy are often added. The only way of prevention is regular check-ups with a gynecologist.

Radiation therapy for cancer of the uterus or cervix is ​​primarily a postoperative measure.Although early irradiation can promise success, surgery provides a better prognosis. That is why radiotherapy makes sense in combination with surgery and is indispensable if surgery is not possible.