Delay 7 days, test negative, reasons, should I immediately go to the doctor

Regularity is key

For the first time, every representative of the fair sex learns what menstruation is at the age of 12-14 years, during adolescence, accompanied by puberty. This indicator may vary depending on the individual and hereditary characteristics of a particular organism (for some girls, menstruation occurs at 10-11, while others do not know what it is until 15). The first two years after the start of discharge is the period of formation of the cycle, when its fluctuations are considered normal (however, this is not a reason to ignore regular preventive visits to the gynecologist). If, after 2 years from the start of menstruation, a woman is still worried about a 7-day delay in menstruation, this is an alarm bell that requires examination of the body.

The menstrual cycle itself is the period between menstruation. It is calculated from the first for a new menstruation until the beginning of the next one. This period should remain within approximately the same range (usually from 21 to 35 days, for most women it is 28 days). Deviations of 1-2 days are considered within normal limits, since even taking antibiotics, changing climate zones or stress affect the frequency of menstruation.

Immediately after the end of bleeding, the next egg matures in the ovary. The endometrium grows in the uterine cavity, which should further contribute to the consolidation of the fertilized egg. All this is accompanied by an increase in the level of female hormone in the blood. The peak of the cycle is ovulation - days 12-14, when the egg begins to move through the fallopian tube to the uterus. In its place, a derivative of the hormone progesterone, the corpus luteum, is formed. If sexual intercourse takes place during this period, then pregnancy occurs, the fertilized egg descends into the uterine cavity, attaches to its wall and develops there. If there was no conception, the level of progesterone and female hormone in the blood drops, and after some time menstruation occurs.

From here we conclude that if a woman is 7 days late and the test is negative, the reasons may lie in disruptions in the body’s hormonal regulation. But not always!

When a rapid pregnancy test is wrong

All rapid tests, regardless of price and method of operation, are based on one principle - they determine the presence of human chorionic gonadotropin (hCG) in the urine. This is a hormone that begins to be produced in the female body 7-10 days after the fertilized egg begins to develop. It is believed that when pregnancy occurs, hCG can be detected already in the first days of a delayed menstrual cycle. The tests contain special substances that detect the hormone and react to it by changing the color on the strip or by appearing on the screen of the electronic device: pregnon or non pregnon (“pregnant” or “not pregnant”).

Why can a negative answer be false?

If the concentration of gonadotropin is insufficient, the test result may be false negative. This can happen when conception occurred shortly before the start of menstruation, and hCG has not yet had time to accumulate in perceptible quantities. By the way, if the period is more than 12 weeks, the rapid test will also be useless: hCG ceases to be produced.

The test can be false negative in case of ectopic pregnancy and threat of miscarriage. With excessive fluid intake, the concentration of hCG in the urine may also decrease, which means the test result may be unreliable. Therefore, before the test, experts advise not to drink a lot of fluids and not to use diuretics. This is especially important in the short term, when a woman does the test in the first days after the delay. And it is best to determine the hormone level in the morning.

“Some tests say that the time of day at which it is carried out does not matter,” says Yulia Dolgo-Saburova. — As a rule, such tests are positioned as highly sensitive. But no matter what the instructions say, a few days after the delay, I would still recommend doing the test in the morning, since a noticeable amount of hCG appears in the urine throughout the day around the third week of embryo development.

Why can a positive answer be false?

In addition to false negative results, rapid pregnancy tests can also show false positive ones. This happens when taking drugs containing hCG, for example, ovulation-stimulating drugs Pregnil and Profazi. After completing treatment with these medications, high hCG levels may persist for up to two weeks. Therefore, you will have to wait with the test for this period. After miscarriages, abortions, or removal of an ectopic pregnancy, the hormone does not disappear immediately - it still remains in the body for some time, and tests can give false positive answers.

(What to do if pregnancy is delayed, find out here)

The test can also show pregnancy where there is none in various tumor processes.

How to avoid mistakes

In addition, rapid tests can show false results, both positive and negative, for “technical” reasons.

The test may be of poor quality or expired. Therefore, it is always necessary to check the expiration date, the tightness of the packaging and do not hesitate to ask for a certificate. You can only use a well-packaged device and print it before direct use. Violation of storage conditions can also be misleading. To be sure that tests are stored correctly, it is better to buy them at a pharmacy.

Failure to follow the test instructions and using stale urine can also change the result. But it happens much more often that one day the test is positive, and after some time it becomes negative. But this is not a mistake. This happens when the pregnancy stops at a very short stage and a miscarriage occurs. Usually a woman does not notice it: everything happens like normal menstruation, only with a slight delay.

Three types of tests - three degrees of accuracy

There are three groups of rapid tests: test strips, tablet and inkjet. The most popular of them are test strips. The principle of operation is simple: you need to dip the test strip in a small amount of urine and after 5-10 minutes the answer will be known. If the second strip is colored, the test is positive; if it is not colored, the test is negative. It happens that the second strip changes color barely noticeably; such a result is considered weakly positive. And gynecologists advise repeating the test after three days. Test strips are the cheapest, but also less “true” than others. The inaccuracy of the results is due to the fact that the strip can be underexposed or overexposed.

(How to choose a contraceptive, read here)

Tablet tests are slightly more expensive, but the quality of their results is considered to be higher. The test consists of two windows: in the first you need to drop a few drops of urine with a pipette, and in the second the answer will appear after a while.

For jet tests, there is no need to collect urine separately - just place the device under a stream of urine, as indicated in the instructions. After a few minutes, the result will appear on the display. Inkjet tests are considered the most expensive, but also the most sensitive - with their help you can determine pregnancy even a few days before the start of the expected menstruation.

No matter how much you test, you still have to go for an ultrasound

“If a pregnancy test is carried out according to all the rules and there are no internal reasons in the body that could affect its reliability, it does not matter what type of tests a woman uses: in 99% of cases it can be trusted,” says gynecologist Yulia Dolgo- Saburova. — In my many years of practice, there were only two or three cases when the tests were wrong.

(you can contact a gynecologist here)

However, the only irrefutable evidence of pregnancy is considered to be an ultrasound, which shows the fertilized egg. And you can see it no earlier than a week after the delay.

If on the first or second day of the delay the pregnancy test turns out to be negative, the specialist advises repeating it after 3 days. If it is positive, this is a definite reason to contact a gynecologist. If the test remains negative, it should be done in another three days. And if it turns out to be negative for the third time, and menstruation still does not begin, you need to consult a doctor as soon as possible.

photo mame.org.ua

Elena Rtishcheva

© Dr. Peter

Can tests be trusted 100%?

