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Period Two Weeks Late: When is the Time to Worry?

Written by Elizabeth Buescher, Gynecologist

Menstrual cycle is a rather regular process, which is controlled by hormones. Each period has an anticipated date, on which it should start. Late period can be associated with intake of hormonal drugs or indicate either to pregnancy or perimenopause. If you are not pregnant, and all other physiological causes are excluded, then you should better consult a specialist in order to fit out other – pathological origins of the delay.

Female reproductive system is a complex mechanism, which is regulated by a combination of hormones that interchange each other. Such an alternation has a cyclic nature and is referred to as menstrual cycle (MC).

Menstruation is a regular, monthly process of rejection of endometrium (uterine mucous lining), which had previously been prepared for possible conception. It marks the start of the new MC and overlaps with the stage of the ovum’s maturation.

Usually, women know when their period is due, within the accuracy of 1-2 days. Any delay of periods first of all rings the bell about pregnancy. However, you should start searching for other possible causes if you make sure you are not pregnant.

Reasons for late period

Causes of the delay can be classified into the following categories:

  1. Disturbance of hormonal balance:
  2. Nonmalignant neoplasms;
  3. Complication after surgical interventions and inflammatory diseases;
  4. Pathological consequences of intrauterine devices;
  5. General diseases.

Hormonal causes

The first group includes two physiological causes of a delayed period, namely perimenopause and intake of hormonal drugs, and four pathological factors – stress, acclimatization, physical exhaustion and rapid weight loss.

  1. Perimenopause – this period lasts about 4 years, preceding the menopause (complete absence of periods at least during a year). It is characterized by reduced estrogen effect and a disturbed balance of male and female sex hormones. Menstrual disorder, accompanied by more frequent anovulatory cycles, is one of the classical perimenopausal signs.
  2. Intake of hormonal contraceptives is aimed at correction of the endocrine profile and provoking anovulatory cycles. That is why scanty and late period, in this case, are considered to be quite normal.
  3. Severe emotional upset is able to affect neurohumoral regulation of the organism, in general. In some cases, emotional shock results in a missed period. Such a condition does not require gynecologic treatment and is considered to pass through after emotional recovery.
  4. Mechanism of menstrual disorder is almost the same as in the case of a moving to a different climatic zone since the endocrine profile requires additional time to adjust itself to the new environment. Thus, this can be one of the reasons of a delayed period.
  5. Women, who are engaged in professional sport, experience disturbed balance of estrogens and androgens, contained in blood, which leads to an irregular MC.
  6. Rapid decrease of fat tissue provokes hyperstrogenism, which has to do with the fact that lipocytes are significant for hormone metabolism. In order to prevent any harmful consequences of a diet, one should calculate her own ideal weight, and move towards it in small steps.

Neoplasms and late period

The two main causes of a delay, associated with neoplasms of genital glands, are polycystic ovarian syndrome and corpus luteum cyst (the yellow body cyst).

The difference between them is that the first pathology has a chronic nature and involves the following symptoms:

  • Obesity;
  • Male pattern of hair distribution;
  • Prediabetes;
  • Infertility.

Yellow body cyst is an acute pathology, which origins from the extension of the “emptied follicle” or effusion of blood into it. The plugged “sack” swells up, and the period does not occur until its dispersion. This disease is dangerous due to possible twisting, disruption or necrosis of the cyst. At the same time, such a mass may regress on its own.

Adhesive changes, resulting in a missed period

Adhesive processes in the uterine cavity or the cervical canal may be associated with past history of endometritis, cervicitis or any other surgical manipulation, including abortion and the Caesarean operation.

Usually, in case of exclusively uterine affection, scantiness and delayed periods are observed due to atrophy of the endometrium, drawn into cicatrices. The damaged tissue does not duly prepare itself to possible impregnation and thus, there is nothing to be rejected and discharged at the end of the cycle. The situation is different with cervical adhesions, which create a mechanical obstacle for the discharge of the appropriate amount of menstrual blood. In some cases, adhesions require surgical therapy.

IUD, causing delayed period

Intrauterine device is a reliable and available birth control method. But the insertion and operation of the device assume certain risks of infectious and other types of complications. Particularly, it is possible to observe thinning of the endometrial lining in the places, where it joins the device, which also leads to minimization or delay of periods.


Decrease of the amount and deterioration of the consistency of red blood cells is referred to as anemia. It develops on the background of vitamin or micronutrient deficiency, particularly, iron deficiency, as well as due to extensive blood loss, etc. Acute anemia may involve missed period.

How late can a period be?

Occasional 3-4 days’ delay of the period is no reason for concern, especially if it is preceded by stress, physical load or moving to another location. If case unprotected sex took place a few weeks ago, then you should better check out whether you are pregnant or not. To do this, you can use a highly sensitive home pregnancy test or give a sample of blood for analysis in the laboratory.

If late period does not occur for more than a week, then you cannot exclude the fact of pregnancy. Even if you have a negative pregnancy test since pathological forms of childbearing (ectopic pregnancy or hydatidiform mole), they can be accompanied by a much slower increase of HCG (the hormone, to which these tests are sensitive).

Thus, sometimes even a missed period (in case if climatic change or weight loss) is considered to be acceptable. Meanwhile, a short delay may be followed by serious complications (such as the case with a yellow body cyst, which takes more than 14 days to disperse). For timely detection of any virulent pathologies, you should consult a gynecologist in case your period is two weeks late.