How can we explain the absence of rules?

Every month, you wait for your period like the Messiah: as long as it doesn't fall on a date, or on a Monday morning, or the day you dare to wear white pants… If your cycles are perfectly regular and you manage to anticipate your period, you are one of the lucky ones!

For others, there are various methods to anticipate the likely start of their period so as not to be caught off guard. Some even go for a short jog or do abdominal massages to try to induce it.

What if, despite your calculations and efforts, your period doesn't arrive? Is it necessarily a cause for concern?

Don't panic, there are several reasons why your period might be late or absent for a few months. Let us explain.

Amenorrhea: when should you worry?

Primary amenorrhea and secondary amenorrhea

“Amenorrhea” is the medical (and somewhat pompous) term for the absence of menstruation . It sounds a bit clinical when put like that, but it's not necessarily serious. To determine if your missed or delayed period is cause for concern, let's start with a brief but essential reminder.

You've probably been told that a menstrual cycle lasts an average of 28.5 days and that you ovulate on day 14. That's true, but it's just an average. According to the Medical Research Foundation , a cycle is considered normal if it lasts between 21 and 35 days . If your period is a few days early or late, don't panic: your body is simply following its own rhythm; it's not yet considered amenorrhea.

There are actually 2 types of amenorrhea:

• Primary amenorrhea, if you are over 16 and have never had your period , is likely a sign of a gynecological or hormonal condition. For your information, the average age of first menstruation in France is between 12 and 13 (Inserm). This figure has remained stable for about ten years!

• Secondary amenorrhea occurs when you normally have periods but, for one reason or another, they have been absent for at least 6 months . If you haven't had your period for less than 6 months, it's not considered an absence of periods but a delay (even if this delay is significant and worrying).

Whatever your situation, we explain how to get back to a regular cycle and what the right steps to take are.

Note : If you've just had your first period , be patient. Your body needs at least two years to regulate itself , sometimes longer. Don't worry if your cycles are a little irregular at first; we've all been there.

How can you explain that you have never had your period?

If you are at least 16 years old and have never had your period, you are suffering from primary amenorrhea (you're following along). This doesn't mean you won't have your period; it's just a sign that your body needs a little help. Several scenarios are possible:

• Case 1: Your puberty is delayed . In this case, secondary sexual characteristics (body hair, breasts, widening of the hips, etc.) do not develop. This can be explained in several ways: a chronic illness, a genetic cause, or a nutritional deficiency. Your healthcare professional will likely refer you for hormone treatment to trigger puberty.

• Second case: This involves a chromosomal abnormality called Turner syndrome (total or partial loss of the X chromosome). The absence of menstruation is then associated with a whole host of other symptoms: short stature, low hairline, and non-functional ovaries. This syndrome is often detected in utero , before birth.

Don't hesitate to consult a doctor to shed some light on this and better understand what is happening to you.

Your period is late: the first good reflexes

You were due for your period a few days or even a few weeks ago? Here are some good first steps to take before looking for a medical cause:

1. Take a pregnancy test . Believe it or not, pregnancy is the number one cause of missed periods. And yes, even if you religiously take your pill (or other contraceptive), there's no such thing as zero risk . Start there!

2. If you are breastfeeding, your period (the return of menstruation after childbirth) won't return immediately. You'll have to wait until you've finished breastfeeding. During breastfeeding, your body produces prolactin, a hormone that blocks ovulation, and therefore, the menstruation that would normally follow.

However, be aware that breastfeeding is not a contraceptive. If you do not wish to become pregnant again, use protection!

3. Depending on your age, irregular menstrual cycles may be the first signs of menopause . During this time, the production of estrogen and progesterone (sex hormones) drops, which directly affects your cycles.

In France, menopause generally occurs between the ages of 45 and 55 ( Inserm ). Again, this is just an average; every woman is different. So pay attention to your body's signals.

Once you have eliminated these natural causes, take a closer look at what is at play at the level of your hormones.

