Polycystic Ovary Syndrome (PCOS): Symptoms and Treatment

Video: How much does PCOS affect fertility?

With PCOS leading to so many subsequent problems, it’s no wonder that many women have a lot of q…

What is PCOS?

Prof Lesley Regan

Polycystic ovaries

How common is PCOS?

PCOS is common. It is difficult to know exactly how common, as figures vary depending on the definitions used and the countries studied.

Research studies of women who had an ultrasound scan of their ovaries found that up to a third of young women have polycystic ovaries (ie ovaries with many small cysts). However, many of these women were healthy, ovulated normally and did not have high levels of male chemicals (hormones).

It is thought that around 1 in 10 women have PCOS (at least two of: polycystic ovaries, raised male hormone levels, reduced ovulation). However, the true figure may be higher because some women with mild symptoms do not seek any assessment or treatment.

PCOS

It is important that healthcare professionals are aware of the full range of signs of symptoms of PCOS and ensure that appropriate attention is given both to their management and their impact on an individual’s mental health.

— Professor Adam Balen, How PCOS affects your mental health

PCOS symptoms

Symptoms typically begin in the late teens or early 20s. Not all symptoms occur in all women with PCOS. For example, some women with PCOS have some excess hair growth but have normal periods and fertility.

Symptoms of PCOS can vary from mild to severe. For example, mild unwanted hair is normal, and it can be difficult to say when it becomes abnormal in women with mild PCOS. At the other extreme, women with severe PCOS can have marked hair growth, infertility and obesity.

Symptoms may also change over the years. For example, acne may become less of a problem in middle age but hair growth may become more noticeable.

• Period problems occur in about 7 in 10 women with PCOS. You may have irregular or light periods, or no periods at all.
• Fertility problems – you need to ovulate to become pregnant. You may not ovulate each month. Some women with PCOS do not ovulate at all. PCOS is one of the most common causes of not being able to get pregnant (infertility).
• Excess hair growth (hirsutism) occurs in more than half of women with PCOS. It is mainly on the face, lower tummy (abdomen) and chest. In other words, it tends to be male-pattern hair. This does not happen to all women with PCOS.
• Acne may persist beyond the normal teenage years.
• Thinning of scalp hair (similar to male pattern baldness) occurs in some cases.
• Weight gain – women with PCOS are more at risk of becoming overweight or obese.
• Depression or poor self-esteem may develop as a result of the other symptoms.

What causes PCOS?

The exact cause is not totally clear. Several factors probably play a part. These include the following:

Insulin resistance

Women with PCOS have insulin resistance. This means that cells in the body are resistant to the effect of a normal level of insulin. More insulin is then produced to keep the blood sugar normal.

This raised level of insulin causes the ovaries to make too much testosterone. A high level of insulin and testosterone causes problems with ovulation – hence, period problems and reduced fertility. It is this increased testosterone level in the blood that causes excess hair growth on the body and thinning of the scalp hair. Increased insulin also contributes towards weight gain.

Luteinising hormone (LH)

This hormone is made in the pituitary gland, which is located in the base of the brain. It stimulates the ovaries to ovulate and works alongside insulin to promote testosterone production.

A high level of LH is found in about 4 in 10 women with PCOS. A high LH level combined with a high insulin level means that the ovaries are likely to produce too much testosterone.

Hereditary factors

PCOS is not usually inherited from parents but it may run in some families. There seems to be a hereditary (genetic) factor involved in some cases but this is not yet understood.

Weight

Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese, excess fat can make insulin resistance worse. This may then cause the level of insulin to rise even further.

High levels of insulin can contribute to further weight gain producing a ‘vicious cycle’. Losing weight, although difficult, can help break this cycle.

Are any tests needed to diagnose PCOS?

Tests may be advised to clarify the diagnosis and to rule out other hormone conditions.

• Blood tests may be taken to measure certain chemicals (hormones). For example, a test to measure the male hormone testosterone and luteinising hormone (LH) which tend to be high in women with PCOS.
• An ultrasound scan of the ovaries may be advised. An ultrasound scan is a painless test that uses sound waves to create images of structures in the body. The scan can detect the typical appearance of PCOS with the many small cysts (follicles) in slightly enlarged ovaries.

