A late period is usually the first sign of pregnancy, but it does not have an absolute value. In certain circumstances, it can indeed be misleading because many elements can come to disturb the female cycles.
Periods late: when to worry
On regular cycles, we talk about late periods when they do not arrive within 3 to 5 days after the expected date. A delay of 1 or 2 days cannot really be considered a delayed period, because ovarian cycles are quite “capricious”.
On irregular cycles, because of this very irregularity, the delay of periods is logically more difficult to detect. A one week delay can be considered a late period.
Delayed period, the first sign of pregnancy
In a woman with regular cycles, a late period is usually the first sign of pregnancy.
If the egg has not been fertilized, that is to say that it has not encountered sperm, the yellow body (envelope of the follicle remaining after ovulation) degenerates, causing the drop in progesterone levels. This fall in turn causes the excess blood stored in the uterine lining, ie menstruation, to melt. On the other hand, if the egg has been fertilized, the corpus luteum persists and secretes a hormone called HCG which will maintain the uterine lining for the implantation of the egg, hence the absence of periods, or “amenorrhea” .
Other small signs may appear with the onset of pregnancy: morning sickness, food distaste, heaviness in the lower abdomen, swelling of the breasts, drowsiness … These signs are however very inconstant depending on the women, and their intensity varies. strongly, so that they can sometimes go unnoticed.
Note that in some women, the implantation of the egg causes some small bleeding that can be taken for periods while a pregnancy is well and truly beginning.
Delayed period and negative pregnancy test
To confirm the pregnancy, a qualitative urine pregnancy test can be done. These tests are based on the detection in the urine of the hormone hCG, a hormone secreted by the corpus luteum upon implantation of the egg, approximately 7 days after fertilization.
The pregnancy test can be done from the first day of the period late, and for some so-called early tests, 3 to 4 days before the due date. Be careful, however, not to do it too early in order to avoid a “false negative”. The detection thresholds for the hormone hCG are in fact based on an average cycle of 28 days with ovulation on the 14th day. However, the length of cycles, the date of ovulation and the hCG levels can vary among women, so sometimes the hormone cannot be detected on the due date of menstruation because the level of hCG is then too low. This is why it is recommended to wait a few days of late period before taking a pregnancy test to avoid the risk of false negative.
If after a negative test the period still does not come, it is recommended to do a new test. If it is negative again and in the absence of rules, it is advisable to consult.
Other causes of late period
Delayed periods can be misleading because other causes can cause ovulation to be delayed, and therefore your period, if you are not pregnant. The control systems of the hypothalamic-pituitary-ovarian axis, at the origin of the secretions of the key hormones of the ovarian cycles (LH and FSH), are indeed fragile and many factors can disturb them:
an eating disorder including anorexia.
excessive consumption of alcohol, drugs or other substances
a change in lifestyle (moving, travel, climate change, etc.)
taking certain medicines and herbs.
It should also be noted that after stopping the contraceptive pill, the cycles may take a little time before becoming regular again due to “laziness” of the ovaries, put to rest for the duration of contraception.
If the delay in menstruation only occurs on one cycle and the cycles then resume steadily, there is no cause for concern. A few days of late period can occur apart from pregnancy or pathology.
On the other hand, if the cycles become irregular when they were previously, it is advisable to consult, especially if they are accompanied by other clinical signs or if the couple has been trying to conceive for several months already. A check-up will then make it possible to detect a possible pathology that can lead to irregular cycles, and have an impact on fertility: polycystic ovary syndrome (PCOS or ovarian dystrophy), ovarian laziness, premature ovarian failure, a thyroid disorder. , but also a male fertility disorder.
Return of menstruation despite all the symptoms of pregnancy
The return of menstruation after a positive pregnancy test and in the presence of all signs of pregnancy can correspond to bleeding which can be either mild (bleeding at the time of implantation, small decidual hematoma, etc.) or the sign of a complication. pregnancy (miscarriage, ectopic pregnancy). In all cases, it is recommended that you consult your doctor, gynecologist or midwife quickly.
Note from Sebastian Marciano, general practitioner in the medical emergencies of Paris
A delay in menstruation with severe abdominal or pelvic pain can be a case of ectopic pregnancy (that is to say that the egg has implanted outside the uterus which can be a surgical emergency it is necessary to call your doctor or consult quickly.
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