Why isn't my period coming if I'm not pregnant?

Sep 16, 2025 Source: Cainiu Health

Dr. Zhang Lu

Introduction

In general, the main causes of absent menstruation in non-pregnant women include excessive mental stress, irregular作息 (作息 should be translated as "lifestyle" or "daily routine"), polycystic ovary syndrome (PCOS), hyperprolactinemia, and endometrial adhesion. If discomfort occurs, it is recommended to seek timely medical consultation and treatment at a qualified hospital. In daily life, it is important to maintain a positive mood and avoid excessive stress; follow a regular作息 (daily routine) and avoid staying up late; and maintain a balanced diet.

Generally, the main reasons for absence of menstruation despite not being pregnant include high levels of stress, irregular sleep patterns, polycystic ovary syndrome, hyperprolactinemia, and endometrial adhesions. If discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a reputable hospital. Specific explanations are as follows:

1. High Stress Levels

Long-term anxiety and tension can disrupt the hypothalamic-pituitary-ovarian axis, leading to hormonal imbalances and menstrual cycle disturbances. Stress can be alleviated through exercise, listening to music, maintaining emotional stability, adhering to regular作息 (daily routines), avoiding excessive fatigue, and seeking psychological counseling when necessary.

2. Irregular Sleep Patterns

Chronic late-night sleeping and reversed day-night cycles disrupt circadian rhythms, affecting the secretion of estrogen and progesterone, which may lead to delayed or absent menstruation. Adjust sleep schedules by ensuring 7–8 hours of sleep per night, maintaining consistent bedtimes and wake-up times, avoiding electronic devices before bedtime, and improving overall endocrine function.

3. Polycystic Ovary Syndrome (PCOS)

Ovarian dysfunction leads to excessive androgen production and impaired follicular development, resulting in infrequent menstruation or amenorrhea, often accompanied by hirsutism and obesity. Medications such as drospirenone ethinyl estradiol tablets, spironolactone tablets, and metformin hydrochloride tablets may be prescribed under medical supervision. Weight management, dietary adjustments, and reduced intake of high-sugar and high-fat foods are also recommended.

4. Hyperprolactinemia

Excessive prolactin secretion by the pituitary gland suppresses ovulation and hormone production, causing amenorrhea, often accompanied by galactorrhea (milky nipple discharge). Treatment may include medications such as bromocriptine mesylate tablets, vitamin B6 tablets, or cabergoline tablets under medical guidance. Avoid prolonged breast stimulation, minimize psychological stress, and regularly monitor prolactin levels.

5. Endometrial Adhesions

Injury and adhesion of the endometrium caused by uterine procedures or infections can impair endometrial shedding, leading to absent menstruation and possibly cyclical abdominal pain. Under medical supervision, estradiol valerate tablets may be used to promote endometrial repair. In severe cases, hysteroscopic adhesiolysis may be required, followed by intrauterine device (IUD) placement to prevent re-adhesion.

In daily life, it is important to maintain positive emotional health and avoid excessive stress; adhere to regular sleep schedules and avoid staying up late; eat a balanced diet to ensure adequate nutrition; and undergo regular gynecological check-ups to detect hormonal or uterine abnormalities early, preventing delayed treatment.

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My period is 15 days late, but the pregnancy test is negative. Why is this happening, and what should I do?

Menstruation delayed by 15 days but pregnancy test negative may be related to early pregnancy, excessive stress, intrauterine adhesions, uterine fibroids, premature ovarian failure, and other factors. If the symptom lasts for a short time, no need to worry excessively; regular observation is sufficient. However, if the symptom persists for a prolonged period, timely medical evaluation is recommended to determine the underlying cause and receive targeted treatment accordingly.

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My period is 7 days late, but the pregnancy test shows I'm not pregnant.

Under normal circumstances, if a pregnancy test shows negative results seven days after a missed period, it may be related to fluctuations in the menstrual cycle, short conception time, endocrine disorders, endometritis, polycystic ovary syndrome (PCOS), or other factors. It is recommended that the patient promptly visit a hospital and follow the doctor's instructions for examination and treatment. In daily life, maintaining a pleasant mood and avoiding excessive emotional excitement is advisable.

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Why is HCG elevated without pregnancy, and what should be done?

In general, elevated HCG levels without pregnancy may be caused by factors such as the ovulation period, use of ovulation-inducing medications, hydatidiform mole, gestational choriocarcinoma, or malignant tumors, and management should vary depending on the specific situation. If HCG levels are elevated but pregnancy is not present, a comprehensive gynecological ultrasound should be performed to check for any abnormal masses in the uterus and adnexa, enabling the physician to comprehensively assess the underlying cause and formulate an accurate treatment plan.

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What should I do if I haven't had a menstrual period and am not pregnant?

Menstruation usually refers to a menstrual period. Generally, if menstruation does not occur and pregnancy is not the cause, it may be due to malnutrition, excessive mental stress, endocrine disorders, endometrial adhesion, polycystic ovary syndrome (PCOS), or other related conditions. Treatment options, including general management, medication, or surgical intervention, should be chosen under a doctor's guidance. If physical discomfort occurs, it is recommended to seek timely medical attention and undergo treatment under the supervision of a qualified physician.