Screening for diabetes or pre-diabetes

Also, you may be advised to have an annual screening test for diabetes or impaired glucose tolerance (pre-diabetes). A regular check for other cardiovascular risk factors such as blood pressure and blood cholesterol, may be advised to detect any abnormalities as early as possible.

Exactly when and how often the checks are done depends on your age, your weight and other factors. After the age of 40, these tests are usually recommended every three years.

PCOS treatment

There is no cure for PCOS. However, symptoms can be treated and your health risks can be reduced.

You should aim to lose weight if you are overweight

Losing weight helps to reduce the high insulin level that occurs in PCOS. This has a knock-on effect of reducing the male chemical (hormone) called testosterone. This then improves the chance of you ovulating, which improves any period problems and fertility, and may also help to reduce hair growth and acne. The increased risks of long-term problems such as diabetes, high blood pressure, etc, are also reduced.

Losing weight can be difficult. A combination of eating less and exercising more is best. Advice from a dietician, and help and support from a practice nurse, may increase your chance of losing weight. Even a moderate amount of weight loss can help.

The best foods for someone with PCOS to eat are likely to be those which are slowly absorbed keeping blood sugar levels steady. These are said to have a low glycaemic index (low GI).

This means avoiding white bread, pasta and rice, and choosing wholemeal alternatives. Potatoes and sugary foods and drinks are also best avoided. Most fruit, vegetables, pulses and wholegrain foods are both healthy and have a low GI.

Occasionally tablets (such as orlistat) or operations for weight loss may be considered.

Treating hair growth

Hair growth is due to the increased level of the hormone testosterone. Unwanted hair can be removed by:

• Shaving.
• Waxing.
• Hair-removing creams.
• Electrolysis.
• Laser treatments.

These need repeating every now and then, although electrolysis and laser treatments may be more long-lasting (but are expensive and are often not available on the NHS).

There are also some medicines which may be helpful. A cream called eflornithine may be prescribed for removing unwanted facial hair. It works by counteracting a chemical (an enzyme) involved in making hair in the skin. Some research trials suggest that it can reduce unwanted hair growth, although this effect quickly wears off after stopping treatment.

Medicines taken by mouth can also treat hair growth. They work by reducing the amount of testosterone that you make, or by blocking its effect. Medicines used include:

• Cyproterone acetate – an anti-testosterone medicine. This is commonly combined with oestrogen as a special oral contraceptive pill called Dianette®. Dianette® is commonly prescribed to regulate periods, to help reduce hair growth, to reduce acne and as a good contraceptive.
• The combined oral contraceptive (COC) pill Yasmin® (a combination of ethinylestradiol and drospirenone) has been shown to help if Dianette® is not suitable.
• Other anti-testosterone medicines are sometimes advised by a specialist if the above treatments do not help.

Medicines taken by mouth to treat hair growth take 3-9 months to work fully. You need then to carry on taking them, otherwise hair growth will come back (recur). Removing hair by the methods above (shaving, etc) may be advised whilst waiting for a medicine to work.

Treating acne

The treatments used for acne in women with PCOS are no different to the usual treatments for acne. The combined oral contraceptive pills, especially Dianette®, often help to improve acne. See the separate leaflets called Acne and Acne Treatments which covers topical treatments and antibiotic tablet treatment for acne.

Treating period problems

Some women who have no periods, or have infrequent periods, do not want any treatment for this. However, your risk of developing endometrial cancer (cancer of the womb/uterus) may be increased if you have no periods for a long time. Regular periods will prevent this possible increased risk to the uterus.

Therefore, some women with PCOS are advised to take the contraceptive pill, as it causes regular withdrawal bleeds similar to periods. If this is not suitable, another option is to take a progestogen hormone, such as medroxyprogesterone for several days every few months.

This will cause a monthly bleed like a period. Sometimes, an intrauterine system (IUS), which releases small amounts of progestogen into the womb, preventing a build-up of the lining, can be used. If none of these methods is suitable, your doctor may advise a regular ultrasound scan of your uterus to detect any problems early.

Fertility issues

Although fertility is often reduced, you still need contraception if you want to be sure of not getting pregnant. The chance of becoming pregnant depends on how often you ovulate. Some women with PCOS ovulate now and then, others not at all.