You haven't had your period: possible causes

Hormonal disorders that impact the menstrual cycle

Disrupted menstrual cycles mean hormonal imbalances: estrogen and/or progesterone production is affected. Estrogen is truly the star of your cycle. They are produced by the ovaries under the control of the hypothalamus , a small region located in the brain. When this area malfunctions, your entire cycle is affected.

Several reasons could explain this:

1. Insufficient calorie intake

Your organs all need nutrients to function, but your body considers estrogen production non-vital . If your intake is insufficient, it will instead direct available energy towards vital organs.

You may experience a lack of menstruation if you suffer from an eating disorder (ED), such as anorexia nervosa. Don't underestimate this possibility; eating disorders are much more common than you might think. According to the Foundation for Medical Research , they are still underdiagnosed, and 80% of those affected are women.

2. Excessive sports practice

You may have heard the testimonies of female athletes during the Olympics, explaining that they had not had their periods for months , sometimes even years.

Intensive training puts a lot of stress on your body. Combine that with insufficient body fat and a low BMI, and you have the perfect recipe for disrupting your menstrual cycle .

3. Emotional stress

A shock, major news, or a significant life change can have real repercussions on your physical health . In such cases, the absence of menstruation is often associated with other symptoms such as hair loss, acne, weight fluctuations, or sleep disturbances.

4. Excessive consumption of tobacco or alcohol

Well, we didn't want to give you the same old speech about healthy living , but once again… the consequences are very real.

“ From a hormonal standpoint, tobacco has a hypoestrogenic effect , promoting irregular, anovulatory, and shorter menstrual cycles (average reduction of 2.6 days). ” Jacques Cornuz , Carole Willi , Gabrielle de Torrenté de la Jara , Arlette Closuit , “Women’s Life Cycles and Tobacco,” Swiss Medical Review

A closer look at PCOS

Have you ever heard of PCOS? Polycystic ovary syndrome is a common condition affecting 1 in 10 women in France ( Inserm ).

A woman with PCOS may see hundreds of small, immature follicles clustered around her ovaries on an ultrasound . On the image, they look like cysts (hence the name), but they aren't actually cysts.

The reason this condition is increasingly being discussed in the media is that it has significant consequences for the hormonal balance and quality of life of the women who suffer from it. Specifically, this accumulation of immature follicles leads to the excessive production of androgens , the male hormones. Several symptoms result from this:

• irregular ovulation, therefore erratic cycles and fertility problems,

• the development of masculine physical characteristics (particularly body hair),

• metabolic disorders that lead to weight gain.

Missed periods or irregular cycles are often the first signs that concern women. If you have any concerns, don't hesitate to speak to a gynecologist or general practitioner.

Are you familiar with premature ovarian insufficiency?

Premature ovarian insufficiency (POI) is the medical term for early menopause . POI is not very common, but it can explain the absence of menstruation.

In practical terms, early menopause is defined as entering the menopausal process before the age of 40. To diagnose premature menopause, your healthcare provider will pay close attention to the behavior of your menstrual cycles and the concentration of FSH in your body. Note that in 80% of cases, the cause of early menopause is not identified ( CHUV ).

However, there are solutions to support you hormonally, physically, and emotionally. Early menopause is a difficult diagnosis because your body is entering a new phase of life for which you may not be fully prepared. Take care of yourself and seek multidisciplinary support .

What to do if you don't get your period?

As you've probably guessed, if you don't get your period, the first thing to do is take a pregnancy test ! Next, try to see if any other symptoms appear: stress, sleep disturbances, chronic pain… and find out about your medical history.

The goal is to arrive prepared when facing your general practitioner or gynecologist to clearly present the situation.

Above all, don't panic. Your body is sensitive to mood swings and its environment. A change in routine, diet, a busy period at work, a difficult breakup … all of these can also affect you physically.

Be kind and gentle with yourself. Eat a balanced diet, get some exercise, continue exploring your intimacy, and the rest will follow!

If your period has been late for a while, you now know how to react. We're counting on you to listen to your body's signals and take care of yourself! Feel free to send this article to a friend who might need it: the more informed we are about our health , the better we can take action and regain control over it.