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Resources

Is Your Child Sick?TM


Menstrual Period - Missed or Late

Is this your child's symptom?

  • Late or missed menstrual period
  • Late period: 5 or more days late compared to normal menstrual cycle
  • Missed period: no menstrual flow for more than 6 weeks
  • Teen not using any birth control that stops periods. These products include birth control shots, implants, and IUDs with hormones.

If NOT, try one of these:


Normal Cause of a Missed Period during the First Year

  • Skipping periods is common during the first 1 to 2 years after they start. This is due to not releasing an egg each month.
  • This is most likely the cause if less than 2 years since the first period
  • Has missed periods in the past or has had only 1 or 2 periods
  • Otherwise healthy
  • No signs of pregnancy such as breast tenderness, breast swelling or nausea

Common Cause of a Missed Period after the First Year

  • Pregnancy is the most common cause

Other Causes

  • Stress
  • Dieting, extreme exercise and weight loss
  • Polycystic ovarian disease
  • Endocrine disorders
  • Birth control products like birth control shots, implants, and some IUDs

Home Urine Pregnancy Tests

  • Home urine pregnancy tests do not cost very much. They are easy to use. Most drugstores sell these tests. No prescription is needed.
  • Urine pregnancy tests are very accurate. They can turn positive as early as the first week after a missed period.
  • It is best to do the pregnancy test first thing in the morning. Reason: hormone levels are higher in the morning urine.
  • Sometimes, a home test is negative even if you think you might be pregnant. In this case, repeat the test. Do the repeat test in 3-5 days. You can also go to a doctor's office for testing.
  • A pregnancy testing fact sheet can be found at www.womenshealth.gov. Search "pregnancy tests."

When to Call for Menstrual Period - Missed or Late

When to Call for Menstrual Period - Missed or Late

Call Doctor or Seek Care Now

  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Call Doctor During Office Hours

  • Home pregnancy test is positive
  • You want a pregnancy test done in the office
  • Sexual intercourse (had sex) within the last 3 months
  • Recent breast swelling, weight gain or nausea
  • Teen acts sick
  • Has missed 2 or more periods and prior periods were regular
  • Recent weight loss
  • Excessive exercise suspected as cause of no periods
  • First period started less than 1 year ago and has missed 4 or more periods
  • Age 15 or older and periods have not started
  • Cause is unknown (not recent onset of menstrual periods or recent stress)
  • You think your teen needs to be seen, but the problem is not urgent
  • You have other questions or concerns

Self Care at Home

  • Pregnancy suspected or possible
  • First period started less than 1 year ago and has missed 3 periods or less
  • Recent stress (such as starting at a new school, break-up) causing late period

Call Doctor or Seek Care Now

  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Call Doctor During Office Hours

  • Home pregnancy test is positive
  • You want a pregnancy test done in the office
  • Sexual intercourse (had sex) within the last 3 months
  • Recent breast swelling, weight gain or nausea
  • Teen acts sick
  • Has missed 2 or more periods and prior periods were regular
  • Recent weight loss
  • Excessive exercise suspected as cause of no periods
  • First period started less than 1 year ago and has missed 4 or more periods
  • Age 15 or older and periods have not started
  • Cause is unknown (not recent onset of menstrual periods or recent stress)
  • You think your teen needs to be seen, but the problem is not urgent
  • You have other questions or concerns

Self Care at Home

  • Pregnancy suspected or possible
  • First period started less than 1 year ago and has missed 3 periods or less
  • Recent stress (such as starting at a new school, break-up) causing late period

Care Advice

Pregnancy Suspected or Possible

  1. What You Should Know About Late Periods if Having Sex:
    • Menstrual periods stop when a woman becomes pregnant.
    • A woman with a missed or late period should think about pregnancy.
    • Here is some care advice that should help.
  2. Pregnancy Test, When in Doubt:
    • If there is a chance that you might be pregnant, use a urine pregnancy test.
    • You can buy a pregnancy test at any drugstore.
    • It works best first thing in the morning.
    • Follow all package instructions.
  3. Call Your Doctor If:
    • You have trouble with the home pregnancy test
    • Pregnancy test is positive
    • Misses 2 periods and pregnancy test is negative
    • Your teen develops any serious symptoms

First Period Started Less than 1 Year Ago

  1. What You Should Know About First Periods in Young Teens:
    • Skipping periods is common during the first 1 or 2 years after they start.
    • It doesn't mean anything serious or cause any harm.
    • A girl can normally go up to 6 months between the first and second periods.
    • Also, a girl can go up to 4 months between the second and third periods.
    • Normal irregular periods can go on for 2 years.
  2. Call Your Doctor If:
    • Misses 4 periods
    • New symptoms suggest pregnancy (such as morning sickness)
    • You have other questions

Recent Stress Causing Late Period

  1. What You Should Know about Stress and Late Menstrual Periods:
    • Stress can disrupt normal menstrual cycles.
    • Try to help your daughter deal with the stress by talking about it.
    • Also, try to avoid or decrease stressors.
    • If this does not help, seek help from a counselor.
  2. Call Your Doctor If:
    • Misses 2 periods
    • Your daughter needs help coping with stress
    • New symptoms suggest pregnancy (such as morning sickness)
    • You have other questions

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.

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