Paused periods

If you haven’t had a period for over 3 months and you’re not pregnant, this is known as paused or missed periods (secondary amenorrhoea).

If you’re experiencing secondary amenorrhoea, speak to your doctor. They’ll talk to you about different things that might affect your periods. This could include:

• your medical history
• your family’s medical history
• your physical and mental health
• any other lifestyle changes – for example any recent changes in your weight or the amount of exercise that you do

Causes

There are different times in people’s lives when it’s normal to not have a period. For example, before puberty, when you’re pregnant or exclusively breastfeeding, and after the menopause. Some hormonal contraception can also offer you the option of no bleeding. 

There are also lots of other reasons periods can stop.

Genetic factors can include having a:

• family history of premature menopause
• genetic or chromosomal condition

Lifestyle factors can include:

• being severely overweight or underweight
• stress
• extreme exercise

Hormonal factors can include:

• polycystic ovary syndrome
• thyroid problems
• premature menopause

Some medications can cause changes in your hormone balance, causing amenorrhoea. This can include:

• medical treatments such as chemotherapy and radiotherapy
• some anti-psychotic medications
• some anti-depressants
• medication for high blood pressure
• some allergy medications

Diagnosis

Your doctor will start by asking you to take a pregnancy test to rule out a possible pregnancy. They might advise you to wait a little longer to see if you periods return or they might think that you need treatment.

If you’re seeing your doctor, there are some useful pieces of information to think about beforehand:

• the first day of your last period (when it started)
• how many days your period usually lasts
• what was the shortest time between your periods (from the first day of one period to the first day of the next)
• what was the longest time between your periods (from the first day of one period to the first day of the next)
• how often you need to change your period products on a heavy day
• if you are over 25, when you had your last smear test

It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. You can then discuss this with your doctor who can decide if any tests or treatments might be needed.

It’s ok to ask any questions about your care to help you get the information you might need.

If your doctor thinks you might have a health condition that’s affecting your periods, they may refer you to a specialist. They may carry out some tests or suggest treatments.

If you do see a specialist doctor, they may carry out an internal examination to check your womb (uterus) and pelvis, as well as your tummy. As this is an intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out. They might then do some more tests, such as blood tests, to rule out any other health conditions.

Treatment

Depending on the cause, your doctor will talk with you about the right treatment for you. This might include:

• lifestyle changes, including changes to diet or activity levels
• taking certain hormonal contraception to help your period become more regular