How does a pregnancy test work, and can its results be trusted? This is the first important question. The principle of operation of a pharmacy pregnancy test is to determine the level of hCG (human chorionic gonadotropin) in the urine. After the fertilized egg attaches to the wall of the uterus, its concentration in the blood and, accordingly, urine begins to grow rapidly. Manufacturers claim that 97% of the tests show a reliable picture, that is, if a woman is pregnant, he will definitely find out. It’s quite logical, because they won’t do anti-advertising for their products.

Usually, gynecologists strongly recommend taking the test again in a week or two, or even better, doing an ultrasound of the uterine cavity and taking a blood test for hCG. Sometimes two test strips can be seen by women suffering from certain gynecological diseases. Therefore, for women who have a 7-day delay, the gynecologist will tell you what to do after the examination.

Features of the test

Before finding out what day of delay the test will accurately show pregnancy, let’s look at their main types. The variety and wide range of products makes it possible to choose the one that is suitable for the method of use, cost and quality. Today there are the following types:

Strip tests, the simplest and most cost-effective option. They are easy to use, you just need to dip the strip in the urine and wait for the reaction. The result is determined by the degree of hue change on the second stripe.
Cassette tests are more advanced; here the test strip is built into a plastic housing. The procedure for use is no different from the first option.
Inkjet tests are convenient because there is no need to collect urine. It is enough to place it under the stream. They are highly sensitive.
Electronic tests are considered the most accurate; the result appears on the screen, which frees you from comparing shades. They have a higher cost.

Now every girl can choose a pregnancy text that is convenient for her, the main difference is in price and method of use

The principle of operation of strips and devices is to detect the content of the pregnancy hormone hCG (human choreonic gonadotropin). It is produced by the outer membrane of the fetus (chorion) immediately after insertion into the endometrium. Therefore, it is clear that it should not be determined immediately after conception, when it has not been produced enough.

On what day of delay will the test show pregnancy exactly?

The fertilized egg attaches to the uterus within 7-10 days. At this time, hCG levels are low, and the most sensitive tests can detect it at a value of only 10 mIU/ml. This means that already on days 7-10 after conception the test will show pregnancy before the delay, if it belongs to the highly sensitive series.

Interesting: Weight gain during pregnancy by week, calculator table online

Delayed menstruation in young mothers

Another aspect that is worth mentioning is that it is normal for a woman to have a delay in menstruation after childbirth due to the active production of the hormone prolactin. If the child is on artificial nutrition, the woman’s cycle will be restored in 1-2 months. Mothers who breastfeed their baby may not remember what menstruation is for a year, or even 2-3 years. The main thing is to know during this period that the absence of menstruation is not a sign that a woman cannot become pregnant again (many young parents forget about this, neglecting contraceptives).

Inflammation in the ovaries and serious gynecological diseases

When a woman has a 7-day delay in her period, the reasons may be various disorders of the functioning of the reproductive system, that is, diseases. Moreover, these diseases are not the simplest: ranging from inflammatory processes that affect the organs of the female reproductive system, and uterine fibroids, and ending with cervical cancer. Of course, postponing the solution of such problems is unacceptable. Moreover, it can have unpleasant and sometimes fatal consequences. Especially if any discharge is observed. When the delay is 7 days, spotting is a clear sign of inflammatory processes in the body that require immediate medical attention!

Polycystic ovary syndrome

A gynecologist can make such a diagnosis to a woman even at the first glance. Women with polycystic ovary syndrome have increased levels of testosterone in the blood. As a result, they have body hair growth that is atypical for a female build (male pattern), excess weight, and increased oiliness in the hair and skin. However, these external signs may not necessarily be direct indicators (unlike a blood test for testosterone) of polycystic disease.

When a woman is 7 days late and the test is negative, the reasons may well be elevated testosterone levels, since its high concentration in the blood disrupts the regularity of menstruation. The most unfavorable consequence of this is the woman’s infertility. However, this problem can be easily solved with the help of oral contraceptives, which doctors often prescribe for women with PCOS. Taking them will not only normalize the cycle, but will also have a positive effect on a woman’s appearance, so you should not be afraid of the diagnosis of PCOS: the main thing is to seek medical help in time.

Low body mass index

A delay in menstruation may not always indicate serious illness; sometimes its cause is quite simple. For example, low body weight. To determine whether a certain weight corresponds to height, you need to calculate BMI. If the resulting figure is in the range of 18-25, the woman’s weight is in ideal proportion to her height. An indicator above 25 is evidence of excess weight, and below 18 is evidence of underweight. Lack of weight can cause a woman to have a 7-day delay in her period. As soon as a woman's weight returns to normal, her cycle becomes regular.

Some other explanations

Also, a delay can occur in a completely healthy woman with normal weight in the absence of pregnancy. It's a matter of external circumstances. As mentioned above, the menstrual cycle is a fragile mechanism; many factors affect its stability. Nervous strain, stress, hard physical work, changing climate zones when traveling, taking antibiotics - all this can cause a delay. It is likely that your period, after a delay of 7 days, caused by external factors, will go normally, as usual.

What are the consequences of cycle jumps?

In general, nothing. Lack of menstruation is not a disease. However, this is an alarm bell for a woman that there is something wrong with her body, and it needs to be examined. Of course, it is better that when a woman is 7 days late, the reasons are not related to illness. But to find out, it is advisable to see a doctor.

He will determine whether pregnancy can be ruled out and whether there are gynecological problems. In some situations, a visit to the doctor is absolutely necessary, since delays can lead to serious consequences. For example, when a woman is 7 days late, brown discharge that suddenly appears indicates possible health problems.

Delayed menstruation is a phenomenon that every woman faces from time to time. Often such a delay is one of the signs of pregnancy. But what to do if the test is negative during a delay, what could cause such a phenomenon, what does it threaten? The reasons for this situation can be very diverse - from emotional to gynecological.

Reasons for delay of menstruation by 6 - 7 days

Menstruation is monthly uterine bleeding.
Menstruation is part of a woman's body cycle that supports the woman's body's ability to become pregnant. The menstrual cycle is maintained by certain hormones that are produced in the brain, in the ovaries of women. In the first fourteen days, the germ cell matures, preparing for fertilization. When this does not happen, the layer of the uterus is rejected and leaves the body in the form of bloody discharge.

