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Missed Your Period But You're Not Pregnant?

In addition to posting updates about important breakthroughs in women’s health, there are some questions that many women ask on my message board. From time to time, I’ll going to post some of the information I share with those women in the hope that it will help others who visit WebMD with similar questions.

A very common cause of a missed period is not having ovulated that cycle. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. In a normal cycle, progesterone production increases following ovulation.

Progesterone “stabilizes” the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining – your period. So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation-associated progesterone. Thus, the hormone levels don’t decline, and the lining stays up inside the uterus – your missed period.

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your “progesterone blood level” will fall, triggering the release of the lining that has been building up. Alternatively, the built-up lining may begin to shed under its own weight. Either way, women report that these periods are very heavy – as though several months of lining are shed.

Such flows can also be prolonged or have a stop and start pattern. The reason for this erratic or prolonged bleeding is this: without the progesterone the lining does not have a clean shed down to the base layer.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with parents or boyfriends/girlfriends, exams), increased body weight, anorexia, rotating shifts at work, etc.

If the bleeding persists you should contact your GYN or clinic. The bleeding can be stopped with hormones, and any possible causes of not ovulating assessed. Hopefully your cycle will reset itself.

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