Many women are likely to say that when they experience missed or late periods, the first thing that comes to mind is pregnancy. Experts say that most women have a cycle of 28 days, however, regular cycles that are longer or shorter than this, from 21 to 40 days, are normal.
Some women do not always have a regular menstrual cycle, as their period may be early or late, and the length of the time it lasts and how heavy it is may differ each time.
According to Dr Iba Mayele, an obstetrician-gynaecologist at Clinic Galien- Kimironko, missed or late periods happen for many reasons other than pregnancy.
Causes range from light to serious medical conditions such as polycystic ovary syndrome, a complicated disorder that affects hormones and metabolism.
He adds that it could also be a result of stress, changes in your daily routine, weight loss or being overweight, too much exercise and taking contraception.
"Prolonged periods of stress are believed to affect a woman’s menstrual cycle, thus resulting in longer or shorter, or even causing a missed period.
"Some women also report more painful period cramps while going through stress,” Dr Mayele says.
He says to try and create time to relax. Regular exercise, such as running, swimming, and yoga, can help you relax. Breathing exercises can be of help too.
"A sudden change may affect your menstrual cycle. Gaining weight or losing weight can have a great impact on your menstrual cycle—either positive or negative. Due to weight change, you may experience irregular or regular, this can make your periods come less frequently or even stop,” he says.
Many illnesses and disorders, such as liver dysfunction, diabetes, thyroid disease, among others, can impede your cycle until they are treated, Dr Mayele says. However, if the condition is treated, it might take a few months before your period returns to normal.
Prof Stephen Rulisa, an obstetrician-gynaecologist at University Teaching Hospital of Kigali (CHUK), notes that usually late or missed periods are due to hormonal imbalance. This occurs when there is too much or too little of a certain hormone. Even small changes can have serious effects throughout one’s whole body.
Fibroids, Dr Rulisa says, can also delay your period. Fibroids can develop when the muscle tissue grows abnormally within the uterus or on uterine walls, when you have fibroid tumours—or any ovarian cyst, or even experience a hormonal imbalance. It’s the imbalance that interrupts the menstrual cycle thus missing your menses.
Urinary tract infections (UTIs) are common and are to be taken seriously, especially in sexually active women of reproductive age. Since the opening of your urethra is the head of your vagina, you may be concerned that developing an infection of this type might make your period late. If the UTI is caused by bacteria, you will be prescribed antibiotics to cure the infection, Dr Rulisa says.
He adds that pregnancy-related conditions such as abortion could delay the menstruation, this is because the woman may experience bleeding right after an abortion, but it will take several weeks for periods to return.
Experts say that a woman will usually have her next period four to eight weeks after having an abortion. The abortion empties the uterus, so it restarts the menstrual cycle. The start date of a woman’s next period will depend on whether she is using birth control and, if so, which one exactly.
Dr Rulisa notes that concern should depend on age, menopause or not, because causes are different.
According to Very Well Health, extreme exercises can cause changes in pituitary hormones and thyroid hormones, which can impact ovulation and menstruation. ‘Working out for one or two hours per day shouldn’t affect your menstrual cycle. It takes hours upon hours of demanding exercise every day for these hormonal changes to occur.’
If you are planning on exercising that much, you may want to consult with a sports medicine doctor. Their job is to help your body support all of the physical demands that you are putting on it.
In the article, ‘How Late Can a Period Be Before You Should Worry? 8 Reasons for a Delayed Period’, published by Flo, an ovulation calendar, period tracker and pregnancy app and go-to digital fertility predictor for women, it says, "A pregnancy test can confirm pregnancy starting from the first day of a missed period. If any of the following symptoms are present, it’s important to see a health care provider:
• Unexpected heavy bleeding
• Severe pain
• Vomiting and nausea
• Dizziness
• High fever
• Pressure in the lower abdomen
Everybody has different cycles, which can vary in length from month to month. If you have any concerns about your symptoms, a health care provider can answer questions, offer advice, and diagnose and treat any underlying issues.”