Menarche marks a major milestone in growing up. It is the first menstrual period and signals that the body’s reproductive system has matured enough to begin regular hormonal cycles. Most girls get their first period somewhere between 10 and 16 years of age. But sometimes menstruation starts later than expected. When that first period has not occurred by about age 15, clinicians label it delayed menarche, and while it may simply be a late start, it can also signal health issues that deserve attention.[1]
Delayed menarche refers to the absence of the first menstrual period by around age 15, despite other signs of puberty, and is a form of primary amenorrhea.
Let’s break down what delayed menarche really is, why it happens, and what it might mean for health later in life, in everyday language.
Simply put, delayed menarche means a girl has not begun menstruating by the age of 15, even if her body has shown other signs of puberty like breast growth or pubic hair. It is not uncommon for girls to experience natural variation in puberty timing. Some simply develop earlier or later than their peers.[1]
Not necessarily.
Some girls naturally mature later than their peers, especially if there is a family history of late puberty. This pattern, known as constitutional delay of growth and puberty, is considered a normal variant and usually resolves without treatment.[1]
However, when delayed menarche is accompanied by poor growth, absent secondary sexual characteristics, chronic illness, or hormonal abnormalities, further evaluation becomes essential.
Delayed menstruation can happen for many reasons. Some are completely harmless, while others signal that the body is under stress or not communicating hormonally the way it should.
Some girls naturally mature a little slower. If a mother or older sister began their period later, it might simply run in the family.
Your body needs energy to support puberty. If a girl has very low body fat because of strict dieting, intense athletic training, or not getting enough calories, her brain may delay reproductive hormones, slowing down the onset of periods.
Sometimes the issue lies in the hormones that control puberty. For example, if the brain does not signal the ovaries correctly, or if the ovaries are not responding normally, menstruation can be delayed. These cases require medical evaluation.[2]
Long term health problems like gastrointestinal disorders, autoimmune disease, or chronic kidney disease can affect the body’s growth and hormonal balance, delaying puberty.[3]
Research suggests that lifestyle, chemical exposures, and patterns of physical activity can influence puberty timing in subtle ways, though scientists continue to study exactly how and why this happens.[2]
If a girl has not started her period by age 15, a doctor will usually start with a basic physical examination and health history, including growth charts and developmental milestones. Tests may include:
Hormone levels to see if the brain and ovaries are signaling properly
Bone age X ray to see if the skeleton matches the child’s chronological age
Pelvic ultrasound to check reproductive organs, if needed
These evaluations help determine whether the delay is a normal variation or something that needs treatment.[1]
A late start to periods is not just about timelines. It can have real implications for long term health.
Estrogen, the hormone that rises with menstruation, is important for building strong bones during the teenage years. Girls with delayed menarche may not build bone as efficiently, which can increase the risk of weaker bones later in life.
In most cases, delayed menarche itself does not mean a woman will not be able to have children. But when the delay is due to hormonal or structural issues, fertility can be affected and may require medical support.
Adolescence is a sensitive time. Being noticeably later than peers can create stress or self consciousness. Supportive guidance and open communication help ensure young people feel confident and understand what is happening with their bodies.
Conversations around delayed menarche and menstrual health are slowly becoming more open, especially within medical and patient communities. Experts emphasize that breaking the silence around puberty and reproductive health can have a lasting positive impact on how young girls perceive their bodies and seek care when needed.
As a fertility specialist, it genuinely makes me happy to see conversations like this becoming more open and less taboo. Menstrual health is such a basic part of growing up, yet so many young girls still move through it silently, confused or embarrassed. The more we talk about it, the more we normalise these experiences, which can change a girl’s entire relationship with her body. Truly glad to see this topic getting the attention it deserves.
Dr. Pallavi Kalghatgi, MBBS, DGO, DNB (ObGyn), and Fellowship in Reproductive Medicine, IVF consultant
If a teenager has not started her period by age 15, or if she had a period but then stops menstruating for many months, it is a good idea to talk with a healthcare provider. Early evaluation ensures any underlying causes are found and treated in time.
A discussion thread on MedBound Hub highlights that delayed menarche often raises unnecessary fear about infertility and the need for awareness among young girls.
Puberty and menarche are significant milestones. Lack of normal development can be psychologically distressing. So the mothers of young girls, as well as girls who are approaching puberty, should be educated about it. The cause should be timely diagnosed, as treatment can be given accordingly to improve the future life of the girl child.
Dr. Ishita Asiwal, GMC (NHS-UK), MRCOG
Creating awareness among young minds is essential to normalise periods and encourage them to embrace it without any embarrassment.
Swetha KVS, PharmD, Clinical Research Coordinator
Delayed menarche is not always a sign of a serious problem. Sometimes it is simply a later part of a normal growth pattern. However, because it can be linked with important health considerations, understanding what is behind it and knowing when to seek guidance empowers families and young women to take charge of their health.
Is delayed menarche the same as delayed puberty?
Delayed menarche refers specifically to the absence of the first period, while delayed puberty includes delayed development of secondary sexual characteristics. The two often overlap but are not always the same.
Can delayed menarche affect fertility later in life?
In most cases, no. Fertility is usually normal unless the delay is caused by an underlying hormonal or structural condition.
When should parents worry about late periods in adolescence?
Medical advice should be sought if menstruation has not started by age 15 or if there are no signs of puberty by age 13.
Mohanraj, S., and H. K. Prasad. “Delayed Puberty.” Indian Journal of Pediatrics 90, no. 6 (June 2023): 590–597. https://doi.org/10.1007/s12098-023-04577-x (accessed December 15, 2025). https://pubmed.ncbi.nlm.nih.gov/37127825/
Lacroix, A. E., H. Gondal, K. R. Shumway, et al. “Physiology, Menarche.” In StatPearls [Internet], updated March 11, 2023. Treasure Island (FL): StatPearls Publishing; January 2025–. https://www.ncbi.nlm.nih.gov/books/NBK470216/ (accessed December 15, 2025).
“Delayed Menarche.” MedGen, National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/medgen/46203 (accessed December 15, 2025).