If you do not ovulate but want to become pregnant then fertility treatments may be recommended by a specialist and have a good chance of success. Tablets such as clomifene can cause you to ovulate.

But remember, you are much less likely to become pregnant if you are obese. If you are obese or overweight then losing weight is advised in addition to other fertility treatments.

Metformin and other insulin-sensitising medicines

Metformin is a medicine that is commonly used to treat people with type 2 diabetes. It makes the body’s cells more sensitive to insulin. This may result in a decrease in the blood level of insulin which may help to counteract the underlying cause of PCOS – see above.

For certain people with PCOS, a specialist may advise that metformin be taken. However, further research is needed to confirm the role of these medicines in the treatment of PCOS.

Possible long-term problems of polycystic ovary syndrome

If you have PCOS, over time you have an increased risk of:

• Developing type 2 diabetes.
• Developing diabetes in pregnancy.
• A high cholesterol level.
• High blood pressure.
• Being overweight, particularly around the tummy.

These problems in turn may also increase your risk of having a stroke and heart disease in later life. These increased health risks are due to the long-term insulin resistance.

A sleeping problem called sleep apnoea is also more common than average in women with PCOS.

Other possible problems in pregnancy include more chance of having premature babies or having high blood pressure in pregnancy (pre-eclampsia). There may be twice the risk of developing diabetes in pregnancy if you have PCOS so you would be checked for this regularly.

If you have no periods, or very infrequent periods, you may have a higher-than-average risk of developing cancer of the womb (uterus). However, the evidence for this is not conclusive and, if there is a risk, it is probably small and can be prevented.

Preventing long-term problems

A healthy lifestyle is important to help prevent the conditions listed above in ‘Possible long-term problems of polycystic ovary syndrome (PCOS)’. For example, you should:

• Eat a healthy diet.
• Exercise regularly.
• Lose weight if you are overweight or obese.
• Not smoke.

Healthy lifestyle advice applies to everyone, whether they have PCOS or not. However, it is particularly important for women with PCOS, as they may have extra risk factors for health problems in later life. These risks are much reduced if you are not overweight and do not smoke.

Menopause: Causes, Symptoms, and Treatment

In this series Vaginal Dryness (Atrophic Vaginitis) Hormone Replacement Therapy (HRT) Alternatives to HRT for Menopause Symptoms Premature Ovarian Insufficiency

The menopause is the time when your ovaries stop working to make an egg each month – it occurres 12 months after your last period. However, most women think of the menopause as the time of life leading up to, and after, their last period, though the correct term for this is the perimenopause. In reality, your periods don’t just stop. First they tend to become less frequent. It can take several years for a woman to go through the menopause completely.

Menopause

In this article

• What is menopause?
• What causes early menopause?
• Menopause symptoms
• How does menopause affect your body?
• Is there a test for menopause?
• Menopause treatment
• Can you get pregnant after the menopause?

What is the menopause?

Dr Sarah Jarvis MBE

How to have great sex during and after the menopause

Reaching the menopause can often be met with feelings of anxiety and uncertainty about how y. ..

What is menopause?

A natural menopause occurs because as you age your ovaries stop producing eggs and make less oestrogen (the main female hormone).

What age does the menopause happen?

The average age of the menopause in the UK is 51. Your menopause is said to be early if it occurs before the age of 45.

What causes early menopause?

There are certain things that may cause an early menopause – for example:

• If you have surgery to remove your ovaries for some reason, you are likely to develop menopausal symptoms straightaway.
• If you have radiotherapy to your pelvic area as a treatment for cancer.
• Some chemotherapy medicines that treat cancer may lead to an early menopause.
• If you have had your womb (uterus) removed (hysterectomy) before your menopause. Your ovaries will still make oestrogen. However, it is likely that the level of oestrogen will fall at an earlier age than average. As you do not have periods after a hysterectomy, it may not be clear when you are in ‘the menopause’. However, you may develop some typical symptoms (see below) when your level of oestrogen falls.
• An early menopause can run in some families.
• In many women who have an early menopause, no cause can be found.

If your menopause occurs before you are 40, it is due to premature ovarian insufficiency. Read more about premature ovarian insufficiency.

