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Reproductive aged women are naturally used to having periods every month. It is no wonder then that most women get anxious when their periods appear to stop for no apparent reason. In many cases, there is usually not much reason to worry as the cessation of the periods is usually transient and innocent. However, if the periods don't return within six months, the cause should always be determined and rectified.
If you miss a period and are sexually active, the first thing you must always not exclude is the possibility of being pregnant. This is regardless of being on contraception due to the known small failure rates even with the most effective contraceptives. If the pregnancy test is negative, the likelihood of some temporary disturbance of your hormone balance is usually the most likely explanation. There is usually no immediate reason to panic, waiting for one to two more cycles normally leads to spontaneous resumption of the periods. For some, the absence of periods may be due to a condition called Polycystic Ovarian Syndrome. There is usually a more pronounced hormonal imbalance, which results in the absence of periods for many months.
Common medications may also interfere with your ovarian function and lead to the absence of periods. This is more so with long term contraceptives like the injectables (Depo), implants and the intra-uterine contraceptive device called Mirena. Once pregnancy is excluded, you will relax in the knowledge that the absence of your periods is due to the contraceptive effect. Chemotherapy and radiotherapy can also interfere with ovarian function and lead to various durations when periods may be absent. Resumption of periods in such cases depends on various factors, including the ages of those affected.
For a small number of women, periods will disappear due to more serious conditions. The control of the menstrual cycle is complex, involving communications between glands in the brain, the ovaries and the uterus. Any interference with the function of any of these organs can lead to the absence of periods. Brain disease or trauma can interfere with hormone production. And so is extreme athleticism, being extremely underweight or mental instability which can all reset the brain function and lead to absence of periods. The ovaries may fail prematurely, usually for unknown reasons, resulting in premature menopause well before the expected age of menopause. If the uterine function is disturbed by disease (like uterine TB for example) or even surgery, periods may also disappear.
Transient absence of periods doesn't usually require much intervention. Prolonged and unexplained absence of periods however requires gynaecological evaluation to determine and address the cause. You may require tests spanning from imaging to genetic testing. The specific cause must be addressed. Some will only require simple remedies, while others may end up with long-term hormone replacement. Others will require help with future fertility depending on their diagnosis.
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