A delay is the expected period when your period should come, but this does not happen. When your period is 6 days or more late, many women immediately begin to suspect that they may be pregnant. This especially happens to those who have a regular cycle.

They get used to one routine and are ready to feel certain symptoms by the time their period arrives. In any case, whether a pregnancy is desired or not, everyone has a moment of panic. If there is a delay of 6 days or a delay of 7 days or more, a lot of questions begin to scroll through your head - what to do next, I was taking pills at that time, how did this happen, etc.

So, the first thing a woman thinks about when there is a delay is that she is most likely pregnant. In order to exclude or confirm the fact of pregnancy, you need to take a test, which can be purchased at any pharmacy.

To be sure, you can do several tests every two days. The test can show results after 6, 7 days of missed period, but also after fourteen days. For a more accurate result, you need to take a hCG test or consult a specialist.

Sometimes it happens that menstruation does not occur for other reasons that have nothing to do with the state of pregnancy:

constant stress (chronic);
fatigue;
lack of sleep;
some kind of stressful situation (isolated incident) at work, at home, injury, accident, etc.;
problems in the functioning of the genital organs;
problems with the thyroid gland;
malfunction of the adrenal glands;
change in climatic conditions (moving, traveling, vacation);
beginning of sexual activity;
change in life (change of study, job, divorce, etc.).

Checking will give you the answer

What can be considered a delay?

The duration of a woman's menstrual cycle is approximately 21 - 35 days, depending on individual characteristics. The countdown is from the first day of bleeding to the first day of the next one.

A delay is considered to be the absence of menstrual bleeding at the expected time or prolongation of the cycle. It can occur under the influence of various factors - physiological, age-related, pathological, psychological.

Deviations of 2-5 days are considered normal. The duration is especially unstable in adolescents, in the first 1-1.5 years after the start of menstruation. Over time, the situation usually stabilizes and the schedule returns to normal.

A slowdown in menstrual function occurs in women before menopause. This is due to the extinction of ovarian activity.

If a delay in a negative pregnancy test is observed in a woman of childbearing age, it should not be ignored. Especially if this period exceeds 7 days. Such prolonged failures may indicate problems in the body.

You should also consider the frequency of such failures. If this happens once, you probably don't need to worry. When this situation repeats systematically, you should definitely contact a gynecologist.

A woman’s cycle is sensitive to everything that happens to her. Stress, illness, well-being and emotional state can easily affect this mechanism. Therefore, in order to determine the cause of the delay, many life factors are taken into account.

Delayed menstruation, negative test, pulling in the lower abdomen and discharge, causes

Many women are able to anticipate the onset of menstruation, even without a special calendar. However, there is a time when there is a delay in menstruation with a negative test. In this case, the woman becomes interested in what caused the delay and is she pregnant or not?

Every woman knows the expected date of her next menstruation, unless, of course, she has a pathology accompanied by menstrual irregularities. But even with a normal cycle, the date of ovulation can be very much shifted in time towards the beginning of the cycle, or towards its end. There are rare exceptions when ovulation occurs on the days when menstruation begins - this is influenced by various factors or pathological processes in the woman’s body. If ovulation occurs quite late, then by the first days after the date of the previously expected menstruation, the level of hCG in a woman’s urine can be very low, and a test to determine pregnancy will show a false negative result.

When pregnancy occurs, hCG appears in a woman’s blood almost immediately. After a few days, this hormone can be detected in the urine, but in a relatively small concentration. If we talk about timing, then human chorionic gonadotropin is detected in the blood a week after conception, and in the urine 10 days - two weeks after conception

It is important to keep in mind that the level of hCG after the onset of pregnancy in the earliest stages of pregnancy approximately doubles in 1 day, but after 4-5 weeks from conception this figure drops, as the developing placenta of the embryo takes on the function of producing the necessary hormones

Women's opinion:

Oksana:

When my period was 2 days late, as well as indirect signs of a long-awaited pregnancy (burning and sensitivity of the nipples, drowsiness, nausea), I took a test to determine pregnancy, it turned out to be positive. That same week I went to the gynecologist, she prescribed me the necessary examination and an additional test to determine pregnancy by hCG in the blood. It turned out that I took this test two weeks after the expected date of my next period, and the result turned out to be doubtful, that is, hCG = 117. It turned out that my pregnancy did not develop, but froze in the early stages.

Marina:

When I was pregnant with my daughter, after a missed period, I immediately took a test, the result was positive. Then I went to the gynecologist, he prescribed an hCG blood test. A week later, the gynecologist told me to undergo blood hCG again - the first and second results were low. The doctor suggested that the pregnancy was not developing and told me to retake the test again in a week. Only when the pregnancy was more than 8 weeks old did the hCG increase, and they listened to the heartbeat on an ultrasound and determined that the fetus was developing normally. It’s too early to draw conclusions from the first analysis, especially if you use tests at home, or if your pregnancy is still too short.

Speaking about delayed menstruation, one cannot fail to speak in general about a woman’s menstrual cycle, which normally has a regular schedule, with a frequency of 21 to 31 days. Every woman knows the length of her menstrual cycle, as well as approximately when her next period will begin. During the days of waiting for menstruation, a slight delay of one or two days is often not perceived by a woman as an alarming signal - we know that many factors can influence this, slightly increasing or shortening the menstrual cycle. Every woman also knows how her body behaves throughout the entire menstrual cycle - during ovulation, in the middle of the cycle, she may experience pain in the lower abdomen, mucous discharge from the vagina, and a week before the onset of menstruation - tingling or sore breasts, There may be bloody discharge from the vagina.

If the test result is negative and menstruation does not occur, it is possible that pregnancy has occurred, but you tested too early. If a woman has recently observed deviations from the usual “picture” of the menstrual cycle, which is completed by a delay in menstruation, it is necessary to use tests to determine pregnancy, and if the result is negative, repeat the procedure a few days later using tests from other companies.

Why does the cycle fail for 7 days or more?

Very often, cycle failures occur for simple physiological reasons. This does not mean that the woman is sick. The body simply reacts subtly to what is happening. If the delay is 7 days and the test is negative, the reasons may be the following:

Ovarian dysfunction

This phrase can be heard most often when the cycle is unstable. However, it can hardly be called a diagnosis. Rather, it is a synonym for the concept of “delayed menstruation.” But the reasons for ovarian dysfunction can be endocrine disorders, pathologies of the thyroid gland or adrenal glands. If the cycle is more like a “swing” and constantly “jumps”, the patient will most likely be sent for an ultrasound of various organs and hormone tests.

