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Two Periods Last Month and Now None
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Confused226 posted:
My periods have been consistently in the middle of the month but last month, I had two periods and they were two weeks apart. This month, I havent had my period. I have taken a pregnancy test and that was negative. I am worried.
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Jane Harrison Hohner, RN, RNP responded:
Dear Confused: How lucky you are to have such regular periods! You definitely did the correct thing in checking a pregnancy test first.

If the pregnancy test is negative then the next most 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. Alternatively, the lining of the uterus will begin to shed erratically.

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 children or spouse,finances), increased body weight, anorexia, rotating shifts at work, etc.

Lastly, everything I have just shared with you pertains to women who are NOT using a form of hormonal birth control. If you are using an oral contraceptive, or DepoProvera, or other hormonal contraceptive you may miss a period (s) for an entirely different reason. Once pregnancy has been "ruled out" (because even reliable methods fail) one can usually assume that the missed period is "normal" or "OK". Unlike the scenarios discussed above, women on hormonal contraception have both estrogen and progesterone available. If the synthetic progesterone is dominant, it can artificially make the uterine lining very thin. So the woman misses her "Pill period" or it is very much lighter than normal. Of note, if you are on a form of hormonal contraception, and you miss a period (s), you will not have a uterine lining build up.

Bottom line, if your test is still negative, you are not using hormonal birth control, and the missed periods mount up to three months you should see your GYN or local family planning clinic for an evaluation.

Yours,
Jane


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