Keep getting negative pregnancy tests but no period

For couples trying to conceive, the missed period is often the first exciting sign of a positive pregnancy. But what should you think, then, when the pregnancy test is negative?

Causes of a Negative Pregnancy Test

There are a several possible explanations for a negative pregnancy test with a missed period that may occur in the absence of pregnancy.

Anovulation

When you are trying to conceive, it is important to determine whether you are successfully ovulating each month, as ovulatory dysfunction or anovulation may play a role in your missed period and can affect your ability to conceive.

There are many causes for ovulatory dysfunction or anovulation. Just a handful of these causes include:

• Polycystic ovary syndrome (PCOS)
• Thyroid dysfunction
• Being over/underweight
• Stress

Primary Ovarian Insufficiency (POI)

Some women may have a condition known as primary ovarian insufficiency (POI). In POI, the symptoms experienced are similar to those of menopause. As the ovarian follicle count is depleted prematurity, falling estrogen levels lead to hot flashes, vaginal dryness, and an absence of menses as the woman prematurely enters menopause.

Miscalculating Your Period

The average menstrual cycle is 28 days, but far too often we forget to note day 1 of our cycle. Additionally, cycles can sometimes vary in length from month to month. Charting Basal Body Temperature or using Ovulation Prediction Kits (OPKs) can help you get a firm grasp on your menstrual cycle to predict when you are most likely to conceive.

Second, there are a few reasons why your pregnancy test may read negative when you are, in fact, pregnant. Some reasons for this may include:

Home Pregnancy Test with a Low Sensitivity

A home pregnancy test will only detect pregnancy when the level of “pregnancy hormone,” also known as human chorionic gonadotropin (hCG), reaches a certain threshold, and it simply may not be sensitive enough to produce a positive result. Certain brands state that they can detect lower thresholds of hCG; depending on how soon you are taking the pregnancy test after the missed period, it may be worth trying again with a more sensitive brand, ensuring you are using the first morning urine for your test (hCG concentrations are highest in the first morning urine).

Taking a Home Pregnancy Test Too Soon

Another reason for a false negative pregnancy test may simply be that you took the test too early. Pregnancy tests vary in how soon they can detect hCG in your urine. It is possible that although an egg may be fertilized, your body has not started secreting enough hCG to register as positive on a test. Your body needs time for the hormone to rise to a high enough level to be detected. Most brands instruct you to wait until the first day of your missed period to test. Remember, hCG rises differently in each woman. If you suspect you are pregnant, even though the test is negative, the test should be repeated in one week.

If you are trying to conceive and your period is more than one week late with a negative pregnancy test, you should consider consultation with a fertility doctor so that you can be properly evaluated and treated, if necessary.

Dr. Jenna Friedenthal is a Fellow in Reproductive Endocrinology and Infertility at Reproductive Medicine Associates of New York. Dr. Friedenthal completed her undergraduate education at Yale University. She went on to complete her medical degree from the Albert Einstein College of Medicine with Distinction in Research. While in medical school, she received the Senior Research Fellowship award for her research accomplishments in reproductive endocrinology and immunology. Dr. Friedenthal then completed her residency training in Obstetrics and Gynecology at New York University. During her residency training, Dr. Friedenthal received the Mortimer Levitz Best Basic Science Award for her research on pre-implantation genetic testing.

Many people who miss a period will take a test to check for pregnancy. If the pregnancy test is negative, various conditions and factors may be responsible for the lack of menstruation.

The ovaries release an egg during ovulation, approximately every 28 days. If no sperm fertilizes the egg, a person’s period will usually start about 14 days later.

While a missed period is one of the first signs of pregnancy, there are various other reasons why it can occur.

Menstrual irregularities, such as missed or late periods, occur in 14–25% of women of childbearing age. They can result from a range of conditions besides pregnancy, including hormonal imbalances, hormonal birth control, stress, weight loss, trauma, and certain health conditions.

This article discusses what can cause a person to miss their period and how common this is.

Amenorrhea is the absence of menstruation during a person’s reproductive years. Someone may have this condition if they miss their period for 3 months in a row or have not had their first period by the age of 15.

This condition affects 3–4% of women.

Amenorrhea usually happens when the ovaries stop making enough of the hormone estrogen. A range of factors can cause a lack of estrogen.

Several health factors and conditions can cause a person to miss their period.

Short-term causes of missed periods

Irregular periods are common, especially during the first few years of a person’s period. Many circumstances may affect the regularity of the menstrual cycle, including:

Weight changes due to an eating disorder

The rapid gain or loss of a significant amount of weight can lead to hormonal imbalances. Eating disorders such as anorexia nervosa may cause dysfunction in the hypothalamic-pituitary-ovarian axis, which causes changes to hormone levels and may cause periods to be irregular or stop altogether.

Stress

Intense stress can affect the part of the brain that controls the reproductive hormones. This can cause ovulation and periods to stop.

Once the cause of the stress eases or the person learns coping strategies to manage it, their regular cycle may return.

