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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.

Causes & Risk Factors

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

Symptoms & Types

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 & Tests

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 & Care

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

  • Changes in your exercise habits
  • Changes in your diet
  • Stress management
  • Hormone therapy or other medications
Jennifer Kurkowski, WHNP