Skip to main content

Amenorrhea

Medically reviewed by Drugs.com. Last updated on Jun 21, 2023.

What is amenorrhea?

Harvard Health Publishing

Amenorrhea is when a woman of childbearing age fails to menstruate. A woman normally menstruates every 23 to 35 days.

The part of the brain called the hypothalamus regulates the menstrual cycle. The hypothalamus stimulates the pituitary gland. The pituitary gland lies just below the hypothalamus at the base of the brain.

The pituitary gland releases two hormones that regulate the female reproductive cycle. They are luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

LH and FSH influence the production of estrogen and progesterone. These hormones control cyclic changes in the lining of the uterus. This includes menstruation.

In order for a woman to have regular menstrual cycles, her hypothalamus, pituitary gland, ovaries and uterus must be functioning properly. Her cervix and vagina must also have a normal anatomy.

There are two types of amenorrhea:

Primary amenorrhea occurs when a woman has not had her first menstrual period (menarche) by age 15 or 16. This condition is also called delayed menarche. It is most often due to late puberty.

This is fairly common in teenage girls who are very thin or very athletic. These young women are typically underweight. Their bodies have not experienced the normal puberty-related rise in body fat. This rise in body fat triggers the beginning of menstruation.

In other girls, the delay of menstruation may be caused by a genetic disorder. Or it may result from abnormal female reproductive organs.

Secondary amenorrhea occurs when a woman has experienced menstrual periods, but stops menstruating for three or more consecutive months.

Secondary amenorrhea can be caused by:

Female athletes, especially young women, are more likely to have amenorrhea. Exercise itself does not cause amenorrhea. But it is more likely in women who exercise very intensely or who increase the intensity of their exercise rapidly.

Secondary amenorrhea occurs quite often in women who engage in activities associated with lower body weight, such as ballet and gymnastics.

Symptoms of amenorrhea

Amenorrhea is a symptom in itself.

Any associated symptoms depend on the problem that is causing the amenorrhea.

For example, hormone imbalances may cause amenorrhea together with:

Diagnosing amenorrhea

Your doctor will ask you about:

Your doctor will review your medical history. He or she will do a general physical examination, followed by a thorough pelvic exam. Your doctor will check whether you are pregnant.

If your doctor suspects a specific cause, he or she will ask additional questions. For example, if your doctor suspects a hormonal abnormality, he or she may ask about:

If you are an athlete, your doctor will ask about your training program. This is particularly likely if you are underweight or have a low percentage of body fat.

The following tests may be done to identify the underlying cause of your absent periods:

Additional testing may be necessary to pinpoint the cause of your missed periods. Diagnosing amenorrhea can be complicated. There are many potential causes.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

Expected duration of amenorrhea

In many teenagers with primary amenorrhea, puberty is late. But there is no permanent problem.

How long secondary amenorrhea lasts depends on the cause.

For example:

Preventing amenorrhea

In many teenagers with primary amenorrhea, puberty is late. But there is no permanent problem.

How long secondary amenorrhea lasts depends on the cause.

For example:

Treating amenorrhea

Primary amenorrhea caused by late puberty usually does not need to be treated. The condition will go away on its own.

For primary amenorrhea caused by genetic abnormalities, treatment depends on the problem. For example, if the ovaries are not functioning properly, you may be given supplemental ovarian hormones. These will allow development of normal secondary sex characteristics such as breasts and pubic hair.

If amenorrhea is caused by a structural problem, surgery is usually necessary. For example, a vagina that doesn't have an opening may be surgically corrected.

Secondary amenorrhea may be due to menopause or a hysterectomy. In this case, your doctor will prescribe medications. They will help prevent complications of low estrogen levels.

For other forms of secondary amenorrhea, the treatment depends on the cause.

When To Call a Professional

You should contact your doctor if:

If you are sexually active, call your doctor if you miss a period. You will need to have a pregnancy test.

If you are not sexually active, see your doctor if:

Prognosis

In most instances, symptoms and conditions related to amenorrhea are reversible and treatable.

Additional Info

American College of Obstetricians and Gynecologists
http://www.acog.org/

American Society for Reproductive Medicine
http://www.asrm.org/

 


Learn more about Amenorrhea

Treatment options

Care guides

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.