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OVERVIEW

What is amenorrhea?

Amenorrhea (say: “ay-men-or-ee-uh”) is when you don’t have menstrual periods. There are two types of amenorrhea. Primary amenorrhea is when you haven’t ever had a period and you are 16 years of age or older. Secondary amenorrhea is when you have had normal periods but then you don’t have one for 3 or more months in a row.

CAUSES & RISK FACTORS

What causes amenorrhea?

Primary amenorrhea can be caused by the following:

• Problems with the hypothalamus, which is an area in your brain that interacts with your pituitary gland to regulate your menstrual cycle
• Abnormal chromosomes
• Pituitary disease, which affects the pituitary gland. The pituitary gland is located just under the brain and helps regulate your menstrual cycle.
• An obstruction of the vagina, such as a membrane that is blocking menstrual flow

You may develop secondary amenorrhea due to:

• Pregnancy
• Use of oral or injected contraceptives, such as birth control pills or Depo-Provera
• Stress
• Certain types of medicine, such as antidepressants, chemotherapy medicine and antipsychotics
• Extremely low body weight
• A problem with the thyroid, which is another gland that produces hormones that have an effect on menstruation
• Regular strenuous exercise, like long distance running, especially if body fat is low

TREATMENT

What should I do if I think I have amenorrhea?

You should contact your healthcare provider if you think you have amenorrhea. The following things may help you and your healthcare provider figure out the cause of your amenorrhea:

• If you could be pregnant, take a home pregnancy test.
• If your periods aren’t the same every month, write down when they start and how long they last. Then give this information to your healthcare provider.
• Find out if you have any family members with similar menstrual problems.
• Remember that it is still possible to get pregnant even if you aren’t having regular periods every month.

How is amenorrhea treated?

Treatment depends on what is causing your amenorrhea. It may be as simple as changing your diet and exercise program to help you maintain a healthy weight. You may need medicine. Rarely, surgery is needed.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• What is the likely cause of my amenorrhea?
• I take birth control pills or get injections. If I stop, will my periods return?
• Do I need any tests?
• Will lifestyle changes, such as to my diet or exercise, help?
• Can I still get pregnant?

Sources

Amenorrhea: Evaluation and Treatment by T Master-Hunter, MD, and DL Heiman, MD (04/15/06, http://www.aafp.org/afp/2006/0415/p1374.html)