It often happens that all indicators are normal, but delays still occur. Sometimes the reason lies in genetic predisposition. Medical science is not always able to identify the exact cause of this phenomenon.

Physical or mental overload

One of the most common causes of delay, besides pregnancy, is overexertion. May affect the psychological sphere - exams, overtime work, family discord, difficult everyday situations, chronic stress, lack of sleep. All this cannot pass without a trace, and inevitably affects health.

Physical fatigue also has its effect. Professional athletes, dancers, and bodybuilders often experience interruptions in their menstrual cycle. The same goes for heavy physical labor. Often the situation is so serious that problems with conception may begin. Then the only way out will be to give up difficult activities.

In order for reproductive function to be normal, you should be more attentive to yourself. Give yourself enough time to rest, consult a psychologist. Do not confuse heavy physical activity with aerobics or jogging. Light exercise and an active lifestyle never hurt anyone.

Severe weight fluctuations

Sometimes, in order for your periods to become regular, it is enough to return to a normal weight. Since adipose tissue affects the hormonal sphere, its deficiency or excess can have a negative impact.

Often, girls who adhere to strict diets cannot find the reason for delays or unsuccessful attempts to get pregnant. The body perceives a situation when the weight is less than 43-46 kg as an emergency. With very strong weight loss, periods may stop altogether. A striking example of this is people with anorexia. Therefore, the first thing to do is return to a normal, nutritious diet.

Sometimes disturbances are observed with too much weight. Adipose tissue promotes too much estrogen production, which is not always good.

Exposure to alcohol or chemicals

Alcohol abuse has an extremely negative effect on reproductive function. Even drinking a small amount of alcohol reduces the chance of pregnancy by 20%. What can we say about narcotic substances that cause severe intoxication.

Working with chemicals can have a negative impact. Sometimes you have to change your occupation to have a successful pregnancy.

If your chest hurts, but the test is negative and your period is late

The most common cause of chest pain due to a delay in menstruation is pregnancy. But if the test turns out to be negative, the unpleasant condition could appear for one of the following reasons:

mastopathy;
frequent and prolonged stress;
consequences of recent infectious diseases;
consequences of heavy physical activity;
consequences of breast surgery;
acclimatization period;
diseases of the female genital organs;
starting new oral contraceptives or other hormonal medications;
ovarian dysfunction;
oncology.

IMPORTANT! If a delay in menstruation with chest pain repeats several cycles in a row, you should consult a gynecologist and mammologist as soon as possible.

Gynecological problems causing delays

When there is a delay of 7 days in menstruation, the test is negative, the reasons may lie in gynecological diseases. They often explain problems with conception.

Under no circumstances should such problems be left unattended. Unfortunately, doctors note quite serious diseases among the most common ones.

The appearance of neoplasms

Polyps, fibroids, cysts, cancer tumors, in addition to menstrual irregularities, are characterized by changes in the duration or nature of discharge, discomfort and pain.

Polycystic ovary syndrome

Even more interesting:

Causes of sores on the labia

Yarina with folic acid

Caused by serious hormonal imbalances, resulting in excessive production of estrogens and androgens. Incorrect functioning of the adrenal glands and pancreas occurs. This pathology is also characterized by causeless weight gain, skin rashes, seborrhea, and the appearance of dark hair above the upper lip.

Inflammatory processes

Vaginitis, adnexitis, oophoritis, endometritis require timely treatment. Otherwise, irreversible changes and adhesions may occur, leading to infertility.

Incorrect installation of the intrauterine device

The position must be checked after installation. Otherwise, unpleasant consequences are possible.

Abortion

A delay in menstruation after termination of pregnancy or curettage should be a reason to go to the doctor. Occurs due to strong hormonal fluctuations or mechanical damage.

Frozen or ectopic pregnancy

This situation requires immediate medical attention. When the fetus freezes, there are no periods, but the embryo no longer develops, poisoning the mother’s body. An ectopic pregnancy is doomed and poses a threat regardless of where it is located - in the tube, on the cervix or in the ovaries.

Gynecological diseases not only cause delays in menstruation, but are sometimes life-threatening.

They can cause infertility or miscarriages. In such cases, you should not postpone your visit to the doctor. Hormonal correction or even surgical intervention may be indicated. You should not resort to taking medications without medical advice. This must be preceded by an examination and examination.

Symptoms that will indicate the cause of the delay

When taking a pregnancy test, there is a possibility of obtaining a false negative result.
This is due to the purchase of a low-quality product that is not able to detect the hCG hormone in the urine, the level of which increases significantly during conception. Another reason for obtaining a false negative result is non-compliance with testing rules. Before using the test, you must carefully study the instructions and do everything, strictly following the recommendations. Urine is collected in the morning, when it contains a high level of human chorionic gonadotropin.

A situation where there is a delay and the test is negative is possible when testing is carried out in early pregnancy. You need to repeat the procedure after a week. If conception has occurred, then the answer will be positive.

Excessive fluid intake can affect the results. The concentration of hCG decreases and the test shows incorrect values. In this situation, pregnancy is possible even if a negative result is obtained. Diuretics also have a similar effect. You should stop taking them before the procedure.

Testing readings are also influenced by the characteristics of the menstrual cycle. If a delay in menstruation by 7 days is normal for a woman and is repeated systematically, with a slight deviation from the timing, the test result is negative. In this case, it cannot be ruled out that pregnancy may be the cause of the cycle failure.

If a woman does not have any pain, then if a negative test result is obtained, the test can be repeated again after a short time. If pain appears in the area of the mammary glands and other signs of successful fertilization, it is strongly recommended not to postpone a visit to the doctor. Such symptoms may indicate a threat of spontaneous miscarriage.

A cycle failure is possible if a number of diseases develop. The reasons for the delay may lie in a pathology such as polycystic ovary syndrome. Its appearance is caused by excessive production of estrogen and the male hormone androgen. Due to the absence of ovulation, a delay of more than 10 days is observed and a diagnosis of PCOS is made. It is strictly forbidden to ignore the disease, as this is fraught with serious consequences, including even infertility.

It is possible that cycle disruptions may occur after abortion. As soon as the organs are restored, the discharge will reappear.

