9 Reasons Why You've Got Period Symptoms But No Period
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You’ve been seriously bloated, moody, and tired. You’ve got monster cramps, and your face is as pimply as a 17-year-old boy’s. In other words, you’re suffering from all of the classic signs of your monthly flow. Yet your period is totally MIA.
Well, it turns out, there are actually numerous reasons you might experience period symptoms but no period.
“Hormonal changes related to ovulation can affect some of the same pathways in your brain that might be affected by other medical conditions, causing mood swings that feel similar to your period but aren’t related to ovulation or menses,” says Chailee Moss, M.D., an ob-gyn at Johns Hopkins Medicine. What’s more, some physical abnormalities in your uterus and ovaries can also cause cramping that feels like PMS, she adds.
While having the rare skipped period is often nothing to worry about, if you have a fever, significant nausea or vomiting, or pain that you can’t control with simple OTC medications or that doesn’t improve within a week, check in with your doctor right away. (Also schedule a visit if you experience extreme mood changes that affect your quality of life or endanger you or anyone else—you could be experiencing depressive symptoms associated with a mood disorder that requires medical treatment.)
Otherwise, it’s time to see your doctor if you skip more than three cycles in a row, suggests Chicago-based ob-gyn Jessica Shepherd, M.D.
Here, nine possible reasons why you have period symptoms but no period:
1
ANOVULATION
Every once in a while, your body goes through all of the hormonal changes associated with PMS, but if you didn't actually release an egg that month, you won't actually get your period. Known as anovulation, it’s more common than one might think. "Ten to 18 percent of all regular cycles are anovulatory,” Shepherd adds.
In case you're wondering, yes, that stat can make getting pregnant tricky!
2
PREGNANCY
If you've had unprotected sex in the last month, were a bit lax about taking your pill, or rely on the pullout method for birth control, it's worth taking a pregnancy test. Many of the symptoms of early pregnancy, including breast tenderness, mood swings, fatigue, and cramping, are the same ones that you were already experiencing month to month before and during your period.
“Both hormonal and uterine changes that happen in early pregnancy can affect the same pathways as a menstrual cycle,” explains Moss. With pregnancy, however, you might have a bit of light spotting around the time you normally get your period. “That could be implantation bleeding, which is when the embryo attaches to endometrial lining, causing a bit of a reaction,” adds Shepherd.
Think there’s a chance you could be pregnant? Take an at-home pregnancy test on the day that you expect your period. If it comes back negative, wait three to four days and try again. “One to two days can make a difference in a positive pregnancy test,” says Moss.
Here's what every woman needs to know about pregnancy tests:
6 Things Every Woman Should Know About Pregnancy Tests
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3
THYROID CONDITIONS
Your thyroid, a small butterfly-shaped gland in your neck, regulates many of your body’s functions, including your metabolism and menstrual cycles. But when it doesn’t make the right amount of thyroid hormones—known as either hypothyroidism or hyperthyroidism—it affects a couple of important hormones that regulate ovulation, FSH (follicle-stimulating hormone) and LH (luteinizing hormone), and your cycles can become irregular, says Shepherd.
“If your ovary is not functioning properly, you can have failure to ovulate, which makes cycles irregular,” explains Moss. You may you go a long stretch without having your period while you experience period-like symptoms. Because your thyroid regulates your brain function, mood swings that you thought were PMS may be related to your neurologic function, she explains. And spotting or cramping may occur because the lining of your uterus has built up but hasn’t shed because you’re not ovulating.
So be sure to check in with your doctor if you’re experiencing other symptoms of a thyroid condition, including sudden unexplained weight loss or gain, shaking, heart palpitations, or significant fatigue.
4
HORMONAL BIRTH CONTROL
One very common side effect of hormonal IUDs is skipped periods. That’s because one of the ways the device prevents pregnancy is by thinning out the endometrial lining so there’s nothing to shed come that time of the month.
And, while they don't typically nix your flow altogether, birth control pills can result in super-light flows or spotting. So you might feel period symptoms like breast tenderness even without a heavy, full-blown period, says Shepherd.
5
STRESS
Stress is a surprisingly common reason for missing your period. “Stress increases your cortisol levels, which affects your hormone balance,” says Shepherd—including the hormones that regulate your ovaries and uterine lining. Unlike extreme exercise or being overweight, both of which can put a pause on menstruation (in part because of elevated cortisol levels), when you’re stressed, your uterine lining continues to grow. It just doesn’t shed. “You may have irregular bleeding or cramping because of a buildup of lining without the shedding that happens with menstruation,” says Moss.
Exams, the death of a family member, and divorce are all big-time stress-inducing events that can cause periods to go awry. But these life-changing biggies aren’t the only reasons you might be feeling the effects of stress. “Some people don’t realize they’re so stressed, but once they talk about it they realize they are going through something,” says Shepherd. If you think stress is messing with your periods, talk to your doctor; therapy, exercise, yoga, and meditation can all help get your stress under control and your periods back on track.
6
PCOS
Frequent skipped periods can be caused by polycystic ovarian syndrome (PCOS). “PCOS is a condition in which a patient has an excess of androgens, which are chemicals in the body that affect how ovaries function, hair growth, weight gain, and sensitivity to insulin,” says Moss.
PCOS can result in anovulatory cycles and irregular spotting. It commonly causes cysts to grow on the ovaries, which, if they rupture or cause the ovary to twist, can cause pelvic pain that feels a lot like period cramps. Excess hair growth related to hormonal imbalance can cause breakouts that you might otherwise have linked to your period, while you could mistake PCOS-induced weight gain for period-related bloating, Moss says.
Up to 20 percent of women worldwide are affected by PCOS, which is more common among women who are overweight or have a mom or sister with by the condition, Moss says. If you think you might be suffering from PCOS, check in with your doctor. While there is no cure, birth control and other medications can help keep symptoms under wraps and get your periods back on track.
7
UTERINE POLYPS
You might associate polyps with your colon, but the same small benign tumors can grow in your uterus. “It’s an overgrowth of lining of the uterus,” says Moss. Polyps in your uterus can cause cramping and period-like discomfort, even when you’re not on your period.
Because polyps can make it harder to get pregnant, and because there is a small risk they may develop into uterine cancer down the line, your doctor will likely want to remove them, most often with a relatively simple procedure known as a hysteroscopy. During a hysteroscopy, a doctor inserts a long tube up through the vagina and into the uterus. The doctor is able to use the scope to both see and cut out the polyps.
8
OVARIAN CYSTS
Every month, your ovaries make several cysts in preparation for ovulation, but only one cyst releases an egg. Although the others usually dissipate on their own by the time you get your period, sometimes one cyst or more sticks around.
Cysts can also occur if you have an anovulatory cycle (such as with PCOS). Ovarian cysts often cause no symptoms at all, although they can sometimes trigger period-like pain when you’re not on your period. So if you’re experiencing irregular cramping, talk with your doctor.
“Cysts in and of themselves aren’t usually a problem,” says Moss. “But if they get particularly large, they can cause the ovary to twist, which is painful and requires an emergency procedure to save your ovary.”
9
GYNECOLOGICAL INFECTIONS
Some sexually transmitted infections like gonorrhea and chlamydia can result in a condition known as pelvic inflammatory disease, which can cause significant discomfort that feels like period cramping when you’re not expecting your period. UTIs can also cause period-similar pelvic pain, says Moss.
Whatever your down-there infection, a round of antibiotics should help clear it up. So keep an eye out for red-flag symptoms including fever, significant nausea or vomiting, or pain that doesn’t go away with OTC pain relievers.
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