Amenorrhea is the absence of a normal monthly period.
Causes & Risk Factors
Possible causes include:
- 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
- Endocrine problems
- Chronic illness such as Crohn's disease, cystic fibrosis, sickle disease, lupus and diabetes
- Certain medications
- 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