Menstrual Period - Missed or Late

Is this your child's symptom?

  • Late or missed menstrual period
  • Late period: 5 or more days late compared to normal menstrual cycle
  • Missed period: no menstrual flow for more than 6 weeks
  • Teen not using any birth control that stops periods. These products include birth control shots, implants, and IUDs with hormones.

Normal Cause of a Missed Period during the First Year

  • Skipping periods is common during the first 1 to 2 years after they start. This is due to not releasing an egg each month.
  • This is most likely the cause if less than 2 years since the first period
  • Has missed periods in the past or has had only 1 or 2 periods
  • Otherwise healthy
  • No signs of pregnancy such as breast tenderness, breast swelling or nausea

Common Cause of a Missed Period after the First Year

  • Pregnancy is the most common cause

Other Causes

  • Stress
  • Dieting, extreme exercise and weight loss
  • Polycystic ovarian disease
  • Endocrine disorders
  • Birth control products like birth control shots, implants, and some IUDs

Home Urine Pregnancy Tests

  • Home urine pregnancy tests do not cost very much. They are easy to use. Most drugstores sell these tests. No prescription is needed.
  • Urine pregnancy tests are very accurate. They can turn positive as early as the first week after a missed period.
  • It is best to do the pregnancy test first thing in the morning. Reason: hormone levels are higher in the morning urine.
  • Sometimes, a home test is negative even if you think you might be pregnant. In this case, repeat the test. Do the repeat test in 3-5 days. You can also go to a doctor's office for testing.

When to Call for Menstrual Period - Missed or Late

When to Call for Menstrual Period - Missed or Late

Call Doctor or Seek Care Now

  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Contact Doctor During Office Hours

  • Home pregnancy test is positive
  • You want a pregnancy test done in the office
  • Sexual intercourse (had sex) within the last 3 months
  • Recent breast swelling, weight gain or nausea
  • Teen acts sick
  • Has missed 2 or more periods and prior periods were regular
  • Recent weight loss
  • Excessive exercise suspected as cause of no periods
  • First period started less than 1 year ago and has missed 4 or more periods
  • Age 15 or older and periods have not started
  • Cause is unknown (not recent onset of menstrual periods or recent stress)
  • You think your teen needs to be seen, but the problem is not urgent
  • You have other questions or concerns

Self Care at Home

  • Pregnancy Suspected or Possible
  • First period started less than 1 year ago and has missed 3 periods or less
  • Recent stress (such as starting at a new school, break-up) causing late period

Call Doctor or Seek Care Now

  • Your teen looks or acts very sick
  • You think your teen needs to be seen, and the problem is urgent

Contact Doctor During Office Hours

  • Home pregnancy test is positive
  • You want a pregnancy test done in the office
  • Sexual intercourse (had sex) within the last 3 months
  • Recent breast swelling, weight gain or nausea
  • Teen acts sick
  • Has missed 2 or more periods and prior periods were regular
  • Recent weight loss
  • Excessive exercise suspected as cause of no periods
  • First period started less than 1 year ago and has missed 4 or more periods
  • Age 15 or older and periods have not started
  • Cause is unknown (not recent onset of menstrual periods or recent stress)
  • You think your teen needs to be seen, but the problem is not urgent
  • You have other questions or concerns

Self Care at Home

  • Pregnancy Suspected or Possible
  • First period started less than 1 year ago and has missed 3 periods or less
  • Recent stress (such as starting at a new school, break-up) causing late period

Care Advice

Pregnancy Suspected or Possible

What You Should Know About Late Periods if Having Sex:

  • Menstrual periods stop when a woman becomes pregnant.
  • A woman with a missed or late period should think about pregnancy.
  • Here is some care advice that should help.

Pregnancy Test, When in Doubt:

  • If there is a chance that you might be pregnant, use a urine pregnancy test.
  • You can buy a pregnancy test at any drugstore.
  • It works best first thing in the morning.
  • Follow all package instructions.

Call Your Doctor If:

  • You have trouble with the home pregnancy test
  • Pregnancy test is positive
  • Misses 2 periods and pregnancy test is negative
  • Your teen develops any serious symptoms

First Period Started Less than 1 Year Ago

What You Should Know About First Periods in Young Teens:

  • Skipping periods is common during the first 1 or 2 years after they start.
  • It doesn't mean anything serious or cause any harm.
  • A girl can normally go up to 6 months between the first and second periods.
  • Also, a girl can go up to 4 months between the second and third periods.
  • Normal irregular periods can go on for 2 years.

Call Your Doctor If:

  • Misses 4 periods
  • New symptoms suggest pregnancy (such as morning sickness)
  • You have other questions

Recent Stress Causing Late Period

What You Should Know about Stress and Late Menstrual Periods:

  • Stress can disrupt normal menstrual cycles.
  • Try to help your daughter deal with the stress by talking about it.
  • Also, try to avoid or decrease stressors.
  • If this does not help, seek help from a counselor.

Call Your Doctor If:

  • Misses 2 periods
  • Your daughter needs help coping with stress
  • New symptoms suggest pregnancy (such as morning sickness)
  • You have other questions

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:41 Version 0.1

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February 12, 2026
There are cases of measles in NC, and we are aware of exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. 2 doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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