What Tests Should Be Done If Menstruation Is Delayed by More Than One Week?

Under normal circumstances, if menstruation is delayed by more than one week, appropriate diagnostic tests may be selected based on individual physical condition—such as serum human chorionic gonadotropin (HCG) testing, sex hormone panel (six-item hormonal assay), thyroid function testing, transvaginal or abdominal color Doppler ultrasound of the uterus and adnexa, and liver function and complete blood count (CBC) testing. If any discomfort symptoms arise, prompt medical consultation is recommended. Detailed explanations are as follows:

1. Serum HCG Testing

Serum HCG testing serves as a fundamental diagnostic tool for evaluating menstrual delay in women of childbearing age—particularly those with recent sexual activity. Following conception, hormonal changes occur that directly result in amenorrhea. This test accurately determines whether pregnancy is present and clarifies whether menstrual delay is attributable to pregnancy.

2. Sex Hormone Panel (Six-Item Assay)

The sex hormone panel assesses endocrine status by measuring six key reproductive hormones. Factors such as chronic sleep deprivation, emotional stress, and fluctuations in ovarian function can disrupt sex hormone secretion, thereby disturbing the regular menstrual cycle. This test quantifies levels of estradiol, progesterone, and other relevant hormones, helping identify endocrine imbalances responsible for delayed menstruation.

3. Thyroid Function Testing

Thyroid dysfunction interferes with systemic endocrine regulation and impairs normal ovarian physiology. Hormonal imbalance—especially involving thyroid hormones—may delay follicular development, leading to prolonged menstrual cycles. This test evaluates thyroid function and helps rule out thyroid disorders as an underlying cause of menstrual delay.

4. Pelvic Ultrasound (Uterus and Adnexa)

Transvaginal or abdominal pelvic ultrasound provides direct visualization of the uterus, ovaries, and endometrium. Conditions such as thin endometrium, ovarian cysts, or polycystic ovary syndrome (PCOS) may impede normal endometrial shedding and contribute to menstrual delay. This imaging modality identifies structural or organic abnormalities within the uterine cavity.

5. Liver Function and Complete Blood Count (CBC)

The liver plays a critical role in hormone metabolism, while anemia compromises systemic oxygen and nutrient delivery—including to reproductive tissues. Hepatic dysfunction or severe anemia may disrupt endocrine metabolism and impair qi and blood circulation, indirectly causing menstrual irregularities and delayed periods. These tests help detect underlying systemic conditions contributing to menstrual abnormalities.

In addition, individuals uncertain about the etiology of their menstrual delay should undergo stepwise evaluation under physician guidance. Concurrently, maintaining regular sleep-wake patterns, emotional stability, and balanced nutrition—and undergoing routine gynecological examinations—can support long-term menstrual cycle regularity.