Menopause symptoms

The menopause is a natural event. Every woman will go through it at some point. You may have no problems. However, it is common to develop one or more menopause symptoms which are due to the dropping level of oestrogen. About 8 out of 10 women will develop menopausal symptoms at some point. Around a quarter of women have very severe symptoms.

Menopause symptoms may only last a few months in some women. However, for others symptoms can continue for several years. Some women may have early menopause symptoms that start months or years before their periods stop (peri-menopausal symptoms). More than half of women have symptoms for more than seven years:

Hot flushes

These will occur in about 3 in 4 women. A typical hot flush (or flash) lasts a few minutes and causes flushing of your face, neck and chest. You may also sweat (perspire) during a hot flush. Some women become giddy, weak, or feel sick during a hot flush. Some women also develop a ‘thumping heart’ sensation (palpitations) and sudden feelings of anxiety during the episode. The number of hot flushes can vary from every now and then, to fifteen or more a day. Hot flushes tend to start just before the menopause and can persist for several years.

Sweats

This commonly occurs when you are in bed at night. In some cases they are so severe that sleep is disturbed and you need to change your bedding and nightclothes.

Other symptoms

Possible further symptoms may develop, such as:

• Headaches.
• Tiredness.
• Being irritable.
• Difficulty sleeping.
• Depression.
• Anxiety.
• Palpitations.
• Aches and pains in your joints.
• Loss of sex drive (libido).
• Feelings of not coping as well as you used to.

Changes to your periods

The time between periods may shorten in some women around the menopause; in others, periods may become further apart, perhaps many months apart.

How does menopause affect your body?

Following the menopausal transition, women’s body may change in several ways:

Skin and hair

You tend to lose some skin protein (collagen) after the menopause. This can make your skin drier, thinner and more likely to itch. See our feature on How to manage skin problems at menopause.

Genital area

Lack of oestrogen tends to cause the tissues in and around your vagina to become thinner and drier. Learn more about vaginal dryness (atrophic vaginitis). These changes can develop months or years after menopause:

• Your vagina may shrink a little and expand less easily during sex. You may experience some pain when you have sex.
• Your vulva (the skin next to your vagina) may become thin, dry and itchy.
• You may notice that you need to pass urine more frequently and may even leak.
• Some women develop problems with recurrent urine infections.

‘Thinning’ of the bones (osteoporosis)

As you become older, you gradually lose bone tissue. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss then you may develop osteoporosis. If you have osteoporosis, you have bones that will break (fracture) more easily than normal, especially if you have an injury such as a fall. Women lose bone tissue more rapidly than men lose it, especially after the menopause when the level of oestrogen falls. Oestrogen helps to protect against bone loss.

Cardiovascular disease (heart disease)

Your risk of disease of the heart and blood vessels (cardiovascular disease), including heart disease and stroke, increases after the menopause. Again, this is because the protective effect of oestrogen is lost. Oestrogen is thought to help protect your blood vessels against atheroma. In atheroma, small fatty lumps develop within the inside lining of blood vessels. Atheroma is involved in the development of heart disease and stroke. You can reduce this risk by looking at other risk factors – don’t smoke, stay at a healthy weight and eat a healthy diet.

Is there a test for menopause?

Hormone blood tests

Your doctor can usually diagnose the menopause by your typical symptoms. Hormone blood tests are not usually needed to confirm that you are going through the menopause. However, they may be helpful in some cases – for example, in women aged under 45 years.

Other blood tests or scans may be undertaken in some women, especially if they do not have symptoms which are typical of the menopause and their doctor wants to look for other causes of their symptoms.

It is important that you keep up to date with the national cervical screening programme and breast cancer screening programme, if appropriate.

Menopause treatment

Without treatment, the symptoms discussed above last for several years in most women. HRT is a very effective treatment for the symptoms of the menopause. It replaces the oestrogen hormone that your ovaries stop making once you are menopausal. It has benefits and risks. Find out more about hormone replacement therapy (HRT).

If your main symptoms are in your vagina and genital area or if you are getting urinary incontinence symptoms, you are likely to benefit from using treatment that is inserted into your vagina or just applied to your genital area as a cream or used inside the vagina as a ring. Read about treatment for vaginal dryness and urinary symptoms. This vaginal HRT can be used alone, or with systemic HRT that is taken as a patch, spray, gel or tablet.