The use of hormonal contraceptives can lead to cycle disruption and delayed menstruation. Drugs in this group have an aggressive effect on a woman’s body. Hormonal imbalance occurs.

Antidepressants and diuretics can also affect the timing of the appearance of menstruation. The cycle is most likely to be restored after using these medications.

Another possible reason for the delay is neoplasms in the area of the internal genital organs. Cycle disturbances can cause cancer, fibroids and cysts. Infectious diseases affecting the genitourinary system affect the regularity of menstrual flow.

The woman is sick. The menstrual cycle is associated with several organs. The process involves: the hypothalamic-pituitary system of the brain, ovaries and uterus. Failure of their work leads to the absence of menstruation. The test is not wrong: in this case, the woman is not pregnant. The cause of amenorrhea is problems in the body.

Incorrect use of the test. The test can be wrong in several cases. If a woman is pregnant, drank a lot of water in the evening, took a diuretic medicine, or suffers from urinary tract diseases, in which the excretion of hCG slows down.

The test is lying. The work of any rapid test is based on the determination of the hCG hormone (chorionic gonadotropin). During pregnancy, the level of this hormone in the urine increases, and in less than a month reaches a concentration of 10-25 mIU/ml. This positive result is what the test shows. An expired or poor-quality test, even with a high hCG, will show a negative result.

Let's look at the delay times in more detail.

Failure of menstruation. This is possible due to climate change and accumulated fatigue. The cycle also shifts when taking certain medications, in particular antibiotics. A one day delay is no big deal. Conclusion: you don’t need to do anything on the first day of the delay.
You are pregnant, but the test was taken early. The instructions for the tests say that pregnancy can be tested almost from the first day of the delay. Gynecologists say that this is not so. It happens that the hCG level is low and the test will not detect it even after a week. Sometimes a woman does not know when and on what day conception occurred, so she incorrectly calculates the period.
Menstrual flow is delayed by a polyp. Blockage of the cervix by a polyp leads to atresia, which restricts the flow of menstrual blood. Then, even if your period has begun, the blood will remain inside the uterus for some time. This pathology is called hemotometer. When the uterus fills with blood, it swells, the blood inside stagnates and deteriorates. This condition is a direct threat to life.

Is this condition dangerous and does it always indicate pregnancy? No! The egg may be delayed from leaving the ovary, which is why menstruation is delayed by a week, even if the woman is not pregnant! You need to wait 3-4 days and take a blood test for hCG. Tests will definitely show whether there is a pregnancy. If you do the tests twice, you can take an online hCG test

If the test gives a negative result, but there is still no period, you need to think: most likely there is a pregnancy, but with a negative test, we can say that it is developing incorrectly or has stopped altogether, and therefore the level of gonadotropin is lower than usual. After a week, if menstruation does not begin, you need to see a gynecologist, get tested for hCG and undergo an ultrasound of the uterus.

If there is no delay in menstruation on the 15th day, this is a serious cause for concern. In theory, a new ovulation should occur at this time.

The reason for long delays is not always a normal pregnancy:

Anemia. A low level of hemoglobin leads to the fact that the female body begins to “save” blood, blocking menstruation.
Body weight is significantly below normal. By losing 10-15 kg in a month, you can achieve amenorrhea.
Inflammation of the ovaries. When inflammation occurs, the release of the egg is disrupted. The production of hormones is disrupted, which causes amenorrhea.
Diseases of the uterus. This category includes endometritis, organ atrophy, and endometrial hypoplasia. With these pathologies, the functional layer of the endometrium becomes thinner and does not exfoliate during menstruation. Accordingly, there is no bleeding. With inflammation, the temperature rises, the lower back and stomach in the area of the uterus hurt.
Pituitary tumor. The reason is hormonal changes in the body, leading to a temporary cessation of menstruation - amenorrhea. The tumor disrupts the functioning of the thyroid gland and adrenal glands - it is in these organs that hormones are produced.
Placental insufficiency. Since the embryo does not receive enough nutrients, the pregnancy does not develop well.
Polycystic ovary syndrome. With this disease, cysts form in the ovary. As a result, the secretion of estrogen is disrupted, and the woman’s menstrual cycle is disrupted. Menstrual function may be restored, but then goes astray again.
Serious illnesses and infections. A weakened body may not menstruate in the next menstrual cycle

False pregnancy. In this case, menstruation with a negative test is a pattern. With a false pregnancy, the signs of pregnancy are caused by self-hypnosis. This happens if a woman is afraid of getting pregnant or, on the contrary, really wants to have children.
Stress. In a depressed mood, the production of necessary hormones by the hypothalamic-pituitary system is blocked.

Anembryonic pregnancy. An embryo does not develop inside the fertilized egg.
Ectopic pregnancy. With this pathology, the fetus is fixed and develops not in the uterus, but in other reproductive organs: the ovary, cervix, oviduct, peritoneum.
Frozen pregnancy. There was a fruit, but it died.

The chest hurts and menstruation is delayed. It is impossible to say for sure whether there is a pregnancy with a delay or not based on this sign. Breasts often hurt during PMS, before menstruation and during pregnancy. Swollen, painful breasts are actually associated with tissue swelling caused by hormonal changes. If the mammary glands not only hurt, but have also increased in size, pregnancy is quite likely. All signs of pregnancy can be found HERE.

When menstruation is late, scanty pink or brown discharge occurs. These are symptoms indicating tubal abortion due to ectopic pregnancy. If the embryo reaches a large size, the tube may rupture. This condition is very dangerous. A habitual early miscarriage has the same symptoms. This usually occurs for genetic and immunological reasons. Such spotting with a negative test should not go undiagnosed, regardless of the day of delay.

When delayed, it pulls the lower back and stomach. Pain in the lower abdomen. These are characteristic symptoms of a miscarriage, ectopic or frozen pregnancy. The same pain occurs when a tube or ovary ruptures. Light discharge and pain can also occur with blood retention in the uterus or sexual diseases.

Other reasons

Delays in menstruation can occur not only due to gynecological problems. The reasons may be of a different nature. These can also be diseases of a completely different area - diabetes, gastritis and even ARVI, colds or flu. Here are some of the most common.

Stopping oral contraceptives

While taking hormonal medications, a stable menstrual cycle is established. After stopping their use, the ovaries may not immediately return to their usual work. With prolonged external supply of hormones, their function slows down. Sometimes it takes some time to restore the natural cycle. If the schedule has not returned to normal after three months, you should consult a gynecologist.

