Late period, negative pregnancy test: What’s happening in your body
Shannon Donohue
Dr. Genevieve Steele
Follows NC° Editorial Policy
At Natural Cycles, our mission is to empower you with the knowledge you need to take charge of your health. At Cycle Matters, we create fact-checked, expert-written content that tackles these topics in a compassionate and accessible way. Read more...
Key takeaways
- A late or missed period can be caused by a variety of hormonal and lifestyle factors
- While it doesn’t always indicate pregnancy, a missed period is worth speaking to your healthcare provider about
- If you got a negative result on a pregnancy test after your period is late, it’s possible (but unlikely) that you are pregnant — more likely, it’s a signal from your body that something is out of balance hormonally and/or in your lifestyle
Missing a period can be a signal from your body that something has changed. Whether you’re trying for a baby or trying to prevent pregnancy, a missing period is a common sign of pregnancy, but many other conditions and circumstances can also cause menstrual irregularities. In this article, we’ll go over what defines a “late” or missing period, along with the most common causes. We’ll also walk you through what to do if you have a late period and a negative pregnancy test, and answer the question of “can you be pregnant and test negative”? (Spoiler alert: yes, but you may have skipped your period for another reason, too).
How late can a period be before pregnancy becomes likely?
If a week or more has passed since your expected period due date, you’re in your reproductive years (between puberty and menopause), and you’ve been having sex, there’s a chance you may be pregnant [1].
There’s more nuance to this though — remember that pregnancy can only happen if ovulation, fertilization, and implantation have occurred. In other words, your ovary needs to release an egg cell, sperm needs to meet with the egg cell to fertilize it, and the fertilized cell then needs to attach to your uterine lining. It’s only once all of these processes have happened that you can become pregnant [2].
Considering that all of that needs to go off without a hitch for pregnancy to happen, it’s also very possible that you missed your period for a variety of other reasons, especially if you got a negative pregnancy test result.
Dr. Karen Tang, member of the Natural Cycles Medical Advisory Board, shared more about how ovulation affects our cycles and may cause a skipped period. “Ovulation, or releasing an egg from the ovary, is a trigger that regulates cycles, and if you don’t ovulate, you’ll skip a period or have a delayed period. Lots of things can throw off ovulation and hormones, including physical or emotional stress, illness, certain medications, medical conditions like thyroid problems, PCOS, or changes in weight, exercise, or nutritional status.”
How do you know if your period is late?
To make matters a bit more complicated, it can be difficult to tell if your period is late (and if you should test for pregnancy) if you’re not sure when to expect it. Logging the dates of your period over time in tools like the Natural Cycles app can help predict your cycle length to make informed decisions about your health and notice patterns over time.
But in general, periods are considered regular if they fall anywhere between 21 to 35 days. If it’s been more than 35 days since your last period (or about one week after it’s due), it may be late or you may have skipped it [3].
“The normal range of cycle length (days between the 1st day or full period flow to the 1st day of full flow the next period) is 21-35 days,” said Dr. Tang. “Some variation from month to month is normal. But if you’re having periods 2 weeks apart or more than 5 weeks apart, skipping multiple months, or having wildly unpredictable cycles, that is something to see your doctor for.”
Causes of a negative pregnancy test with no period
Seeing your doctor can be helpful in determining the most likely underlying cause of a late period and a negative pregnancy test, but below we’ll list some of the most likely causes for a missed period aside from pregnancy.
We’ll start with common hormonal reasons like birth control, hormone levels, breastfeeding, and menopause, then get into circumstances that may be causing a missed period. We’ll finish it off with some rare, but possible, medical conditions that may cause missed periods.
Hormonal birth control
Hormonal birth control methods, like the pill and the implant, work to prevent pregnancy by thinning the uterine lining and preventing ovulation (the release of an egg cell), among other processes. Since a period includes the shedding of the uterine lining and an unfertilized egg cell, it’s common for periods to be lighter or to skip them altogether while on hormonal birth control [4, 5].
For the pill particularly, you have the option to skip the placebo week and keep taking the birth control pills in order to skip a period. It’s highly unlikely that you’re pregnant if you’re on hormonal birth control and skip a period, but it’s always a good idea to reach out to your healthcare provider with any questions or concerns to be sure [6].
Abnormal hormone levels
Another potential cause of a missed period is abnormal hormone levels in the body. The menstrual cycle is regulated by a complex hormonal system, consisting of many signals and changes throughout the cycle to first prepare the body for pregnancy, and if pregnancy doesn’t happen, to menstruate. The glands that contribute to and regulate this system include the hypothalamus, the pituitary gland, and the ovaries. When this system doesn’t function as expected, it can cause abnormal hormone levels and potentially, a missed period [7].
