Women's Health Community

Dear appy: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—as either your missed or too light 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. Many women report that these periods are very heavy-- as though several months of lining are shed.

There are MANY causes for not ovulating: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with boyfriends/girlfriends, jobs, finances), increased body weight, anorexia, rotating shifts at work, etc.

There is a second, less common cause for not having a period. In some women the estrogen levels become very low. The levels are so low that no uterine lining is available to be shed. When these women are given the progesterone pills to take, no flow occurs after the medication is finished. This tells the GYN that the woman is not making enough estrogen to produce a thickened uterine lining.

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.

Your own GYN can give you the most "for sure" answer specific to you. But it helps to know what some of the causes MIGHT be so you can formulate your questions in advance.

Yours,
Jane

thank you for replying it make alot of sense, seeing I only have a tiny bit of one ovary left. I've had two surgeries on my ovaries and fallopian tubes ( had severe cysts on both) so they removed the whole one side and then I got another cyst on the other side, so they had to take most of it as well.

I am not on any birth control pills, so that isn't revelant for me, my doctor told me to call her if my period doesn't show up in another cycle that they would want to take blood and maybe do an ultrasound, I appreciate your help alot and it eases my mind tremendously, i was very worried that it could be bigger issues. but your input has put my mind at ease alot. I also have endometriosis in the tube that I have left, so i was concerned that it could be related to that, thank you again for your time and info :)

take care,

appy81