Missed period but pregnancy test is negative: when should you see a gynaecologist?

English version

A missed period does not always mean pregnancy

Menstrual cycles can occasionally vary. If pregnancy is possible, take a home pregnancy test according to the kit instructions. A result taken very early can be negative even when a pregnancy has begun. If your period still does not start, repeat the test after a few days or seek medical advice.

Most home tests can be used from the first day of a missed period. If you do not know when your next period is due, test at least 21 days after the last unprotected sexual intercourse. Check the expiry date, follow the reading time exactly and avoid testing immediately after drinking a large amount of fluid.

What can cause a missed period?

Possible causes include:

• Stress, poor sleep or significant emotional strain.
• Sudden weight loss, weight gain or very intensive exercise.
• PCOS, irregular ovulation or thyroid problems.
• Increased prolactin levels, breastfeeding or hormonal contraception.
• Perimenopause or reduced ovarian function.
• Certain medicines or chronic medical conditions.

When someone who previously had periods does not menstruate for three months or longer, this is known as secondary amenorrhoea and should be medically assessed.

Arrange a consultation if

• You have missed three consecutive periods.
• Your periods repeatedly become very late or irregular.
• You are trying to conceive.
• You notice unusual weight changes, tiredness, facial hair, acne or scalp-hair thinning.
• You have hot flushes or vaginal dryness before age 45.
• You have nipple discharge when not breastfeeding.
• You experience headaches, vision changes, or your periods stopped after a new medicine or procedure.

What tests might be advised?

Evaluation depends on your age, symptoms and medical history. It may include pregnancy testing, thyroid and prolactin tests, selected reproductive-hormone tests, blood sugar assessment or a pelvic ultrasound. Not every patient needs every test. Avoid taking hormonal “period-starting” tablets without medical advice because treatment depends on the cause.