A missed period is not always pregnancy — and even when it is, early assessment matters. This page covers the common causes of a missed period in Lagos, what tests and scan you need, and when to come in urgently.
A missed or very late period can have many causes beyond pregnancy. The most important first step is always a pregnancy test — then, if negative, investigating the underlying hormonal or structural cause.
The most common cause — a urine pregnancy test is 99% accurate from the day of a missed period. If positive, an early scan at 6–7 weeks confirms viability and location.
The most common cause of irregular or absent periods after a negative pregnancy test. Often associated with weight change, acne, or facial hair. Requires a pelvic scan and hormonal blood tests.
Extreme psychological stress or rapid weight loss can suppress ovulation — causing a temporary missed period. Usually resolves when the trigger resolves.
Elevated prolactin (from a pituitary adenoma or medication) suppresses ovulation. Causes missed periods + sometimes milky nipple discharge. Requires a prolactin blood test.
Both hypothyroidism and hyperthyroidism disrupt the menstrual cycle — weight gain or loss, fatigue, and missed periods. A TSH test identifies this.
Positive pregnancy test + missed period + one-sided pain = ectopic pregnancy until proven otherwise by scan. This is a same-day scan emergency.
Urine Pregnancy Test — First test — done at home or at Mascot Healthcare. Accurate from day of missed period.
Early Pregnancy Scan (if positive) — Confirms intrauterine location and viability at 6–7 weeks. Excludes ectopic pregnancy.
Hormonal Profile (LH, FSH, Prolactin, TSH) — If pregnancy test is negative — identifies PCOS, thyroid disease, hyperprolactinaemia.
Pelvic Ultrasound (if PCOS suspected) — Confirms polycystic ovaries, endometrial thickness, and rules out structural cause.
AMH (Ovarian Reserve) — If premature ovarian insufficiency is suspected — especially in women under 40 with persistent missed periods.
A urine pregnancy test is the mandatory first step. If positive — book an early scan. If negative — investigate hormonal causes.
Ectopic pregnancy cannot be excluded without an ultrasound. This is a same-day scan emergency.
A hormonal profile (FSH, LH, TSH, prolactin) and pelvic scan identifies the cause in most cases.
Note when the last period was, its character, and any associated symptoms (weight change, discharge, pain, mood changes) — this information helps significantly at the appointment.
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