Producing too much prolactin — breastfeeding

Prolactin is a hormone that the body usually makes during breastfeeding. It can affect menstruation and is why most people who breastfeed do not have periods. Periods typically return once a person stops breastfeeding.

A milky discharge from the nipples can signify that the body is making an abnormally high amount of prolactin in people who are not breastfeeding. Doctors can treat excessive prolactin production with medication.

Polycystic ovary syndrome (PCOS)

People with PCOS have a hormonal imbalance that can affect their overall health and appearance, in addition to causing ovarian cysts. This can cause a person to have irregular periods or stop having them entirely.

Up to 10% of women of childbearing age have PCOS and may have enlarged ovaries with clusters of small, benign cysts.

People with PCOS may experience other symptoms as well as missing periods. These include:

• very light, very heavy, or unpredictable bleeding during periods
• skin conditions, such as acne, dark patches, or skin tags
• being overweight or having obesity
• thinning hair
• sleep apnea
• difficulty getting pregnant
• excess hair on the face, back, or thighs
• increases in vaginal discharge
• cramping

Excessive exercise

Amenorrhea is common among athletes who train intensely. Intense exercise causes the body to release stress hormones, which can interfere with the production of reproductive hormones and cause irregular or missed periods.

Exercises that may cause a person to have low body weight, such as long-distance running or intensive ballet, are more likely than others to cause amenorrhea.

Hormonal birth control

Hormonal birth control works by suppressing ovulation, which means a person may experience changes to their period, including having periods that are early, late, or stopped altogether.

Long-term causes of missed periods

Some underlying health conditions may cause a person to stop having periods altogether.

Thyroid problems

The thyroid is a gland that produces hormones to control the body’s metabolism.

Hypothyroidism, or an underactive thyroid, is when the thyroid does not produce enough of these hormones. Hyperthyroidism, or an overactive thyroid, results in the levels of thyroid hormones in the body being too high. Both conditions can affect the frequency of a person’s period.

Doctors can usually diagnose thyroid problems using a simple blood test.

Thyroid disorders can cause a person to miss their period but may also cause other symptoms, including;

• fatigue, or extreme tiredness
• hair loss
• unexplained weight gain or loss
• always feeling cold or being warm all the time

Perimenopause

People enter menopause when they have not had a period for at least 12 months. The average age of people entering menopause in the United States is 52 years old. However, the transition to menopause, known as perimenopause, may cause symptoms that begin at a younger age.

Other symptoms of perimenopause include:

• heavier or lighter periods
• hot flashes
• problems sleeping
• mood swings or irritability
• vaginal dryness
• reduced interest in sex

Diabetes

People with type 2 diabetes are at an increased risk of irregular menstrual periods due to anovulation, which happens when an ovary does not release an egg into the fallopian tube. When this occurs, a person will not get their menstrual period.

Learn more about diabetes and periods here.

Primary Ovarian Insufficiency (POI)

POI is when a person’s ovaries stop working as expected before they reach 40 years old. POI is not the same as early menopause or perimenopause. People with POI may not get their monthly periods or may experience irregular periods.

Cushing’s syndrome

Cushing’s syndrome is a hormonal condition that occurs due to exposure to too much cortisol or medications similar to cortisol. People with Cushing’s syndrome may experience irregular or stopped periods.

Missed period with discharge

Some people may experience vaginal discharge alongside missed periods.

Potential causes of this include:

• hormonal birth control
• PCOS
• delayed ovulation

Missed period with cramps

In some instances, a person may experience abdominal cramps and missing periods.

Potential causes of this include:

• delayed ovulation
• PCOS
• uterine fibroids

Home pregnancy tests can sometimes give a false negative result, indicating that someone is not pregnant when they are. The accuracy of a home pregnancy test varies depending on how and when a person takes it.

Some of the reasons a test may give a false-negative result include:

Taking a test too soon

Home pregnancy tests look for the presence of human chorionic gonadotropin (hCG) in urine. Although some tests can detect hCG from the first day of a missed period, they are generally more accurate later on.

Low hormones

Tests are usually more precise first thing in the morning because the urine is less diluted at this time, making hCG easier to detect.

If a person starts to experience irregular periods, they should contact their doctor immediately. This includes having periods more frequently than every 24 days or less often than every 38 days.

Individuals may miss a period due to several causes, including specific medical conditions, so it is essential to get a proper diagnosis.

To ensure that a home pregnancy test is accurate, people should follow the instructions on the packaging and wait until at least 1 week after the first day of the missed period before taking the test.

Menstrual irregularities such as missed or late periods are common, especially in younger people who are menstruating. If a person misses a period and is not pregnant, it could be due to situational factors such as increased stress, intense exercise, starting new hormonal birth control, or experiencing sudden weight changes.

In some cases, a missed period may be due to a chronic condition such as a thyroid condition, type 2 diabetes, Cushing’s syndrome, or PCOS.

If a person misses more than three periods in a row, they should contact a healthcare professional to make sure their reproductive system is healthy and functioning properly.

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