What to do about a delayed menstrual period

Sep 10, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, delayed menstruation may be caused by factors such as excessive mental stress, extreme dieting for weight loss, polycystic ovary syndrome (PCOS), hyperprolactinemia, hypothyroidism, and other related conditions. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general lifestyle adjustments, medication, or other treatments. Additionally, maintaining a balanced diet and avoiding excessive fatigue are important in daily life.

Generally, delayed menstruation may be caused by excessive mental stress, extreme dieting for weight loss, polycystic ovary syndrome (PCOS), hyperprolactinemia, hypothyroidism, and other related factors. It is recommended to seek timely medical consultation to identify the underlying cause and improve the condition under a doctor's guidance through general lifestyle adjustments, medication, and other approaches. The detailed analysis is as follows:

1. Excessive Mental Stress: Prolonged anxiety, tension, and other negative emotions can affect the hypothalamic-pituitary-ovarian axis, leading to hormonal imbalances and delayed menstruation. Stress can be relieved in daily life through physical exercise, listening to music, communication with others, maintaining regular sleep patterns, and avoiding staying up late, which helps regulate the endocrine system.

2. Excessive Dieting for Weight Loss: Long-term insufficient caloric intake places the body in a low metabolic state, affecting estrogen synthesis and resulting in delayed menstruation or even amenorrhea. Normal eating habits should be resumed, ensuring adequate intake of proteins, vitamins, and other essential nutrients. Gradually adjust body weight to a healthy range and avoid extreme dieting.

3. Polycystic Ovary Syndrome (PCOS): Endocrine disorders lead to elevated androgen levels and abnormal ovulation, manifesting as delayed menstruation, reduced menstrual flow, and often accompanied by hirsutism and acne. Patients should follow medical advice to use medications such as dydrogesterone tablets, ethinylestradiol cyproterone acetate tablets, and spironolactone tablets to regulate hormone levels.

4. Hyperprolactinemia: Excessively high prolactin levels inhibit ovulation, leading to delayed menstruation and possibly accompanied by breast galactorrhea. Patients should follow medical advice to use medications such as bromocriptine mesylate tablets, vitamin B6 tablets, cabergoline tablets, and others to reduce prolactin levels.

5. Hypothyroidism: Insufficient secretion of thyroid hormones affects metabolism and the endocrine system, leading to delayed menstruation, increased menstrual flow, intolerance to cold, and fatigue. Patients should follow medical advice to use medications such as levothyroxine sodium tablets, thyroid extract tablets, and levothyroxine sodium enteric-coated tablets to supplement thyroid hormones.

In daily life, maintain a balanced diet, avoid excessive fatigue, and engage in mild physical activities such as walking and yoga. Monitor changes in the menstrual cycle, record menstrual dates, and promptly detect abnormalities to adjust management strategies and maintain reproductive health.

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Can I wash my genital area during menstruation?

Under normal circumstances, the term "below" refers to the perineum. It is acceptable to clean the external genitalia during menstruation, but proper techniques must be followed; otherwise, it may have counterproductive effects. For daily wear, choose breathable cotton underwear and change it every day, avoiding tight pants that can cause a hot and moist environment. It is advisable to drink plenty of warm water and consume iron-rich foods such as animal liver and dark green vegetables in moderation. If menstrual pain is severe or there is a sudden increase or decrease in menstrual flow, prompt medical attention is recommended.

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Can I receive breast massage for enhancement during my menstrual period?

In general, breast massage for the purpose of breast enhancement should be avoided during menstruation. A safer approach is to schedule breast care 3–5 days after the menstrual period ends, when hormone levels have declined, breast tenderness has subsided, and breast tissue is most receptive. Daily maintenance should focus on wearing well-fitted bras, maintaining a balanced diet, and engaging in regular exercise. If persistent breast asymmetry occurs, a consultation with a breast specialty clinic is recommended for evaluation.