Systemic HRT is available as:

• Tablets.
• Skin patches.
• Gels to apply to the skin.

There are several brands for each of these types of HRT. All deliver a set dose of oestrogen (with or without progestogen) into your bloodstream.

There are treatments other than HRT for menopausal symptoms. As a rule, they are not as effective as HRT but may help relieve some symptoms. See the separate leaflet called Alternatives to HRT for Menopause Symptoms.

Can you get pregnant after the menopause?

Although women become less fertile as they get older, it is still possible to get pregnant around the time of the menopause. So, if you are sexually active and don’t want to become pregnant, you will need to consider contraception:

• Until a year after your last period if you are 50 or over.
• Until two years after your last period if you are under 50.

Assessing when to stop contraception is more difficult if your periods have stopped due to your current contraception. For example, the implant, the hormone coil and some pills can cause your periods to stop. If this applies to you then you have two choices. You can either continue contraception until the age of 55 (at which time all women can stop), though you may need to change the type of contraception at age 50. Or you can have a blood test at the age of 50 – if this shows that you are in the menopausal range then you can stop your contraception one year after the blood test.

See the separate leaflet called Contraception for Women over 40.

Dr Toni Hazell works for the Royal College of General Practitioners and worked as the eLearning fellow on the RCGP 2022 menopause course, funded by Bayer. She is currently on the board of the Primary Care Women’s Health Forum. She has lectured on menopause and HRT for a variety of organisations.

• Menopause: diagnosis and management; NICE Guideline (November 2015 – last updated December 2019)

• Contraception for Women Aged over 40 Years; Faculty of Sexual and Reproductive Healthcare (2017 – last updated September 2019)

• HRT – Guide; British Menopause Society (2020)

• Menopause and later life; RCOG

• Rock My Menopause; Primary Care Women’s Health Forum

• Factsheets and other resources; Women’s Health Concern

Five causes of missed periods: symptoms, diagnosis and treatment

Content

• 1 Five reasons why women miss their periods
  • 1. 1 Five causes of missed periods
  • 1.2 Symptoms and possible causes of missed periods 900 08
  • 1.3 Diagnosis and analysis
  • 1.4 Pregnancy test
  • 1.5 Treatment and advice
  • 1.6 Prevention of missed periods
  • 1.7 Related videos:
  • 1.8 Question-answer:
    • • 1.8.0.1 What can cause a delay in menstruation?
      • 1.8.0.2 What symptoms can accompany a missed period?
      • 1.8.0.3 How can the cause of delayed menstruation be diagnosed?
      • 1.8.0.4 What can help in the treatment of delayed menstruation?
      • 1.8.0.5 Can problems with delayed menstruation affect the possibility of conception in the future?
      • 1.8.0.6 Can I prevent missed periods?

Find out what can cause your period to be delayed by five days. In this article, we’ll take a look at the most common causes of cycle irregularities, including pregnancy, stress, weight changes, and other factors. Be aware of what to do in such a situation and how to proceed further.

Menstruation is a natural process in the female body that occurs about once a month. However, some women experience slowdowns or delays in their menstrual cycle. This can be caused by various reasons and requires additional attention and medical supervision. In this article, we look at five possible causes of missed periods, along with symptoms, diagnosis, and treatment.

Pregnancy may be the first cause of missed periods. If you have a delay, and you have had sexual intercourse without the use of contraception, then the first step is to check for pregnancy. However, pregnancy is not always the only reason for delay.

The second possible factor may be breastfeeding. Breastfeeding can affect a woman’s hormonal balance, which can lead to a slower menstrual cycle or delayed periods.

The third possible reason for the delay could be stress. Long periods of stress can lead to hormonal imbalances in the body, which can cause a missed period.

The fourth reason for the delay may be due to a change in weight. Sudden weight loss or weight gain can affect the hormonal balance of the female body, which can lead to a delay in menstruation.

A fifth possible reason for delay may be illness. Some conditions, such as polycystic ovary syndrome, can cause menstrual irregularities and delayed periods.

