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I am 26. What are the reasons for my missed periods?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am 26 years old, weigh 127 pounds, and my height is five feet. My blood pressure is normal, but I have not had a period for 59 days. I tested beta human chorionic gonadotropin (hCG) twice, and the results were negative. What could be the reason for the missed periods?

Please advise.

Answered by Dr. Ali Osman

Education:

MBBS

Professional Bio:

Dr. Ali Osman is a dedicated obstetrics and gynecology specialist committed to providing compassionate and comprehensive care for women at every stage of life. He has experience in managing a wide range of women’s health concerns, including pregnancy care, menstrual disorders, reproductive health, and gynecological conditions. Dr. Osman focuses on patient education, preventive care, and personalized treatment plans to ensure the best possible outcomes. Known for his supportive and professional approach, he strives to create a comfortable environment where patients feel heard, respected, and confident in their healthcare journey.      

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I understand your concerns and will try to help you.

There are several possible causes of irregular menstrual bleeding or amenorrhea (absence of periods). Let me explain them:

  1. To rule out pregnancy, a test is required. You have already done this, and your results are negative.
  2. Patients with polycystic ovary syndrome (PCOS) often experience weight gain, acne, and excessive hair growth (on the chin, upper lip, chest, back, arms, or legs).
  3. Possible causes for hyperprolactinemia include idiopathic (unknown cause), use of certain drugs, such as SSRIs (selective serotonin reuptake inhibitors), anti-anxiety, or antidepressants, and prolactinoma (a tumor in the pituitary gland).
  4. Thyroid disorders like hyperthyroidism or hypothyroidism may cause irregular menstrual bleeding. Symptoms may include heat or cold intolerance, palpitations, tremors, and tachycardia (rapid heart rate).

To determine the underlying cause of your condition, I recommend the following tests:

  1. Serum FT4 (free thyroxine) and TSH (thyroid-stimulating hormone) to check thyroid function.
  2. Serum FSH (follicle-stimulating hormone) and LH (luteinizing hormone) to evaluate ovarian function.
  3. Serum prolactin to rule out hyperprolactinemia.
  4. Pelvic ultrasound to check for PCOS or other abnormalities.

I suggest taking the tablet Dydrogesterone 10 milligrams. Take one tablet twice a day for 21 days, followed by a seven-day pill-free interval. Repeat this cycle for three months. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

I hope my explanation is clear. If you have any further questions, please do not hesitate to contact me.

Thank you.

Answered by Dr. Ali Osman
Medically reviewed by iCliniq medical review team
Published At December 20, 2024
Reviewed At February 26, 2026

Education:

MBBS

Professional Bio:

Dr. Ali Osman is a dedicated obstetrics and gynecology specialist committed to providing compassionate and comprehensive care for women at every stage of life. He has experience in managing a wide range of women’s health concerns, including pregnancy care, menstrual disorders, reproductive health, and gynecological conditions. Dr. Osman focuses on patient education, preventive care, and personalized treatment plans to ensure the best possible outcomes. Known for his supportive and professional approach, he strives to create a comfortable environment where patients feel heard, respected, and confident in their healthcare journey.      

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Ali Osman is a dedicated obstetrics and gynecology specialist committed to providing compassionate and comprehensive care for women at every stage of life. He has experience in managing a wide range of women’s health concerns, including pregnancy care, menstrual disorders, reproductive health, and gynecological conditions. Dr. Osman focuses on patient education, preventive care, and personalized treatment plans to ensure the best possible outcomes. Known for his supportive and professional approach, he strives to create a comfortable environment where patients feel heard, respected, and confident in their healthcare journey.      

This doctor is not available for online consultations on the platform anymore.

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