How late can a period be?

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In order to establish this, we must first look at what a period comprises, what is a 'normal' period and the many factors that can influence the delay of a period. In doing this we will establish what constitutes a late period and indeed, how late a period can be.

The Menstrual Cycle

The hormones in a woman's body control her menstrual cycle. A typical menstrual cycles lasts twenty eight days. This is then followed by a 'period' - usually four to eight days - where the woman actually menstruates (bleeds). In a woman who has 'normal' periods, levels of Gonadotropin-releasing hormone are released by the brain (from the hypothalamus), this then causes the pituitary gland to create Follicle-stimulating hormone and Luteinizing hormone. These stimulate levels of oestrogen, progesterone and testosterone in the ovaries. The menstrual cycle as dictated by these hormones causes the endometrium layer to build up in the uterus. Ovulation occurs (around fourteen days before menstruation) and if the egg does not implant (due to fertilisation) and pregnancy does not occur, then the uterus sheds the endometrium layer at which point a woman has her period. If fertilisation does occur then the endometrium layer becomes the placenta.

A 'typical' 'normal' cycle thus lasts for around twenty eight days. However, menstrual cycles can vary dramatically from woman to woman – as can menstrual flow. Whilst one woman may be able to predict her period to literally within hours of when it will start and know that it will consist of three days 'light ' bleeding, other woman may have infrequent and irregular bleeding (oligomenorrhoea) - with a cycle that lasts forty days and consists of nine days menstrual bleeding. However, most women get to know how long their cycle lasts and can usually recognise their premenstrual symptoms.

Premenstrual symptoms can be physical, emotional and behavioural. They can range from a bloated stomach, to cramping, constipation, joint aches and headaches, to food cravings, nausea, mood swings, change in libido, tiredness, depression, clumsiness and breast tenderness. The symptoms usually go away once a woman has started to bleed.

Pregnancy

However, some of the above symptoms can also mirror the most common cause of a late period – pregnancy! Indeed, in response to "How late can a period be?", the most obvious answer is – nine months! Missing a period, or your period being late, is often one of the first signs of pregnancy. As an egg has been fertilised there is no need for the womb to shed its lining, so a woman will miss her period for nine months whilst the baby grows. A missed period, in combination with breast tenderness and nausea (also an aversion to strong smells, vomiting and an increase in breast size) often means that you are pregnant. With advances in pregnancy testing equipment it is now possible for home pregnancy tests to be accurate the day your period is due, or by using high sensitivity tests it is possible to know up to six days before your period is due.

Other Causes of Missed Periods

Many other internal and external causes can lead to late or missed periods. For example, women who suffer from polycystic ovarian syndrome (PCOS) can suffer from irregular, prolonged or even absent periods. Having this condition, which is normally attributed to hormonal disturbances leading to 'cysts' on the ovaries – can make predicting your period quite difficult. Not only this but women who suffer from PCOS can also suffer from lack of ovulation, difficulty getting pregnant, severe mood swings, depression, weight gain and hirsuitism. The contraceptive Pill may be prescribed to regulate periods and control testosterone and androgen production.

Women who suffer from anorexia, bulimia or are severely underweight may experience absent periods. Amenorrhoea can be caused by low body weight and the disruption of the sex hormones. As a result, the body may try to conserve its blood (and also protein) reserves by ceasing menstruation. Periods normally return once some weight is re-gained. Rapid weight gain or obesity can also cause disruption to a woman's period. Even excessive exercise can affect your menstrual cycle and cause disruption such as late or missing periods.

Changes in diet, irrespective of weight gain/loss can make your period late. Certain foods such as dairy products (particularity if you have PCOS), Soya and caffeine can all influence your body and its monthly cycle.

Other factors such as lifestyle changes, in particular stress, can cause a woman's period to be late. Anxiety, bereavement, a new job, moving house . . . all can take their toll. Excess alcohol consumption, drug use (including prescription drugs such as antidepressants) and heavy smoking can also cause havoc with your body.

Aside from PCOS there are other medical conditions which may make your period late. Early menopause (which can happen as early as your twenties although this is a rarity), thyroid problems, prolactin issues and ectopic pregnancy, can lead to periods being late. When you first start to menstruate, periods can be irregular and infrequent, this problem should correct its self over time. Pre-menopausal women can suffer from irregular or absent periods, as can women with uterine conditions such as fibroids, polyps or cervical cancer. Coming off the contraceptive pill, certain types of pill, hormone patches and hormone injections can all also impact upon your cycle. Sexually transmitted infections and diseases can also effect your menstrual cycle.

Monitoring Your Pattern

It is best to keep a note of your regular cycle to establish a pattern as this will help you work out if your period is late and indeed, how late. As so many factors can influence your period it can be normal for your period to be a couple of days late, even up to a week or so. If you do not menstruate for more than six weeks then you have officially 'missed' a period. To establish the reason behind your missed period then you need to be aware of your body and any symptoms you may have experienced.

If you are sexually active then you should take a pregnancy test if you miss a period, as no contraception is 100% effective. If you have experienced a very light bleed when your period is due, but no further bleeding, this may be caused by implantation bleeding due to pregnancy – again a pregnancy test is advisable.

It is always advisable to consult your doctor if you are concerned about a missed or late period, especially if it is accompanied with any other symptoms such as cramping or spot bleeding.

How late can a period be?

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The Menstrual Cycle

Pregnancy

Other Causes of Missed Periods

Monitoring Your Pattern

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