For all our chronic gripes about our monthly flow—pain, mood swings, eexcessive bloating, pimples—a period missed often signals a serious change in the body. Pregnancy is, of course, the most common cause for a cycle change, but there’s a bevy of reasons why your monthly bill may be a no-show. As you review our list of 12, it’s worth noting that they’re interconnected. In Western medicine, we often forget that the body is one constantly moving machine and that one malfunction can throw the whole thing off. When seeking diagnosis and treatment for irregular menses, it’s best to start with your PCP or gynecologist. After that, he or she may recommend that you visit a specialist such as a reproductive endocrinologist, a neurologist, a nutritionist, or even a psychiatrist or psychologist. You may not be preggers, but here are 12 reasons why you may save on tampons this month:
1. Polycystic Ovarian Syndrome (PCOS)
PCOS is a common condition that affects 5 to 10% of women in the U.S., according to the NIH. The condition—marked by irregular menses, infertility, hirsutism, acne, and weight gain—is caused by excessive testosterone in a woman’s endocrine system. There may or may not be a presence of actual cysts on the ovaries, detected by an ultrasound. “This is an important condition that should not be missed because of its association with reproductive consequences, increased risk of diabetes, and cardiovascular disease,” says Dr. Sharon Lahiri, an endocrinologist at the Henry Ford Hospital in Detroit.
2. Eating Disorders or Lousy Diet
Eating disorders including anorexia and bulimia wreak havoc on one’s body in general, but particularly take their toll on a woman’s reproductive system. Even still, a plain old lousy diet devoid of nutrition can also throw things off — especially a diet high in carbs.
3. Excessive Exercise
Many competitive athletes experience amenorrhea, though there are mixed views as to why this clinically happens. The most general consensus is that an extreme exercise regimen combined with an often-limited intake of calories halts the reproductive system. “Some research shows that you need to be within 5% of your ideal body weight to have regular menses,” notes Dr. Marcelle Pick, ob/gyn and author of Are You Tired and Wired?: Your Proven 30-Day Program for Overcoming Adrenal Fatigue and Feeling Fantastic Again. So if you’re training for a triathlon, make sure you eat a sufficient amount to keep your body running properly.
4. Stress
As I discussed in a Blisstree post a few weeks ago, stress messes up one’s cycle in myriad ways, including a condition known as hypothalamic amenorrhea. If there’s an imbalance of female sex hormones, estrogen, or progestin, this will disrupt the pituitary gland’s production of Follicle Stimulating Hormone and Luteinising Hormone, and will throw off the fine-tuned cycle.
5. Lack of Sleep
Sure, we blame lousy sleep habits for just about everything, but they can be the culprit when it comes to an erratic menstrual cycle. Though there’s no direct correlation between sleep and your cycle, studies have shown that women with more erratic sleep patterns are more likely to experience amenorrhea. Shift workers and incarcerated women, says Dr. Kenneth Ginsburg, Director of the Henry Ford Center for Reproductive Medicine, should consider the consequences of lack of shut-eye.
6. Other Women
Remember in college when you suddenly needed a tampon around the same time as your roommate? “Pheromones are produced by all individuals and those cause a type of synchronicity with women who are together for any length of time,” says Dr. Pick. So essentially, you could blame your best friend when your period is late.
7. Booze and Drugs
I’ll refrain from making jokes about how hard living leads to a certain activity that may halt your period. “The extreme result of this exposure would be loss of the ability of the ovary to respond to hormonal control, in which case premature menopause occurs,” says Dr. Ginsburg. “Of course, this would not happen with modest use, but would be expected to be seen only with sustained, significant intake.”
8. Smoking
Under no circumstances is smoking good for your health, but clinical studies have also shown that cigarettes can actually kill your eggs and cause early menopause. Pardon my scare tactics: Want to be alone with hot flashes while you smell like an ashtray?
9. Hypothyroidism
Irregular and painful periods are associated with hypothyroidism, a condition in which your thyroid is not producing enough of the thyroid hormone. This slows down metabolism and causes your entire endocrine system to lose its rhythm. Check out our recent Blisstree post on hypothyroidism to learn more about the symptoms and consequences of this frustrating and under-diagnosed condition.
10. Diabetes
Diabetes and PCOS go hand-in-hand. “Hormonal abnormalities, such as diabetes, thyroid disease, insulin resistance, or polycystic ovarian syndrome (PCOS), which may encompass features of diabetes and insulin resistance, are common medical causes of menstrual abnormalities. Many times, these problems are best managed primarily, or with the assistance of endocrinologists, who are much more familiar and comfortable with managing these problems,” says Dr. Steve Goldfarb, a gynecologist at the Henry Ford Center.
11. Prolactinoma
A non-cancerous tumor of the pituitary gland often causes menstrual irregularity, says Dr. Lahiri. The tumor secretes prolactin, the hormone involved in lactation. Too much of this hormone also causes lactation in a woman who is not pregnant or has not had children; and it can lessen sex drive. Double bummer.
12. Early Menopause
Premature ovarian failure (POF) or menopause before age 40 is caused by a number of conditions, including autoimmune disease, chromosomal disorders, chemotherapy, and the removal of ovaries. “The most common cause probably is related to a woman’s inherited genetic program,” says Dr. Ginsburg. “Although this is a diagnosis reached by excluding other causes, when the cause of POF cannot be determined by current testing, the POF is termed idiopathic.”
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