Taking other medications

Some drugs, even non-hormonal ones, can affect the functioning of the reproductive system. If you experience persistent delays while taking any medication, tell your doctor. It might make sense to change it.

Emergency contraception

Drugs such as Postinor or Escapela contain large doses of hormones. The body may react to such a shake-up by disrupting the cycle. You can resort to potent drugs very rarely and only in exceptional cases.

Time after childbirth

The first months after the birth of a child there is a natural absence of menstruation. Especially if a woman is actively breastfeeding. However, this method of birth control is not very reliable. The release of a new egg from the ovary can occur at any time. Typically, menstruation returns 2-8 months after childbirth. If they have been absent for more than a year, you should consult a doctor.

Climax

After 45-50 years, women complain of irregular periods. In anticipation of menopause, this is quite normal. A woman’s reproductive function fades and the ovaries gradually slow down their work. After some time, menstruation stops altogether.

If the cycle is disrupted due to the above factors, this is normal. In most cases, a doctor's help is not needed. When illnesses of another kind are to blame, the underlying disease needs to be treated.

What to do

Delaying your critical days by two weeks is a reason to conduct a pregnancy test. If the express strip shows a negative result, it is recommended to repeat the test a few days later to confirm the absence of pregnancy.

If there is a long delay, you should immediately contact a gynecologist. During the appointment, the doctor will perform an external examination of the genitals and take a smear for laboratory testing. As an additional diagnosis, the patient is referred for an ultrasound examination of the ovaries.

If the examination results confirm the presence of a hormonal imbalance, the patient must visit a consultation with an endocrinologist. In the event that the delay of critical days is a side effect of taking heavy medications, the gynecologist selects an alternative drug option.

Delayed menstruation due to physical or mental exhaustion of the body can be treated with walking in the fresh air and good quality sleep. The oxygen-enriched body begins to function properly, helping to restore the menstrual cycle.

Women on a diet need to carefully monitor their diet and make up for the deficiency of useful components with the help of vitamin supplements. To ensure that the diet does not exhaust the body, you need to gradually stop eating harmful foods. First of all, it is advisable to reduce the amount of sugar consumption, and then eliminate baked goods from the diet.

Why you shouldn’t ignore menstrual irregularities

A delay in menstruation in itself does not pose a threat. Isolated cases are quite acceptable and not dangerous. However, if this situation repeats from time to time, measures should be taken. The threat is posed by those diseases that have led to regular failures.

Any gynecological pathology without treatment can lead to infertility in the future. Hormonal imbalances can cause miscarriage, neoplasms, deterioration in well-being and quality of life. In rare cases, prolonged absence of menstruation can be a symptom of brain cancer when there is an impressive increase in prolactin levels.

If a woman complains of menstrual irregularities, the doctor will first prescribe a comprehensive examination:

An ultrasound of the female organs, thyroid, and adrenal glands will be required.
To assess the functioning of the endocrine system, tests should be taken to determine the concentration and balance of hormones in different phases of the cycle.
In some cases, a CT scan of the brain is necessary.
The doctor may recommend that the woman regularly measure her basal body temperature. As a result, it will be possible to see the time of ovulation or determine its absence.

Since there are a huge number of factors for delay, it will be difficult for a woman to figure it out on her own. You should not wait for the situation to worsen, but rather determine the cause of what is happening in time. This will help maintain health and reproductive function.

Often a delay in menstruation is a normal reaction of the body to certain changes in life. But the reason may also lie in health problems and gynecological pathologies. A woman needs to monitor her schedule all the time so that in case of problems she can get help in a timely manner.

Additional information about the reasons for a delay in menstruation with a negative test is in the video:

Every girl who has reached reproductive age has experienced a disruption in her menstrual cycle at least once in her life. It could manifest itself as excessively abundant or scanty discharge, long-term or short-term flow of regula, as well as the early arrival of menstruation. However, the most common occurrence is a delay of more than a week. Such a violation of the regularity of menstruation may indicate many physiological and pathological conditions: pregnancy, diseases of vital systems, hormonal imbalance, emotional stress, infections, etc.

If you are 7 days or more late, it is best to seek advice from a qualified healthcare professional before diagnosing yourself.

Natural reasons for the lack of regulation

Sometimes a delay in menstruation by several days is normal and does not mean that you need to seek help from a specialist. A common cause of this phenomenon is a strong emotional shock (breakup, death of a loved one, a strong quarrel with a friend), a sudden change of environment (a new team, a move, a new place of work) or a woman’s depressive state. At such moments, a woman’s body is subjected to severe stress, as a result of which the level of hormonal elements that are responsible for the timely arrival of menstruation changes, which causes a natural delay in this physiological process.

Signs of pregnancy

Another natural reason that causes a delay in menstruation is pregnancy. This is due to the fact that during fertilization of the egg, the woman’s hormonal background begins to change rapidly, which provokes the complete cessation of menstruation. In addition to a prolonged delay, pregnancy may be indicated by the following symptoms:

Frequent urge to urinate;
Breast augmentation;
Excessive irritability;
Tearfulness;
Pain sensations localized in the mammary glands;
Changes in taste perceptions;
Morning sickness, vomiting;
Unreasonable aggression.

To confirm that conception has occurred, a woman is advised to do a special test or visit a gynecologist.

Also, before going to a specialist, many women often wonder whether there could be pregnancy if the delay is more than 7 days and the test is negative. The doctors answer: “definitely yes.” After all, these tests are aimed at detecting pregnancy for a period of 12-14 days. If conception occurred right before the onset of your period, then a week-long absence of menstrual flow and a negative test result does not mean the absence of pregnancy.

To learn more about your situation, it is better to go to an appointment with a qualified doctor and undergo all the necessary diagnostic tests.

When can a false negative test occur?

Another reason for obtaining a false negative result is non-compliance with testing rules. Before using the test, you must carefully study the instructions and do everything, strictly following the recommendations. Urine is collected in the morning, when it contains a high level of human chorionic gonadotropin.

Excessive fluid intake can affect the results. The concentration of hCG decreases and the test shows incorrect values. In this situation, pregnancy is possible even if a negative result is obtained. Diuretics also have a similar effect. You should stop taking them before the procedure.

Testing readings are also influenced by the characteristics of the menstrual cycle. If a delay in menstruation by 7 days is normal for a woman and is repeated systematically, with a slight deviation from the timing, the test result is negative. In this case, it cannot be ruled out that pregnancy may be the cause of the cycle failure.

