Delayed Period After Intercourse: Causes and Clinical Perspective

Intercourse itself does not delay menstruation. A late period reflects hormonal, physiological, or pathological factors independent of coital timing.

Common Causes of Delayed Menses

• Pregnancy: Most common cause in reproductive-age women. Test if >7 days late.
• Stress (physical/emotional): HPA axis suppresses GnRH → anovulation/delayed ovulation.
• Weight changes: Rapid loss/gain, low BMI (<18.5), high BMI (>30).
• Exercise: Excessive energy expenditure → hypothalamic amenorrhea.
• Thyroid dysfunction: Hypo- or hyperthyroidism.
• Hyperprolactinemia: Prolactinoma, medications (antipsychotics, metoclopramide).
• PCOS: Chronic anovulation, irregular cycles.
• Perimenopause: Age 40–50s, increasing variability.
• Medications: Hormonal contraception (especially depot, implant, IUD), chemotherapy, antidepressants.
• Illness: Acute or chronic.

Withdrawal Method & Cycle Timing

Withdrawal does not alter cycle length. If period is >1 week late, pregnancy test. If negative and no period × 2 cycles → clinical evaluation.

Contraception Guidance

Withdrawal typical failure rate 22%. Use reliable methods: IUD/implant (>99%), pill/patch/ring (93%), condoms (87% + STI protection). Emergency contraception up to 120h post-exposure (ulipristal > levonorgestrel).