Amenorrhea

Conditions

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Amenorrhea is the absence of a normal monthly period.

Patients can be seen by Texas Children's experts in Adolescent Medicine and Pediatric and Adolescent Gynecology.

Possible causes include:

Pregnancy
Eating disorders and weight changes
Excess exercise (also called athletic amenorrhea)
Polycystic ovary syndrome (PCOS) – the ovaries produce excessive amounts of male hormones, causing irregular periods and other symptoms
Premature ovarian insufficiency (POI) – the ovaries do not make enough estrogen to cause periods
Obesity
Endocrine problems
Chronic illness such as Crohn's disease, cystic fibrosis, sickle disease, lupus and diabetes
Certain medications
Stress
Depression
Congenital defect of the reproductive tract

There are two types of amenorrhea:

Primary amenorrhea is when a girl has never had a period. Most girls start their period by the time they are 16.
Secondary amenorrhea is when a girl who has had periods stops having them for several months. This is the most common type of amenorrhea.

Diagnosis starts with a thorough medical history and physical exam, and possibly a pelvic exam.

Additional testing may include:

Pregnancy test
Blood tests
Progestin challenge test (to check for lack of estrogen)
Imaging tests
Laparoscopy or hysteroscopy – minimally invasive procedures used to view internal organs

Treatment will depend on the cause of the amenorrhea but may include lifestyle changes and medical treatment, including:

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