Why doesn’t my period come?

Menstruation is a process that every woman needs to go through. The normal menstrual cycle is 28 to 30 days or 40 days. Depending on different physical constitutions and conditions, the time of menstruation will also be different. A delay of one week in menstruation is normal. If menstruation is delayed for more than one week, you need to first rule out the cause of pregnancy and have a physical examination.

1. Pregnancy causes amenorrhea

If a woman has sexual intercourse, she can use an early pregnancy test strip to test her urine 7 days after her period is delayed. If she is pregnant, the result will be positive; if she is not pregnant, the result will be negative. Of course, the best way to detect pregnancy is to go to the hospital for an ultrasound examination.

2. Side effects of medications leading to amenorrhea

Drugs can affect women's endocrine system. For example, taking birth control pills, weight-loss pills, drainage drugs, etc. can cause endocrine disorders in women, thereby affecting menstruation and causing amenorrhea.

(1) Contraceptive pills: The main ingredients of contraceptive pills are progesterone and estrogen. By taking contraceptive pills, women’s ovulation is inhibited, thereby interfering with the combination of egg and sperm, achieving the purpose of contraception. However, if you take too many birth control pills, the drug ingredients will affect the ovaries' secretion of estrogen, and the endometrium will not grow normally, resulting in a thin endometrium, which will lead to a decrease in menstrual flow or even amenorrhea.

(2) Diet pills: For example, hormonal diet pills generally contain thyroid hormones. Improper use of diet pills can easily lead to menstrual disorders in women, symptoms of irregular menstruation or amenorrhea, affecting normal menstruation, and in severe cases may cause infertility.

(3) Abortion drugs: Medical abortion generally involves taking the receptor-level anti-progesterone drugs mifepristone and misoprostol tablets. These drugs will inhibit central dopamine receptors, reduce the amount of hypothalamic release factors entering the anterior pituitary, and thus lead to a decrease in the secretion of gonadotropin and corticotropin by the anterior pituitary, leading to amenorrhea and delayed ovulation. After the drainage drugs enter the human body, they will damage the endometrium, which requires a period of time to repair. Generally, menstruation will resume about a month after the medical abortion, but menstruation may not come for 40-50 days.

3. Surgery causes amenorrhea

The surgery will affect menstruation. For example, intrauterine surgery may cause cervical adhesion, resulting in menstrual blood stasis in the uterus, and symptoms of amenorrhea and delayed menstruation.

(1) Abortion: Abortion generally includes vacuum aspiration and curettage. If the curettage is performed improperly, it can easily damage the cervix or the basement membrane of the endometrium, causing adhesion of the internal os of the cervix or partial adhesion of the uterine wall, thus leading to amenorrhea.

(2) Ovarian cyst surgery: After ovarian cyst surgery, the uterus and ovaries need some time to recover. Some women resume menstruation one month after the surgery.

4. Pathological factors lead to amenorrhea

Pituitary tumors, hypopituitarism, premature ovarian failure, ovarian hypoplasia, etc. may all lead to amenorrhea.

(1) Pituitary factors: The absence of menstruation caused by this condition is also called pituitary amenorrhea. The pituitary gland is located below the brain. Although it is small in size, it shoulders the important task of controlling the endocrine organs of the entire body. If the function of the pituitary gland changes, it will also lead to decreased ovarian function. Common pituitary diseases include tumors and hypopituitarism.

(2) Central nervous system factors: The central nervous system controls the activities of the pituitary gland and indirectly controls the female ovarian function, including the brain and hypothalamus. When the central nervous system is stimulated, changes in ovarian function can cause amenorrhea. Hypothalamic tumors can also cause amenorrhea.

(3) Ovarian factor: also known as ovarian amenorrhea. If the ovaries cannot secrete hormones, the endometrium will not change, and there will be no endometrial shedding. Therefore, the endometrium will not change and menstruation will stop naturally. For example, congenital ovarian dysplasia, premature ovarian failure, etc. may lead to no menstruation.

(4) Uterine factor: also called uterine amenorrhea. If a woman has uterine problems, it may also cause amenorrhea. Common causes include congenital absence of the uterus, uterine hypoplasia, or childhood diseases involving the endometrium, resulting in adhesions or scars. Although the ovaries function well and female characteristics develop normally, there is no menstruation. If menstruation does not occur for a long time after the onset of menstruation, such as endometrial tuberculosis, endometrial schistosomiasis, endometrial suppuration, or when the basal layer of the endometrium is scraped off during curettage, the woman will not be able to respond to ovarian hormones and will develop secondary amenorrhea.

5. Other factors leading to amenorrhea

For example, factors such as excessive mental stress, high work and life pressure, changes in living habits, irregular work and rest, changes in diet, and changes in the environment may affect endocrine function and may cause menstruation to occur or be delayed.