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.

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.

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

Contact 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

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.

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.

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

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.

Call Your Doctor If:

• Misses 4 periods
• New symptoms suggest pregnancy (such as morning sickness)
• You have other questions

Recent Stress Causing Late Period

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.

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

Remember! Contact your doctor if you or your child develop any "Contact 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.

Last Reviewed: 05/01/2025

Last Revised: 01/25/2025

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.