Ever found yourself wondering how to introduce a new sex act to your partner, or how to have orgasms that really hit the spot? If so, you’ve come to the right place! The Center for Sexual Pleasure and Health will be publishing a monthly question and answer series for all your sex and sexuality-related inquiries. From sex toys to fantasies to safer sex, we’ll be doling out advice to keep your bedroom romps fresh and your inner sex kitten purring.
This month’s column is by staff member Gypsy Vidal. Email your pressing sex questions to firstname.lastname@example.org, where they will be kept confidential!
I haven’t had my period in the last sixty-five days. I’ve taken a pregnancy test, which came back negative. I’m usually fairly regular. What could be going on?
For many vulva-owners, particularly those who have sex with people with penises, a missing or late period is a cause of great stress and anxiety. Even with home pregnancy tests, it can be all too easy to freak out a bit– after all, Aunt Flo is more important than the average houseguest!
Before I delve into the ins and outs of pregnancy tests and missed or late periods, however, I’d like to note that none of what I write should be construed as medical advice. The best person to answer this question is your local health care provider.
So, what’s up with the negative pregnancy test?
Depending on the circumstances, pregnancy may still even be in the picture. For example, whether your pregnancy test was done at home or through a blood test is noteworthy, as blood tests are much more accurate than home pregnancy tests.
That said, it should be noted that home pregnancy tests are, in fact, quite reliable. Most brands boast 99% accuracy, but this varies according to a few mitigating factors: use after the expiration date, not following the instructions, use too soon after missed period (you should take the test a week after), not waiting long enough for the test results (research recommends 10 minutes), and diluted urine.
If you take a home pregnancy test that comes back negative and you still haven’t started menstruating, try taking another test a week following the initial one. Unfortunately, drugstore tests can be quite expensive and therefore prohibitive to some. Thankfully, Amazon sells bulk pregnancy tests on the cheap– Wondfo in particular sells 25 test strips for $10-15.
Here is more information on how to use a home pregnancy test.
What about the absent period?
While textbooks describe a 28-day cycle, give or take 7 days, vulva-owners’ menses can be notoriously irregular. In fact, some 30% of vulva-owners report having irregular periods. Irregular menstruation is defined by menstrual bleeding more often than 21 days, longer than 8 days, missed, early, and otherwise late periods.
There are many reasons for irregular and absent periods, including drastic change in weight (either gained or lost), stress/anxiety, fluctuating hormone levels, and hormonal birth control.
Nevertheless, you mention that you are usually fairly regular, so your missed periods are likely the result of a change in your life and/or body. Have you been experiencing a lot of stress lately, maybe due to school exams, financial troubles, or a big move? Have your eating and exercise habits changed recently, and/or have you gained or lost a significant amount of weight? Have you recently had a new sexual partner? All of these things can throw a person’s cycle out of whack.
Other factors that influence the menstrual cycle are fluctuating hormone levels, hormonal contraception, and even spending a lot of time with or living within a household of multiple women, which causes estrogen level changes.
With that said, I will note that there is a difference between occasional irregularity and consistently irregular menstruation. The latter situation may indicate underlying medical conditions such as thyroid disorders or polycystic ovary syndrome (PCOS), which affects up to 10 percent of vulva-owners of reproductive age. A visit to your primary care provider will help assess the root of irregular periods, consistent or otherwise.
As irregular as periods can be, however, it is noteworthy that you have not menstruated in a little over 9 weeks, and that you are usually fairly regular. Aside from pregnancy, this may be indicative of what is usually a minor health condition called amenorrhea. There are two types of amenorrhea: primary amenorrhea, which is when a vulva-owner has not had their first period by the age of 16, and and secondary. Secondary amenorrhea is characterized by at least 3 missed periods, which you may be approaching, depending on your cycle.
There are a number of potential causes of secondary amenorrhea, including not only pregnancy, but also menopause, breastfeeding, contraceptives (such as hormonal intrauterine devices), certain medications (antipsychotics, cancer chemotherapy, antidepressants, and blood pressure drugs, to name a few), stress, hormonal imbalances, extremely high or low body weight, and excessive exercise.
What do I do now?
It is recommended that people with absent menstruation visit a medical care provider following two consecutive missed periods. A healthcare professional will be able to work with you to discover the cause(s) of your conspicuously late Aunt Flo, as well as help you get your period back on track. Potential treatments for secondary amenorrhea include oral contraceptives to help regulate the patient’s menstrual cycle, visiting a nutritionist to help maintain bodily health, and stress-reducing techniques.
Reprinted with permission by The Center for Sexual Pleasure and Health.