In any case, if you have a missed period, you need to see a doctor who will diagnose and determine the cause. Based on this, appropriate treatment will be suggested.

Five causes of delayed menstruation

Menstruation is a natural process in the life of every girl and woman. But sometimes delays can occur, which can be caused by various factors.

• Stress and emotional tension. Nervous shocks, stress and excessive physical exertion can have a negative impact on the hormonal balance in the body, which can lead to a delay in menstruation.
• Eating disorders. Not following a healthy diet, excessive consumption of fatty, spicy and salty foods, lack of iron and vitamins can lead to hormonal imbalance and delayed menstruation.
• Incorrect use of contraceptives. Improper use of contraceptives (especially after their withdrawal) can lead to delayed menstruation and other cycle disorders.
• Polycystic ovary syndrome. This is a common disorder that causes hormonal imbalance and can delay menstruation.
• Pregnancy. The most common cause of missed periods is pregnancy. If you have a delay, it is worth checking for pregnancy.

If you have a missed period, the best solution is to see a gynecologist who can help determine the cause of the delay and prescribe the appropriate treatment.

Symptoms and possible causes of delayed menstruation

There are various factors that can cause a missed period. One of the most obvious symptoms is the absence of vaginal bleeding for more than 35 days. Let’s note a few more characteristic signs:

• Pain in the lower abdomen and back. May occur after menstruation is delayed and may indicate hormonal disorders.
• Tension of the mammary glands. A common cause of this condition is a change in the level of estrogen in the blood in the presence of cysts, tumors or pathological pregnancy.
• Increased body temperature. If it stays at 37.5-38 degrees for several days, it is necessary to exclude the presence of a gynecological disease.
• Menstrual dysmenorrhea. It may appear in some women in the middle or at the end of the cycle and may well be the cause of the delay.
• Change in weight. Critical changes in body weight can affect the functioning of the hypothalamus and gonads, causing irregular menstruation.

Thus, the delay in menstruation is a consequence of disorders in the body. It is necessary to know all the possible causes of this phenomenon and contact a gynecologist in a timely manner for diagnosis and treatment.

Diagnosis and analysis

If a woman notices that her menstrual cycle is delayed by several days, then you need to contact a gynecologist. The doctor will conduct an examination and may prescribe additional studies:

• General analysis of blood and urine. Allows you to assess the general condition of the body and identify the presence of inflammatory processes.
• Ultrasound of the pelvic organs. Allows you to determine the condition of the uterus and ovaries, to identify the presence of cysts, tumors and other volumetric formations.
• Hormone analysis. Allows you to assess the level of hormones in the body and identify the presence of disorders in the endocrine system.
• Colposcopy. Allows you to check the condition of the cervix and identify the presence of pathologies and tumors.

After receiving the results of tests and diagnostic studies, the doctor may prescribe treatment depending on the identified reasons for the delay in menstruation.

Pregnancy test

Pregnancy can be one of the reasons for missed periods. If the delay continues for more than 5-7 days, a pregnancy test is recommended.

How to carry out a pregnancy test? To do this, you need to buy a test at a pharmacy and follow the instructions that are usually attached to the test. The test can be a strip, a cassette, or a tree. It determines the presence of the hormone chorionic gonadotropin (hCG), which is produced only during pregnancy.

When performing a pregnancy test, certain rules must be observed, for example, to test in the morning from the first portion of urine, when the concentration of hCG in the urine is highest. It is also important to consider that some medications and body conditions can affect the result of the test.

If a pregnancy test is positive, you should see a doctor to confirm pregnancy and start preparing for childbirth. In the event of a negative pregnancy test result, but a continued delay in menstruation, it is necessary to consult a doctor for additional examinations in order to identify the cause of the delay.

Treatment and recommendations

The treatment for missed periods depends on the cause of the delay. If the delay is due to pregnancy or hormonal changes, then treatment may not be required. However, if the delay is due to other problems, then you should consult your doctor.

For polycystic ovaries, the doctor may prescribe contraceptives to normalize hormones. If the delay is caused by emotional stress, then it is necessary to eliminate the cause of stress, for example, visit a psychologist or practice relaxation.

If the delay is due to diet or increased physical activity, it is necessary to change the diet and rest. It is important to make sure that the body receives the vitamins and minerals necessary for normal functioning.

