Women's Health Community

Dear mommaof3gals: The most common reason for a menstrual pattern like you have described is not having an ovulation every month. 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 and release of an egg.. 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/late period.

There can be MANY causes for not ovulating: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with lovers or kids, money worries), increased body weight, anorexia, rotating shifts at work, etc. In your specific case the right lower abdominal pain MIGHT be from an ovarian cyst. More distantly, if you have had a tubal ligation, you could have a tubal/ectopic pregnancy.

Given the pain, you really need to be seen by a GYN or your local family planning clinic. You can expect to get a sensitive pregnancy test and a pelvic exam to check for an ovarian cyst. An ultrasound is usually needed to confirm an ovarian cyst.

Yours,
Jane