What Are the Causes of Delayed or Missed Menstruation?

Generally, delayed or absent menstruation may result from factors such as irregular sleep-wake cycles, excessive dieting, polycystic ovary syndrome (PCOS), intrauterine adhesions, or hypothyroidism. Patients may choose appropriate interventions—including lifestyle adjustments, pharmacotherapy, or surgical treatment—based on their individual circumstances. A detailed analysis follows:

1. Irregular Sleep-Wake Cycles

Chronic late-night sleeping and disrupted circadian rhythms can disturb endocrine regulation, impair ovarian hormone secretion, and delay the menstrual cycle. Maintaining a consistent sleep schedule—going to bed early and rising early—and minimizing overnight activity helps stabilize the body’s endocrine system.

2. Excessive Dieting

Severe dietary restriction leads to inadequate nutrient intake and abnormally low body fat, compromising estrogen synthesis and causing menstrual delay. Restoring a balanced diet rich in protein and vitamins, discontinuing extreme calorie restriction, and achieving moderate weight gain support normal metabolic function.

3. Polycystic Ovary Syndrome (PCOS)

Endocrine and metabolic dysfunction in PCOS impairs ovulation and disrupts hormonal balance, resulting in delayed menstruation or even amenorrhea. Under medical supervision, medications such as ethinylestradiol–cyproterone acetate tablets, metformin tablets, and progesterone capsules may be prescribed. Additionally, weight management and regular physical exercise are essential components of daily care.

4. Intrauterine Adhesions

Damage and subsequent adhesion of the endometrium within the uterine cavity hinder normal endometrial proliferation and shedding, leading to menstrual delay and reduced menstrual flow. Medications—including estradiol valerate tablets, dydrogesterone tablets, and enteric-coated aspirin tablets—may be prescribed per physician guidance. In severe cases, hysteroscopic adhesiolysis is required.

5. Hypothyroidism

Insufficient thyroid hormone secretion slows overall metabolism and interferes with gonadal hormone production, thereby disrupting the menstrual cycle. Under medical supervision, medications such as levothyroxine sodium tablets, thyroid tablets, and Yikang Capsules may be administered. Regular monitoring of thyroid function and timely dosage adjustment are crucial.

Adopting healthy dietary and sleep habits, avoiding excessive weight loss, maintaining emotional stability, and seeking prompt medical evaluation for persistent menstrual irregularities are essential for restoring and sustaining normal menstrual function.