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Causes of delayed menstruation with a negative test, diagnosis and actions

Normally, menstruation should come at regular intervals - this is a relative indicator that the hormonal system of a woman is functioning in the correct mode.

During the year there may be 1 or 2 anovulatory cycles, during which the menstruation may come a little earlier or a little later than the allotted time. A few days of delay usually encourage a woman to take a pregnancy test, but when he gives a negative result, questions arise as to how to interpret it.


The reasons for the delay in menstruation with a negative test

The reasons for the delay in menstruation with a negative test

If there is no line on the test strip that reacts to the presence of the hormone HCG in the blood, then you must visit the ultrasound room and have a blood test for chorionic gonadotropin. Both that, and another will help to establish precisely the reasons of a delay of periods at the negative test. They may be as follows:


Even if there is only one control line on the test strip, and critical days did not start on time, this does not mean that the pregnancy is really absent.

It may well happen that ovulation in this cycle occurred later than usual and the concentration of hCG in the blood at the time of testing was still very low. And if at this time the pregnancy is only 4-5 days, then even the probability that hCG itself has already been developed is minimal.

Its excretion into the blood begins only after implantation of the ovum into the uterine wall (or the fallopian tube, if the pregnancy is ectopic ).

Implantation can occur on days 3 - 12 after fertilization, so if the delay is 3-5 days and the test is negative, pregnancy may well be. But, the situation must be kept under control, this is only a possibility.

Late ovulation

The magnitude of the cycle, basically, is determined not by its second phase, but by the first one. The dominant follicle can ripen in the ovary for 14-15 days (as it should be normal), or it can stretch its growth to 30 days or more.

This period is due to the fact that the dominant is released too late from the antral follicles (from which a mature egg will later emerge). Thus, if ovulation has moved to the end of the cycle, then the delay may be because the time of the second phase of the cycle has not yet passed.

On average, this phase is stable and lasts 10-14 days.

Anovulatory cycle

The menstrual cycle, in which there was no ovulation, is called anovulatory. Normal for a year a woman can have it no more than two times. However, in the event that hormones are disturbed, a whole series of anovulatory cycles may occur.

Maturation of the dominant follicle can interfere with increased testosterone or reduced estradiol, or a combination of these two factors. If there is no ovulation, then the cycle can stretch out indefinitely: there will be a delay in menstruation, a negative test and a white discharge.

Ovarian dysfunction

Often, polycystic ovary syndrome (PCOS) or multifollicular ovaries (MFL) can cause irregular menstruation. These diseases are caused by improper functioning of the endocrine system (most commonly the adrenal glands).

What to do in the absence of menstruation?

delayed menstruation for 5 days test negative

Delay may mean a harmless anovulatory cycle within normal limits, or pregnancy, as well as a serious gynecological disease. Therefore, in such cases, it is necessary to pay close attention to your body and begin an examination as soon as possible, which consists of the following algorithm of actions:

  • You must donate blood for hCG to rule out pregnancy. If the analysis is negative at the time of delivery, then you need to repeat it after a couple of days (normally, the hCG level doubles every two days). If the second indicator remains unchanged, then pregnancy can be excluded.
  • Visit the ultrasound room, where the examination of the uterus and appendages will be carried out by two sensors: abdominal and transvaginal. The doctor examines the ovaries for the presence of cysts, which are most often the cause of delayed menstruation. Particularly relevant is a trip to an ultrasound scan in cases where a woman has not only a negative test, but also lower abdomen and lower back.
  • If the ultrasound showed no pathologies, then it is necessary to pass tests for female hormones. Typically, the time of their collection - 6 - 8 day of the menstrual cycle. But if during the delay of menstruation the chest also hurts, and pregnancy is excluded, then it makes sense to pass the analysis for the hormone prolactin.
  • With the results of the ultrasound and both tests should consult a doctor. Of course, you can come to the gynecologist from the very beginning, but the doctor will still do the above examinations, because without them it is difficult for him to say anything about the patient's state of health, and it is even more difficult to prescribe her treatment. The only exception may be those cases where a sharp severe abdominal pain appears during the delay - this is a signal that a doctor should be consulted immediately.

You need to know what to do in case of delayed menstruation, because inaction can adversely affect the state of the reproductive system of a woman and her health in general.

Possible complications due to delayed menstruation (test negative)

delayed menstrual test negative

In itself, the absence of menstruation will not cause harm to the body. But if time does not pay enough attention to this issue, then you can miss the onset of acute or chronic gynecological diseases, such as:

  • Adnexitis ;
  • Ovarian follicular cyst;
  • Dermoid ovarian cyst;
  • Tumors of the uterus;
  • Cervical tumors;
  • Ectopic pregnancy ;
  • Endometriosis;
  • Diseases of the thyroid gland.

Possible complications due to the delay of menstruation, which were not seen in time, can carry a serious threat to the life of a woman. Therefore, it is not necessary to postpone the examination and visit to the clinic.

It should be remembered that you do not need to panic every time due to the fact that the monthly came later for 1-2 days. Usually it can be considered a cause for concern when the delay in menstruation is from 5 days and the test is negative.


The main measure to prevent menstrual failures is a regular examination of the reproductive organs. It includes a preventive examination of a gynecologist 2 times a year and an ultrasound examination of the uterus and appendages 2 times a year.

Moreover, it is better to visit the ultrasound room before a visit to the doctor, and to have an appointment with the finished result, so that the gynecologist can get the most complete picture of the patient's state of health.

It is important to remember that even if a woman has previously been diagnosed with diseases such as MFN or PCOS, which suggest regular cycle delays and failures, this does not mean that the absence of menstruation should be taken calmly each time.

If the menstruation is no more than 20 days, then an ultrasound scan should be done to exclude a follicular cyst or notice its presence in time and take the necessary measures for its resorption.


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