What does a late period mean?
A late or missed period means menstruation has not started when expected. The menstrual cycle is counted from the first day of one period to the first day of the next. In adults, cycles are commonly 21–35 days, although each person's established pattern matters.
A single short delay may follow stress, illness, travel, or a change in routine. Repeated irregularity, absence of periods for three months or more, or consistently very frequent or infrequent cycles should be evaluated.
First step: rule out pregnancy
For anyone of reproductive age who has had sexual intercourse, pregnancy is an important first possibility. Use a home pregnancy test according to its instructions. A very early negative result can be misleading; repeat it if menstruation does not start or contact a clinician.
With a positive test, the timing of ultrasound depends on symptoms and estimated dates. Severe one-sided pain, bleeding, dizziness, or fainting requires urgent assessment for ectopic pregnancy.
Common causes of menstrual irregularity
- Pregnancy and breastfeeding;
- Stress, sleep disruption, travel, or acute illness;
- Rapid weight loss or gain and insufficient nutrition;
- Very intensive exercise;
- Polycystic ovary syndrome (PCOS);
- Thyroid or prolactin disorders;
- Perimenopause or premature ovarian insufficiency;
- Hormonal contraception and certain other medicines.
Which other symptoms are important?
Tell your clinician about acne, increased facial/body hair, weight change, breast discharge, headache, visual change, pelvic pain, very heavy bleeding, or difficulty conceiving. These details help direct testing.
How is it diagnosed?
Evaluation includes your cycle history, medication, nutrition, exercise, and pregnancy possibility. Tests may include a pregnancy test, full blood count, thyroid and other hormone tests. Pelvic ultrasound evaluates the uterus, endometrium, and ovaries and may identify a cyst, fibroid, or features associated with PCOS.
Ultrasound is only one part of the assessment. PCOS, for example, cannot be diagnosed from ovarian appearance alone; symptoms and laboratory findings are also required.
When should you see a clinician?
Arrange assessment if previously regular cycles become irregular for several months, you have had no period for three months without pregnancy, cycles are consistently shorter than 21 or longer than 35 days, or you bleed between periods or after sex.
Seek urgent care for a positive pregnancy test with significant pain or bleeding, or for heavy bleeding with faintness or severe weakness.
Pelvic ultrasound with Lana Ezieshvili
When investigating irregular periods, high-quality imaging provides important structural information about the uterus and ovaries. Radiologist Lana Ezieshvili performs transabdominal and, where appropriate, transvaginal pelvic ultrasound.
If missed periods recur or your clinician has requested imaging, book an appointment with Lana Ezieshvili. Bring recent cycle dates, laboratory results, and previous scans.