In rare cases, surgery may be required, such as in the presence of an ovarian tumor or other diseases of the reproductive system.

In general, to prevent missed periods it is important to lead a healthy lifestyle, eat right, avoid stressful situations and take care of your physical and mental health.

Prevention of delayed menstruation

Delayed menstruation can be caused by various factors: stress, poor environmental situation, malnutrition, etc. However, there are several simple ways to help prevent missed periods:

1. Sports and an active lifestyle . Regular exercise will help strengthen the immune system, improve overall health, promote proper hormonal function, and may prevent missed periods.
2. Proper nutrition. It is necessary to consume enough vitamins, minerals and proteins that take care of the health of the body. Limit the consumption of fatty and fried foods, flour products and sweets, which can cause disturbances in the body.
3. Psycho-emotional health. It is important to avoid constant stress, rest and relax, practice yoga or meditation, which will help minimize negative emotions and prevent missed periods.
4. Regular examination by a gynecologist. Women should visit a gynecologist at least once a year to prevent possible diseases. Regular check-ups are an important step to prevent missed periods.
5. Correct genital hygiene. It is necessary to observe the hygiene of the genitals, to prevent possible infections and the development of diseases.

Video on the topic:

Q&A:

What can cause a delay in menstruation?

A missed period can be caused by a variety of factors, including pregnancy, thyroid problems, PCOS, fatigue, stress, etc.

What symptoms can accompany a missed period?

Delay symptoms may include: slight spotting, breast enlargement and tenderness, loss of appetite and drowsiness, irritability, etc.

How can the cause of a missed period be diagnosed?

Various blood and urine tests, ultrasound, MRI, PCT, hysteroscopy and other examinations may be ordered to diagnose the causes of the delay, depending on the suspected cause.

What can help with missed periods?

Treatment for missed periods depends on the cause. In some cases, lifestyle changes, including proper nutrition and the rejection of bad habits, are enough. Other cases may require hormone therapy or surgery.

Can problems with missed periods affect my ability to conceive in the future?

Yes, if it is necessary to take care of the health of the female reproductive organs. If the delay is caused by serious problems with the body, then treatment may be required.

Can I prevent missed periods?

Yes, if you lead a healthy lifestyle and take care of your body. It is important to avoid stress, eat right, exercise. If you suspect a missed period, it is recommended that you contact your doctor immediately.

ᐉ 10 Reasons for delayed periods other than pregnancy ➡ And what to do?

A woman’s period can be delayed at any age. This problem is one of the most common reasons to visit a gynecologist. The reason for the absence of menstruation is not only pregnancy – with a delay, the test may be negative. Then it is possible that the failure of the menstrual cycle indicates serious problems in the female body. What could be the reasons for the delay in menstruation, other than pregnancy, and how to normalize the menstruation cycle – read our article.

Women’s cycle: how many days of delay – within the normal range

Each woman’s body is characterized by an individual rhythm of the menstrual cycle, the duration and volume of bleeding and other features. If the menstruation did not go on time, the girls ask themselves: is this normal, how many days can there be a delay? Normally, the cycle of menstruation lasts from 21 to 35 days, a slight delay within 7-10 days is not a cause for concern. If the menstruation disappeared for a longer period, while the test is negative, it is necessary to consult a gynecologist and find out the reasons for the delay.

What are the reasons for the delay in menstruation?

The reasons why there may be a delay in menstruation are often physiological (stress, climate change, unbalanced diet, obesity) or pathological (hormonal imbalance, inflammation, STIs). One way or another, the failure of the menstrual cycle is an alarm, and in no case should it be ignored. Let’s figure out what are the reasons for the absence of menstruation other than pregnancy.

Hormonal imbalance

A common reason for the lack of menstruation is endocrine disruption or imbalance of hormones. There are more than 60 of these biologically active substances in the human body. All of them interact with each other, regulating the functioning of organs and body systems. Violation of the synthesis of one hormone affects the concentration of another, causing an imbalance. Delayed menstruation is one of the symptoms of a malfunction in the endocrine system. As provocateurs usually act:

• follicle-stimulating and luteinizing hormones produced by the pituitary gland, their function is to regulate the process of maturation of the follicle and the release of the egg from it;
• thyroid hormones – affect the synthesis of sex hormones;
• hormones produced by the adrenal cortex (corticosteroids).

