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Amenorrhea causes and diagnosis

What is amenorrhea? Amenorrhea is called ‘absent period’, ‘menstruation’ or ‘no period’. It is the absence of a monthly period. Women normally do not menstruate before puberty, during pregnancy, and after menopause. If amenorrhea happens at other times, it may be the symptom of a treatable medical condition.

There are two types of amenorrhea: primary amenorrhea and secondary amenorrhea. Primary amenorrhea is the absence of a first period in a young woman by the age of 16. Secondary amenorrhea is when a woman who has had normal menstrual cycles stops getting her monthly period.

What causes amenorrhea?
Amenorrhea can be caused by any number of changes in the organs, glands, and hormones involved in menstruation.

Primary amenorrhea

Possible causes include:

Failure of the ovaries (female sex organs that hold eggs)
Problems in the nervous system or the pituitary gland (a gland in the brain that makes a hormone involved in menstruation)
Poorly formed reproductive organs
In many cases, the cause of primary amenorrhea is not known.

Secondary amenorrhea

Common causes of secondary amenorrhea are:

Pregnancy
Breast feeding
Stopping the use of birth control pills
Menopause
Some birth control methods, such as Depo Provera
Other causes of secondary amenorrhea include:

Stress
Poor nutrition
Depression
Certain drugs
Extreme weight loss
Over-exercising
Ongoing illness
Sudden weight gain or being very overweight (obesity)
Problems with hormone-making glands, including the thyroid (rare)
Tumors on the ovaries (rare)
A woman who has had her uterus or ovaries removed will also stop menstruating.

How can I know if I have amenorrhea?

If you miss your period, contact your health care provider. First, he or she will want to know if your period has stopped because of a normal condition such as pregnancy or menopause. (Most women go through menopause in their early 50s.) You will be given a physical and pelvic exam, and will be asked about your medical history. You will also be asked to describe your symptoms. A sample of blood and urine may be taken for testing.

In some cases, finding the cause of amenorrhea can be difficult. You can help your health care provider by keeping a record of changes in your menstrual cycle. Note how long your periods last and when you had your last period. Also, report any drugs you are taking and changes in your diet and/or exercise program. You should also report any emotional problems you are having, including stress.

How is amenorrhea treated?

Amenorrhea due to normal causes, such as pregnancy, does not need to be treated. In other cases, treatments will depend on the cause. Treatments include:

Dieting and exercising to lose weight (for amenorrhea caused by obesity)
Dieting to gain weight (for amenorrhea caused by extreme weight loss)
Learning ways to manage stress
Changing exercise levels
Hormones, ordered by a health care provider
Surgery (rarely)
Amenorrhea may be the symptom of anorexia nervosa, a serious eating disorder. If you or someone you care about has this condition, get help right away

When should I see my health care provider?

See your health care provider if you:

Miss a period
Have trouble with your balance, coordination, or vision
Begin producing breast milk, although you have not given birth
Have excessive body hair growth
Are over age 16 haven’t had your first period

How can I prevent secondary amenorrhea?

The best way to prevent secondary amenorrhea is to maintain a healthy lifestyle. Stay at a healthy weight, learn ways to cope with stress and emotional problems, and get a pelvic exam and Pap test once a year.



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