Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.

Q. I am age 34 and have had three children. Right now I'm single and not sexually active. My periods are usually 5 or 6 weeks apart. This time is has been 8 weeks and still waiting. I am going through a lot of stress. What could be possibly happening?

A. Stress can definitely cause irregular periods and actually is a common cause of missed periods. Of course, the first thing to rule out is pregnancy but as long as you are not sexually active, the next most common cause of delayed periods is fluctuations of your hormone levels. This can be caused by stress, rapid changes in weight (especially weight loss), or excessive exercise. Of course, the missed period itself causes more anxiety and delays your menses even further.

It sounds as if your plate is quite full as a single mother of three children and that menstrual irregularity may be more common in your future. The best solution is finding ways to de-stress, such as exercise, meditation, even the occasional hot bath. However, in the meantime, you may need a booster of hormones. Your doctor can prescribe a week of progesterone, and after stopping this medicine, you will have a period. Alternatively, beginning low-dose birth control pills will assure that you have a steady amount of estrogen in your system so that you have a regular period.

Try not to be too hard on yourself and carve out even a few minutes every day just for you. You and all the people who depend on you will be happier and healthier for it.



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