Pregnancy is often the first thought when a period is missed, but there are many reasons for having a late period. Increased risk is associated with extreme and prolonged exercise (particularly without adequate conditioning), body fat content less than 15% to 17%, extreme obesity, and taking hormonal supplements.
Anxiety over a possible pregnancy may cause a missed period, thereby increasing the anxiety even further. Emotional distress from other causes can also cause a missed period.
Drugs such as busulfan, chlorambucil, cyclophosphamide, oral contraceptives, phenothiazines, and non-oral contraceptives (such as Norplant and Depo-Provera) can all cause scanty or missed periods. Also, procedures such as a dilation and curettage (D and C) can cause a woman to develop amenorrhea if scar tissue develops within the uterine cavity.
Early appearance of menopause may account for some cases (menopause is normal for women over age 45).
The incidence of secondary amenorrhea (due to some cause other than pregnancy) is about 4% in the general population.
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