Breastfeeding
On the other hand, it is normal to skip a period while breastfeeding [7]. After you give birth, it can be difficult to predict exactly when your periods will start again, especially if you’re breastfeeding. If you’re only breastfeeding without any bottles, your periods may not start again until you stop, or reduce, breastfeeding, but the timeline can look a bit different for everyone [8].
Menopause
It’s also possible that you’re in the perimenopause phase of life, approaching menopause (the time when you haven’t had a period for a full year and you can no longer get pregnant). If you’re between the ages of 45 and 55 and you’re noticing other perimenopause symptoms such as hot flashes, night sweats, incontinence, or weight gain, this may explain the missed or late period and negative pregnancy test [9].
Sleep quality
Aside from hormonal changes, lifestyle circumstances like your sleep hygiene and fatigue levels can also affect your cycle. One study found that shorter average sleep duration, poor sleep quality, and higher fatigue levels were associated with menstrual irregularity. While more research is needed in this area, improving sleep can contribute to an overall healthier lifestyle [10].
Stress
Stress can also cause a missed period — this includes emotional/mental stress as well as physical stress, such as excessive exercise or not eating enough. Emotional stress can look like anxiety or depression, and physical stress is common in female athletes or those who have recently lost weight. Stress on the body can cause the hypothalamus to malfunction, which can cause menstrual irregularities [7].
Medications
Some prescription medications, including anti-psychotics, antidepressants, and high blood pressure medication, may cause missed periods as a side effect. Medical treatments like chemotherapy and radiotherapy can also cause hormonal imbalances. Some allergy medications may also affect your hormone levels. Speak to your doctor about side effects of medications they prescribe so that you know what to expect [11].
Polycystic ovary syndrome
In terms of conditions that may cause missed periods and negative pregnancy tests, polycystic ovarian syndrome (PCOS) is a common hormonal disorder that may lead to late or skipped periods. One in 10 women of reproductive age experience PCOS, and it’s caused by a hormonal imbalance. This imbalance can cause the egg cell to not develop as it should, or it may not be released correctly during ovulation. This can cause anovulatory cycles (when you don’t ovulate), which in turn can lead to late or missed periods [12].
Other medical conditions
A few other medical conditions to consider that may cause missed periods include:
- Chronic disorders involving the lungs, digestive system, blood, kidneys, or liver
- Some autoimmune disorders
- Cancer
- HIV
- Head injuries
- Cushing syndrome
- Overgrowth of placenta tissue
- Scarring of the uterus
- Polyps
- Fibroids [7].
What should you do if your period is late?
If your period is late and you got a negative pregnancy test result, you may have nothing to worry about, especially if you’re on hormonal birth control, breastfeeding, in perimenopause, or on a certain medication that may cause skipped periods as a side effect.
If you think it’s a lifestyle factor like sleep or stress, see if there’s anything you can do to improve these circumstances and help your body relax (we know this is easier said than done!) It can be helpful to share your problems with a friend or family member, and you can always reach out to your doctor or a mental health support provider for assistance, if you prefer to speak to someone impartial.
If you’re still thinking you may be pregnant, take another test a few days after your missed period. Dr. Natalie Crawford, also on the Natural Cycles Medical Advisory Board, told us the best time to take a pregnancy test for the most accurate results. “Home pregnancy tests are extremely accurate with a 99% accuracy rate if taken at the correct time. Since hCG levels rise as the pregnancy is implanting, taking a pregnancy test too early can result in a negative result. This is why we recommend you take a test once you have missed your expected period.”
When to speak to a doctor
It’s worth contacting your healthcare provider to assess your condition if you think you may have abnormal hormone levels, or any of the medical conditions listed above that may contribute to missed periods. They can get to the bottom of the cause and suggest treatment options to get your cycle back on track. Doctors also recommend reaching out if you’ve missed three periods in a row, or if you have fewer than nine periods in one year [7].
Get to know your body better with Natural Cycles
So to wrap it all up, yes, you can be pregnant and test negative, and if you’ve missed a period and are sexually active, you may be pregnant. But that’s not the only circumstance that can cause a missed period. Hormonal factors, lifestyle factors, and certain medications all play a part in the regularity of your cycle. Tracking the timing of your cycle and your symptoms with the Natural Cycles app can help you get the information you need to prevent pregnancy, plan a pregnancy, and more. Plus, you’ll learn loads about the regularity of your cycle along the way! See how Natural Cycles can support your fertility journey today.
Did you enjoy reading this article?
