Know the basics
What is amenorrhea?
Amenorrhea is the absence of menstruation. Menstruation is a woman’s monthly period. Each woman’s menstruation may vary due to differences in hormones and how their genital or pelvic organs are formed. There are 2 types of amenorrhea:
- Primary amenorrhea: occurs when a girl has not received her menstrual period but had gone through other changes of puberty and is older than 15 years.
- Secondary amenorrhea means no periods for more than three cycles or 6 months.
After proper evaluation from your doctor, a diagnosis can be determined.
How common is amenorrhea?
Amenorrhea is common condition that usually indicates there is an imbalance in bodily function. Amenorrhea most commonly affects women who are pregnant. During pregnancy the hormone are regulated to stop ovulation and menstruation. Primary amenorrhea affects girls who are older than 15 years old while secondary amenorrhea affects women at an older age.
Know the symptoms
What are the symptoms of amenorrhea?
The primary sign of amenorrhea is abnormal absence of a menstrual period. Some signs and symptoms that may accompany amenorrhea include:
- Milky nipple discharge
- Hair loss
- Vision changes
- Excess facial hair
- Pelvic pain
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- You’ve missed at least three menstrual periods in a row,
- You have not received a menstrual period by age 15 years old.
If you have any signs or symptoms listed above or have any questions, please consult with your doctor.
Know the causes
What causes amenorrhea?
Causes of amenorrhea may be due to the following reasons:
- Birth defects: Underdeveloped reproductive organs may include narrowing or blockage of the neck of the uterus (cervix), missing uterus or vagina, a vagina that divides into 2 sections (vaginal septum).
- Natural hormone changes: amenorrhea will occur during pregnancy, breast-feeding and menopause.
- Drug-induced: Drugs can cause amenorrhea. These drugs include contraceptives, antipsychotics, antidepressants, blood pressure medications, cancer chemotherapy drugs and some allergy medications.
- Low body weight: Body weight that is 10% lower than normal can cause hormonal imbalances that can stop ovulation. Some condition such as bulimia and anorexia can cause this to happen.
- Stress: Stress can alter the function of the hypothalamus, which is the area that controls the menstrual cycle. This is usually temporary and menstrual cycle will resume when the stress decreases.
- Excessive exercise: Physical activity, such as ballet, that requires intense training may disrupts the menstrual cycle.
- Disorders that cause a hormonal imbalance: This may include conditions such as polycystic ovary syndrome, thyroid disorder, pituitary tumor or premature menopause.
Know the risk factors
What increases my risk for amenorrhea?
There are many risk factors for amenorrhea, such as:
- Family history: If there are women in your family with amenorrhea, you might have the same problem.
- Eating disorder: If you have problems such as anorexia or bulimia, you have higher risk of amenorrhea.
- Athletic training: High intensity training can lead to a higher risk of amenorrhea.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is amenorrhea diagnosed?
Your doctor may perform the following tests to determine diagnosis:
- Asking about medical history, physical examination, and laboratory tests.
- The health care provider may also use X-rays or ultrasonography to determine the cause of the amenorrhea.
- Magnetic resonance imaging (MRI) of the brain may be done when abnormalities of the pituitary gland or hypothalamus are suspected.
Computed tomography (CT) of the abdomen (belly) and pelvis is another possible test if abnormalities of the uterus or ovaries are suspected.
How is amenorrhea treated?
Treatment depends on the cause of the missing period. Primary amenorrhea that is caused by birth defects may require hormone medications, surgery, or both.
In some cases, a drug called medroxyprogesterone or estrogen replacement will help periods start in most women.
Other drugs may be used for women with adult-onset congenital adrenal hyperplasia, premature ovarian failure, and hypothyroidism.
Women with anatomic abnormalities may need surgery.
In women with amenorrhea due to polycystic ovarian syndrome (PCOS), treatment may include weight loss by dieting and exercise. Medicines such as metformin can also be given.
Women with hereditary causes of amenorrhea can see a genetics specialist for additional evaluation and treatment.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage amenorrhea?
The following lifestyles and home remedies might help you cope with amenorrhea:
- See your health care provider and specialists regularly.
- Take your medicine or change the dosage only after proper instructions from your doctor.
- Don’t use any over-the-counter drugs, herbal products, or other drugs without talking to your doctor or pharmacist first.
- Keep to a healthy weight and a balance diet.
- Don’t over exercise or continue a strenuous workout routine.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Ferri, Fred. Ferri’s Netter Patient Advisor. Philadelphia, PA: Saunders / Elsevier, 2012. Downloaded version.
Porter, R. S., Kaplan, J. L., Homeier, B. P., & Albert, R. K. (2009). The Merck manual home health handbook. Whitehouse Station, NJ, Merck Research Laboratories. Page 1524
Assessed July 11, 2016.
Review Date: May 30, 2016 | Last Modified: January 4, 2017