Jumps in hormone levels and, as a result, a delay in menstruation, occur in girls during adolescence, in women after 45 years of age during perimenopause, as well as after long-term use and then abrupt withdrawal of hormonal drugs.

Inflammatory diseases in the genital area

Inflammation of the reproductive organs (endometritis, adnexitis) is another common cause of delayed menstruation, except for pregnancy. Along with menstrual irregularities, inflammatory processes in the genital area are accompanied by atypical vaginal discharge, pain in the lower abdomen, and fever. This condition requires immediate medical attention. Running inflammation in a feminine way leads to infertility and other complications.

Severe, long-term stress

One of the possible causes of delayed periods is constant exposure to severe stress. When a person is nervous, the level of cortisol and adrenaline in the blood rises, inhibiting the synthesis of sex hormones. The result is a violation of the menstrual cycle, the absence of menstruation.

Catarrhal diseases

Quite often the reason why menstruation may be delayed is ARVI, influenza, tonsillitis. Viral and bacterial infections weaken the body, affect the pituitary and hypothalamus, cause hormone imbalance and, as a result, a delay.

Diabetes mellitus types 1 and 2

Metabolic syndrome, diabetes mellitus (DM) types 1 and 2 – such pathologies of the endocrine system also cause menstrual cycle failure, delayed menstruation, menstrual pain. The main factor in the development of diabetes is a violation of the pancreas and its function to produce the hormone insulin, without which the body does not absorb glucose. In type 1 diabetes, insulin is not synthesized in the right amount. In type 2 diabetes, insulin is produced, but cells and tissues become insensitive to it (insulin resistance develops). The connection of insulin with sex hormones (progesterone, estradiol, testosterone) causes a delay in menstruation in diabetes.

Polycystic ovary syndrome

Polycystic ovary syndrome is a pathology of the female reproductive system associated with impaired egg maturation. The disease develops against the background of hormonal failure, namely, increased synthesis of the male hormone testosterone and reduced production of progesterone and estradiol. Polycystic ovary syndrome is another possible cause of persistent missed periods and difficulty conceiving.

Malfunctions of the liver and biliary tract

Liver dysfunction leads to inhibition of the process of inactivation of steroid hormones, which include thyroid hormones produced by the thyroid gland, female and male sex hormones, insulin. As a result, an excessive amount of unsplitted hormones enters the bloodstream, which is the cause of various pathological conditions, including delayed menstruation and reduced fertility.

Obesity or underweight

Normal body mass index (BMI = height squared in meters / body weight in kg) from 18.5 to 25. Overweight BMI over 25, obese over 30. Underweight observed with a BMI below 18.5.

The work of the female body is negatively affected by deviation from the norm, both up and down:

Adipose tissue performs the functions of an endocrine gland: like in the ovaries, estrogens are produced in it. Obesity leads to excessive estrogen synthesis, which means to hypersecretion of luteinizing hormone and, in a chain, to excessive stimulation of androgen production. An imbalance of hormones causes the absence of monthly or excessive uterine bleeding, over time, polycystic ovaries, chronic anovulation and endocrine infertility may develop.

Starvation, lack of nutrients, sudden weight loss – all this often leads to severe stress, hormonal shake-up, metabolic disorders. And it can cause the disappearance of menstruation.

Change of climate, daily biorhythms

The process of adaptation of the body to changing climatic conditions (difference in temperature, humidity and atmospheric pressure) may be accompanied by a menstrual cycle failure. The same applies to changes in the usual daily biorhythms – wakefulness at night, work in night shifts.

Taking certain medications

Uncontrolled intake, incorrect dosage of certain drugs – antidepressants, anticonvulsants and hemostatics, neuroleptics, glucocorticoids, antibiotics, tablets for hypertension can serve as a reason for delaying menstruation.

What to do: when you need to worry about a delay in menstruation

Delayed menstruation is accompanied by an imbalance of hormones, a decrease in the adaptive capacity of the female body and can signal serious health problems. It is impossible to establish a hormonal background without high-quality diagnostics, determining the level of hormones in the blood.