Diseases leading to delay

In addition to pregnancy, a delay of a week or more in menstruation may mean that some disease is progressing in the body, disrupting the normal functioning of vital systems. Sometimes even banal and common diseases, such as colds, flu or acute respiratory viral infections, can provoke disruption of the menstrual cycle. Also, the following diseases can be the reasons why menstruation is delayed:

Disturbances in the gastrointestinal tract (ulcers, gastritis, etc.);
Pathologies affecting the thyroid gland;
High blood sugar levels (diabetes mellitus);
Problems with the functioning of the adrenal glands;
Diseases that impair the normal functioning of the kidneys;
Diseases of the respiratory system (bronchitis, pneumonia, influenza);
Disorders in the cardiovascular system (hypertension, atherosclerosis, varicose veins, heart attack);
Advanced stages of obesity;
Anorexia.

Only a qualified doctor can determine the true cause of hormonal imbalance and irregularity of regulation based on the results of a diagnostic examination.

Why no periods? Possible reasons

For most women, menstrual irregularities cause stress, thoughts about a possible pregnancy and the question - what to do next? Even if the delay is two days, a woman with a stable cycle already notices that her period has not come. Even more reasons for worry arise when the test shows a negative result even after 10–15 days of delay. What could this be connected with and what is the reason for the absence of menstruation?

Gynecological reasons

A delay in menstruation for a period of 7 days or more, with a negative pregnancy test, most likely indicates the progression of dangerous diseases in the body that inhibit the functioning of the reproductive system. In addition to general diseases of the whole body, most often a delay of a week or more than a week is provoked by the following gynecological diseases:

Inflammatory diseases of the pelvic organs (adnexitis, salpingitis, oophoritis);
Benign or malignant formations in the reproductive organs (cysts, polyps, fibroids, cancer);
Entry into the body of infectious agents (human papillomavirus or HPV, chlamydia, syphilis, cystitis).

In addition to the main symptom - a long-term absence of regulation, the progression of the above diseases may be accompanied by the appearance of the following signs:

Severe pain in the lower abdomen of various types;
Headaches and dizziness;
Nausea, vomiting;
Drowsiness, lethargy;
Deterioration in general health;
Problems with the urination process.

It is worth noting that the presence of the symptoms described above indicates a dangerous condition that can lead to severe and irreversible consequences (infertility, death, disability). To prevent the development of dangerous complications, consult a doctor immediately if you find at least two signs of a serious illness.

On what day of delay should the test be done?

Any delay in menstruation is always a cause for concern, especially if a woman does not plan to become a mother in the near future. Pregnancy causes this phenomenon only in 65-70% of cases. In other situations, the absence of menstruation may be the result of unsuccessful sexual intercourse, stress or gynecological diseases. The likelihood of disturbances in the functioning of the female body increases if the delay is more than 5-10 days, and nagging pain appears in the lower abdomen, while the pregnancy test shows a negative result.

Delayed menstruation, negative test, pulling in the lower abdomen

The first menstruation in girls appears at the age of 11-13 years. With a hereditary predisposition and early maturation of the reproductive organs, menstruation may appear at 8-9 years of age. The irregularity of the cycle at this age is explained by the activity of hormonal levels, so the absence of menstruation in adolescence is considered normal.

Important! Stabilization of the menstrual cycle in adolescents occurs in approximately 6-8 months. If this does not happen, you should visit a pediatric gynecologist and get tested for hormones and hidden gynecological diseases.

In women of reproductive age who do not have health problems, the cycle ranges from 28 to 35 days. The countdown must begin from the beginning of the first menstruation. Doctors consider 1-2 days an acceptable deviation from this norm. If cycle failure occurs regularly, the woman needs a full examination in a hospital setting. Delaying the time to seek medical help is fraught with infertility and other health problems. Even if a woman has already given birth, you should not take this problem lightly, since a delay in menstruation in combination with painful sensations in the abdomen and lower back can indicate serious pathologies that can lead to the development of cancer.

Physiology of the menstrual cycle

Most often, a delay in menstruation, if it occurs for the first time, means pregnancy, especially if a woman experiences nagging pain in the lower abdomen. A special test for home diagnostics can be done on the first day of the delay, since most of them are highly sensitive to hCG contained in the urine. But in some cases, the test may show a false result at short gestational ages, so to get a more accurate result it should be done after 3-5 days.

To get the correct result from the first day of absence of menstruation using home test strips, you must follow these recommendations:

The test must be done in the morning immediately after waking up, since at this time the concentration of hCG reaches its maximum value;
the container in which urine is collected must be sterile;
Before the procedure, you must wash yourself thoroughly using gentle, fragrance-free products;
to evaluate the result, the strip must be held horizontally with the test zone facing upward;
the used strip should not be placed near sources of high temperatures, as this may distort the result;
The maximum time to evaluate the result is 10 minutes.

How to take a pregnancy test

On the tenth day after the absence of menstruation, any test will show a reliable result, but to be on the safe side, it is better to contact an antenatal clinic.

If the test shows one line, and an ultrasound examination confirms that there is no pregnancy, but nagging pain in the abdomen persists, you need to contact a gynecologist. This should be done after 7-10 days of absence of menstruation. In some cases, the delay can be explained by completely harmless factors, the elimination of which leads to the resumption of menstruation and stabilization of the cycle. Lack of discharge can be caused by:

stress and anxiety;
an abundance in the diet of harmful foods containing large amounts of carcinogens, preservatives, flavor enhancers, flavors and other synthetic additives;
insufficient intake of iron and B vitamins, as well as ascorbic acid from food;
smoking;
drinking large doses of alcohol;
lifting heavy objects;
lack of oxygen (with rare and short walks).

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Stress and anxiety can cause missed periods and pain in the lower abdomen

The lifestyle a woman leads is of great importance. Correcting eating behavior, increasing physical activity, and swimming have a positive effect on the functioning of the reproductive system. Reducing the calorie content of the daily diet due to fatty foods, as well as increasing the proportion of vegetables, herbs, fruits and berries in the daily menu helps control the synthesis of estrogen and progesterone - the main sex hormones that regulate the process of maturation of follicles and the release of eggs into the fallopian tube.

