Causes of Delayed Period with a Negative Pregnancy Test

Late Period with a Negative Pregnancy Test: Causes, Symptoms and When to See a Doctor

Summary: A late period with a negative pregnancy test is common, and the cause is often simple, such as stress, a change in weight or testing too early. Common medical causes include polycystic ovaries, thyroid disorders and raised prolactin. If your period is a week late and the test is negative, repeat it in a few days or have a blood test, and see the doctor if you have had no period for three months or have other symptoms.

When is a period late?

A normal cycle comes every 21 to 35 days, and its length differs from woman to woman. A period is late when it is more than a week later than your usual date.

Could the negative test be wrong?

Yes, and this is the first thing to consider, especially if:

·       You tested early, before the pregnancy hormone had risen enough.

·       You ovulated late this cycle, so pregnancy and the hormone are also later.

·       Your urine was diluted because you had drunk a lot of water.

What to do: repeat the test in three to seven days using the first urine of the morning, or have a blood pregnancy test, which is more accurate.

Common causes of a late period with a negative test

1. Stress

Stress raises cortisol, which can delay ovulation, so the period comes late. This happens with work pressure, exams, family problems or even travel.

2. Weight change and excessive exercise

Large or rapid weight loss, eating too little or very strenuous exercise can stop ovulation. Marked weight gain can also upset the cycle.

3. Polycystic ovaries

One of the most common causes of irregular periods. It may come with acne, excess hair on the face and body, and weight gain.

4. Thyroid disorders

An overactive or underactive thyroid can delay periods or make them irregular.

5. Raised prolactin

It may cause a milky discharge from the breasts without breastfeeding, and sometimes headaches. Some medicines can raise this hormone.

6. Breastfeeding

Breastfeeding can delay the return of periods after childbirth for months; this is normal.

7. Stopping the pill or other medicines

After stopping the contraceptive pill or hormone injections, the cycle may take some time to become regular. Some other medicines can affect periods too; tell your doctor everything you take.

8. Approaching the menopause, or premature ovarian insufficiency

After 40 the cycle gradually becomes irregular. If periods stop before 40 with hot flushes or vaginal dryness, the ovarian reserve should be checked.

9. Less common causes

Such as serious illness, adhesions inside the uterus after a previous D&C, or other long-term conditions.

Symptoms that may come with a late period and point to the cause

·       Acne and excess hair: may point to polycystic ovaries.

·       Milky breast discharge or headaches: may point to raised prolactin.

·       Palpitations, severe tiredness or unexplained weight change: may point to a thyroid problem.

·       Hot flushes and night sweats: may point to low ovarian hormones.

When to see the doctor

·       If you have had no period for three months or more.

·       If you are trying to conceive and your periods are irregular.

·       If any of the symptoms above appear.

·       If you have severe abdominal pain or abnormal bleeding: see the doctor straight away.

Tests the doctor may ask for

·       A blood pregnancy test.

·       Hormone tests: thyroid, prolactin and ovarian hormones.

·       An ultrasound of the uterus and ovaries.

Treatment depends on the cause: changes to lifestyle and weight, treating the thyroid or prolactin, treating polycystic ovaries, or inducing ovulation for women who want to conceive.

Read more in our articles on [polycystic ovary syndrome](/polycystic-ovary-syndrome-pcos/) and [stress and ovulation](/stress-and-ovulation-a-hidden-dialogue-between-the-brain-and-the-ovaries/).

This article is for general information and does not replace a medical consultation.