Menstrual Period - Missed or Late

By David A. Thompson, M.D. 
March 22, 2017

911 warning

Menstrual Period - Missed or Late

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Does this describe your symptoms?


  • Late Menstrual Period: 5 or more days overdue compared to usual menstrual cycle

  • Missed Menstrual Period: no menstrual flow for more than 6 weeks

General Information

  • The first day of menstrual bleeding is considered the first day of a new menstrual cycle.

  • Menstrual bleeding typically lasts 3-7 days.

  • Ovulation generally occurs around day 14 of the cycle.

  • The length of the menstrual cycle varies from woman to woman. The range is from 24 to 35 days. The average is 28 days.


  • Pregnancy is the most important cause. This possibility needs to be considered in any woman who has a missed or late period.

  • Stress

  • Dieting, exercise and weight loss

  • Menopause

  • Polycystic ovarian disease

  • Birth control pills

  • Depoprovera injection

  • Pituitary and other endocrine disorders

Home Urine Pregnancy Tests

  • Home urine pregnancy tests are inexpensive, accurate, and easy to use. Most drug stores sell these tests over-the-counter.

  • Urine pregnancy tests can often diagnose pregnancy during the week after the first missed period (2 weeks after ovulation).

  • Use of a first-morning urine specimen is recommended because the urine HCG concentration is highest in the morning.

  • When a home pregnancy test is negative, but there is still a high suspicion of pregnancy, the woman should either repeat the test in 3-5 days or go to her doctor's office for testing.

  • The urine pregnancy test can sometimes be falsely negative if the urine specimen is very bloody. A small amount of blood (e.g., blood-tinged urine) should not interfere with the accuracy of the test.

  • More information is available at:

If not, see these topics


When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Passed out (fainted)

  • Severe abdominal pain

call now

Call Your Doctor Now (night or day) If

  • You feel weak or very sick

  • Abdominal pain and you are pregnant

  • Abdominal pain and you might be pregnant

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • You are pregnant

  • You want a pregnancy test done in the office

  • Recent weight loss

  • Age greater than 45 years

  • Missed 2 or more periods in a row

  • Missed period has occurred 2 or more times in the last year

home care

Self Care at Home If

  • Missed or late period and you don't think you need to be seen



  1. Pregnancy test, when in doubt:

    • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.

    • Follow the instructions included in the package.

  2. Stress: Stress can interrupt normal menstrual periods. Try to reduce your stress by talking about it with a friend or family member. Try to avoid or decrease stressors. If this is not effective, seek help from a counselor or talk with your doctor.

  3. Call Your Doctor If:

    • Pregnancy test is positive

    • You have difficulties with the home pregnancy test

    • New symptoms suggest pregnancy (e.g., morning sickness, breast tenderness/swelling)

    • You need help coping with stress

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.


March 22, 2017