Menstrual Period – Missed or Late
Is this your child’s symptom?
- Late or missed menstrual period
- Late period: 5 or more days late compared to normal menstrual cycle
- Missed period: no menstrual flow for more than 6 weeks
- Teen not using any birth control that stops periods. These products include birth control shots, implants, and IUDs with hormones.
Normal Cause of a Missed Period during the First Year
- Skipping periods is common during the first 1 to 2 years after they start. This is due to not releasing an egg each month.
- This is most likely the cause if less than 2 years since the first period
- Has missed periods in the past or has had only 1 or 2 periods
- Otherwise healthy
- No signs of pregnancy such as breast tenderness, breast swelling or nausea
Common Cause of a Missed Period after the First Year
- Pregnancy is the most common cause
Other Causes
- Stress
- Dieting, extreme exercise and weight loss
- Polycystic ovarian disease
- Endocrine disorders
- Birth control products like birth control shots, implants, and some IUDs
Home Urine Pregnancy Tests
- Home urine pregnancy tests do not cost very much. They are easy to use. Most drugstores sell these tests. No prescription is needed.
- Urine pregnancy tests are very accurate. They can turn positive as early as the first week after a missed period.
- It is best to do the pregnancy test first thing in the morning. Reason: hormone levels are higher in the morning urine.
- Sometimes, a home test is negative even if you think you might be pregnant. In this case, repeat the test. Do the repeat test in 3-5 days. You can also go to a doctor’s office for testing.
- A pregnancy testing fact sheet can be found at www.womenshealth.gov. Search "pregnancy tests."
When to Call Us for Menstrual Period – Missed or Late
Call Doctor or Seek Care Now
- Your teen looks or acts very sick
- You think your teen needs to be seen, and the problem is urgent
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Contact Doctor During Office Hours
- Home pregnancy test is positive
- You want a pregnancy test done in the office
- Sexual intercourse (had sex) within the last 3 months
- Recent breast swelling, weight gain or nausea
- Teen acts sick
- Has missed 2 or more periods and prior periods were regular
- Recent weight loss
- Excessive exercise suspected as cause of no periods
- First period started less than 1 year ago and has missed 4 or more periods
- Age 15 or older and periods have not started
- Cause is unknown (not recent onset of menstrual periods or recent stress)
- You think your teen needs to be seen, but the problem is not urgent
- You have other questions or concerns
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Self Care at Home
- Pregnancy suspected or possible
- First period started less than 1 year ago and has missed 3 periods or less
- Recent stress (such as starting at a new school, break-up) causing late period
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Care Advice
Pregnancy Suspected or Possible
- What You Should Know About Late Periods if Having Sex:
- Menstrual periods stop when a woman becomes pregnant.
- A woman with a missed or late period should think about pregnancy.
- Here is some care advice that should help.
- Pregnancy Test, When in Doubt:
- If there is a chance that you might be pregnant, use a urine pregnancy test.
- You can buy a pregnancy test at any drugstore.
- It works best first thing in the morning.
- Follow all package instructions.
- Call Your Doctor If:
- You have trouble with the home pregnancy test
- Pregnancy test is positive
- Misses 2 periods and pregnancy test is negative
- Your teen develops any serious symptoms
First Period Started Less than 1 Year Ago
- What You Should Know About First Periods in Young Teens:
- Skipping periods is common during the first 1 or 2 years after they start.
- It doesn’t mean anything serious or cause any harm.
- A girl can normally go up to 6 months between the first and second periods.
- Also, a girl can go up to 4 months between the second and third periods.
- Normal irregular periods can go on for 2 years.
- Call Your Doctor If:
- Misses 4 periods
- New symptoms suggest pregnancy (such as morning sickness)
- You have other questions
Recent Stress Causing Late Period
- What You Should Know about Stress and Late Menstrual Periods:
- Stress can disrupt normal menstrual cycles.
- Try to help your daughter deal with the stress by talking about it.
- Also, try to avoid or decrease stressors.
- If this does not help, seek help from a counselor.
- Call Your Doctor If:
- Misses 2 periods
- Your daughter needs help coping with stress
- New symptoms suggest pregnancy (such as morning sickness)
- You have other questions
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.