A missed period or irregular menstrual cycle can sometimes be a symptom of ovarian cancer, but not always. Any change to the normal fluctuation of estrogen levels can cause missed or irregular periods. Besides ovarian cancer, there are many reasons for interruptions of the normal menstrual cycle, including:

• Pregnancy
• Breastfeeding
• Birth control pills or injections
• Extreme weight loss
• Eating disorders, such as anorexia or bulimia
• Extreme or excessive exercise
• Polycystic ovarian syndrome
• Pelvic inflammatory disease
• Uterine fibroids
• Perimenopause (the beginning of menopause)
• Premature ovarian failure
• Endometrial or cervical scarring

According to the American Cancer Society, more than 21,000 women will be diagnosed with ovarian cancer in the U.S. this year. It can be helpful to understand the wide range of symptoms ovarian cancer can cause, as well as when to be concerned about a missed period.

What Are the Symptoms of Ovarian Cancer?

Ovarian cancer shares symptoms with many other conditions that occur in the pelvis and abdomen, including other cancers. The most common symptoms seen in ovarian cancer are:

• Pain the abdomen or pelvic area
• Bloating
• Changes in urination, such as increased frequency or urgency
• Difficulty eating, or feeling full after eating less food than usual

These symptoms could be caused by many other things from time to time, but symptoms of ovarian cancer are typically severe, frequent, and persistent — not mild or occasional. The American Cancer Society recommends seeking medical treatment if these symptoms occur more than 12 times in a month.

Other symptoms of ovarian cancer include:

• Irregular menstrual cycle or missed periods
• Periods that are longer or heavier than usual
• Swelling or a lump in the pelvis
• Indigestion, loss of appetite, or nausea
• Changes in bowel habits, including constipation and diarrhea
• Pain during sex
• Fatigue
• Unexplained weight loss
• Back pain

When Missed Periods May Mean More

For most women, menstrual cycles follow a regular pattern month to month. Women typically have periods every 21 to 35 days, sometimes occurring a few days late or early. Irregular periods (periods that do not follow a predictable schedule) are common in teens and perimenopausal women, two groups who are at the beginning or end of menstruation. A missed period is skipping a cycle of menstruation or going longer than usual between periods.

The sudden onset of missed periods or irregular periods can indicate a change in your health and may be a cause for concern. Missed periods and irregular periods can have many different causes, but if the cause is not clear, it could be a sign of a more serious condition such as ovarian cancer. Understanding your risk can help you take appropriate action.

What Are Ovarian Cancer Causes and Risk Factors?

Missed periods and irregular menstrual cycles do not cause ovarian cancer, but they can indicate an increased risk of developing ovarian cancer. Ovarian cancer, like other cancers, is caused by genetic mutations in cells. Cancer-causing mutations can be inherited from your parents or acquired by normal aging and exposure to carcinogens (potential cancer-causing chemicals). Having specific variations of normal genes or certain environmental exposures are risk factors for developing ovarian cancer.

Inherited risk factors for ovarian cancer that run in families include:

• Hereditary breast and ovarian cancer syndrome
• Mutations in the BRCA1 and BRCA2 genes
• Lynch syndrome, also called hereditary nonpolyposis colorectal cancer
• Peutz-Jeghers syndrome

Environmental risk factors include:

• Having had breast cancer
• Fertility treatments
• Early menstruation or late menopause
• Hormone replacement therapy after menopause
• Smoking

On the other hand, pregnancy, breastfeeding, and hormonal birth control can all reduce the risk of ovarian cancer. Hysterectomy and tubal ligation (having your “tubes tied”) can also reduce the risk.

What Should You Do If You Miss a Period?

Any missed or irregular periods can be indicators of a serious condition, but they can also have benign (noncancerous) causes. It is a good idea to keep track of your cycles, noting the length of your periods and how often they occur, to watch for changes in menstruation.

Because pregnancy is a common cause of missed periods, getting a pregnancy test at home or at a doctor’s office is a good first move to determine what is causing your missed period.

You should also consider seeking medical care for your missed or irregular periods. Getting a medical opinion when symptoms such as menstrual changes first appear can help catch ovarian cancer or other issues at an early stage. If your doctor suspects ovarian cancer is the cause, they may perform screening tests to look for signs and evaluate your risk of developing ovarian cancer.

People who are at a greater risk of ovarian cancer or who have unexplained symptoms should seek a doctor’s medical advice sooner rather than later, especially if the following apply:

• You have not had any lifestyle changes before the missed period.
• You have a personal history of breast cancer (or other cancer).
• You have a family history of breast, colon, or ovarian cancer.
• You have inherited risk factors, such as BRCA1 and BRCA2 mutations.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Do you or someone you care for live with ovarian cancer? Share your experience in the comments below, or start a conversation by posting on MyOvarianCancerTeam.