If lifestyle changes do not bring results, a woman needs the help of specialists. Gynecologists strongly recommend contacting an antenatal clinic in the following cases:

the delay lasts more than 10 days;
cycle disturbances are permanent;
I haven’t had my period for several months now, but the possibility of pregnancy has been ruled out by a specialist.

Important! You should consult a doctor immediately if your missed period is accompanied by pain in the lower abdomen, lumbar region or gluteal muscles.

Video - Delayed menstruation, negative test, pulling in the lower abdomen. What could it be?

Almost all causes of pain in the lower abdomen are pathological in nature, so you should not delay a visit to the clinic. For an accurate and correct diagnosis, a woman needs to undergo tests and undergo an examination, which includes a number of procedures performed only in a hospital setting.

Ectopic pregnancy

This is one of the most common reasons causing the absence of menstruation on time. In most cases, a pregnancy test will show a positive result, even if the fertilized egg is stuck in the fallopian tubes, but sometimes this diagnostic method turns out to be inaccurate, and only one strip appears on the surface of the test zone.

Types of ectopic pregnancy

An ectopic pregnancy is a dangerous phenomenon that can lead to rupture of the fallopian tubes at any stage and severe internal bleeding. To prevent the consequences of the pathology from leading to death, it is important to know the warning signs and symptoms. These include:

pulling or stabbing pain in the lower abdomen and lower back;
temperature increase;
nausea, possible single vomiting;
lack of appetite;
cold sweat.

All these symptoms require immediate medical attention. Any delay can cause a pipe rupture and the death of a woman (if she is not provided with the necessary assistance in time).

Endometrial pathologies

Endometritis - inflammation of the uterine mucosa - often causes absence of menstruation, which is replaced by prolonged and heavy bleeding. The same clinical picture is characteristic of endometrial hyperplasia, a pathology that leads to excessive growth of epithelial tissue and thickening of the endometrium. Both pathologies are caused by hormonal disorders, so treatment consists of taking oral contraceptives (Yarina, Zhanin, Diane-35) and normalizing nutrition, which helps maintain the synthesis of female sex hormones. Bleeding is stopped using diagnostic curettage.

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Hyperplasia and normal endometrium

The woman will also need special nutrition with a high iron content, which is actively lost during prolonged bleeding. To prevent anemia, you need to eat more veal, legumes, buckwheat dishes, and apples. Pomegranate and apple juice, as well as rosehip decoction, are useful.

Important! Using hematogen as a source of iron is only permissible if you are of normal weight. This product is contraindicated for women with carbohydrate metabolism disorders and excess body weight.

Sexual infections

The most common female problem is thrush. This disease is caused by yeast fungi of the genus Candida, so the medical name for thrush is candidiasis. The growth of pathogenic flora is facilitated by changes in the acidity of the vaginal environment and the death of lactic acid bacteria, which maintain an optimal balance of microorganisms on the surface of the mucous membranes of the genital organs. A common cause of this disease is poor hygiene and the use of care products that are not suitable for intimate hygiene. Frequent washing and douching also dry out the vaginal mucosa, creating favorable conditions for the growth of fungus.

Any sexually transmitted infections (gonorrhea, chlamydia, trichomoniasis) are accompanied by additional symptoms, so it is quite easy to suspect their presence.

Symptoms of gonorrhea in women

Symptoms of sexually transmitted infections

Sign	Consistency of discharge	Discharge color	Smell	Painful sensations
Candidiasis	Curdled, possible inclusions and lumps	White, cream	May be absent, but more often there is a sharp sour milk smell (reminiscent of spoiled kefir)	Burning and itching in the perineum, vagina or anus, nagging pain in the lower abdomen
Gonorrhea, chlamydia, trichomoniasis	Thick	Green, yellow, brown	Putrid, “fishy”, pronounced	Cravings when emptying the bladder, pulling sensations in the lumbar region
Viral infections	Sticky, slimy	Transparent	Rotten egg smell	Mild itching may occur

Sexual infections must be treated immediately. If the disease becomes chronic, complications cannot be avoided.

Inflammation of the appendages

Inflammation of the appendages in women

At the initial stage, inflammatory processes in the fallopian tubes and appendages (adnexitis) are accompanied by slight nagging pain in the lateral part of the lower abdomen. As the pathology progresses, the intensity of the pain increases and it becomes acute and stabbing in nature. It is difficult to stop such sensations on your own, since this requires eliminating the cause, that is, getting rid of inflammation.

The delay with adnexitis can range from 3 to 7 days. By the end of this period, the pain becomes almost unbearable and reduces motor activity, so the woman requires qualified assistance in a gynecological hospital.

Important! Incorrect or insufficient treatment of adnexitis in 50% of cases ends in infertility and disturbances in the functioning of the reproductive organs.

Appendicitis

Sometimes a slight delay in menstruation and nagging pain may be the first signs of inflammation of the appendix. When the catarrhal stage ends, the pain becomes diffuse and intense. You can distinguish appendicitis by its characteristic position: the woman tries to lie on her left side and pulls her knees towards her stomach.

The absence of menstruation on time can be a completely harmless phenomenon that goes away after all provoking factors are eliminated. But if the delay is accompanied by pain, you need to go to the hospital as soon as possible. Effective treatment of any gynecological diseases is possible only in the initial stages, so any delay in this matter is unacceptable.

07/18/2018 — Medist

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Diagnostics

It is extremely necessary to visit a gynecologist if a woman has a delay of 7 days or more. As a rule, this phenomenon indicates a malfunction of the reproductive system, which could be provoked by various diseases (not only gynecological) or the sudden conception of a child. In both cases, consultation with a qualified medical professional is very important. This will help identify the true cause that caused the hormonal imbalance. After determining it, the doctor will be able to direct all his efforts to eliminate diseases (if any) or normalize the condition of the expectant mother.

First of all, the gynecologist conducts a survey of the patient, during which he draws attention to the symptoms associated with the delay. Then proceeds to the following diagnostic measures:

Conducts a gynecological examination on a special chair;
Takes blood, urine and secretory fluid for analysis;
Feels the reproductive organs;
Performs internal and external ultrasound examinations and colposcopy.

Based on the results obtained, the specialist determines whether menstrual irregularities occurred as a result of fertilization of the egg or the progression of a gynecological disease. If there is no pregnancy or disease of the reproductive organs, the doctor refers the woman to other highly specialized specialists (endocrinologist, proctologist, psychotherapist, gastroenterologist, etc.) for a general diagnostic examination of the body.