- Hormone imbalance
- Extreme weight loss
- Drugs or certain medications
- Depression or ongoing illness
- Surgery of the uterus
- Removal of the ovaries or uterus
Amenorrhea is the term for a woman missing a monthly menstrual period. Not having a period during pregnancy or after menopause is normal. But missing periods at any other time can be a symptom of a medical issue.
There are two types of amenorrhea. Primary amenorrhea is when a woman doesn't begin her menstrual cycle by age 16. Secondary amenorrhea is when a woman misses her monthly period for three consecutive months after having normal cycles for the previous nine months. Secondary amenorrhea is more common.
Amenorrhea has many potential causes. For primary amenorrhea, a common cause is a structural problem with the sex organs, such as underdeveloped or malfunctioning ovaries. Another common cause can be a problem with the pituitary gland, which produces a hormone necessary for menstruation. Anorexia nervosa, malnutrition, or over-exercising may also cause secondary amenorrhea. Tumors and illnesses like cystic fibrosis are other possible causes.
Pregnancy, breast-feeding, and menopause can cause secondary amenorrhea. Starting, stopping, or changing birth control can also affect menstruation.
In young women, common causes of secondary amenorrhea are over-exercising and extreme physical training. Having a poor diet, or not consuming enough calories, is another cause.
Other causes of secondary amenorrhea are:
Secondary amenorrhea can also be caused by uterine cancer, ovarian tumors, or thyroid or other gland issues.
Missing a period can be a sign of a serious health condition. You should see your doctor if you’ve missed three periods in a row or are 16 years of age and haven’t yet started menstruating.
Your doctor will first need to rule out pregnancy, menopause, or another normal change. He or she will ask you to describe your symptoms and medical history. You will have a pelvic exam. Urine and blood tests are also possible. Be sure to tell your doctor about your regular cycle, including when your last period was and how long they generally last. This will help your doctor make an accurate diagnosis.
Your doctor will also want to know about medication and drug use, including birth control. It is important to discuss changes to your diet or exercise routine, and any emotional challenges in your life.
Treatment depends on the cause. For obesity-related amenorrhea, a weight-loss program is usually suggested. For amenorrhea caused by extreme weight loss or exercising, your doctor will recommend weight gain or less exercise. Emotional care can help with depression, stress, or issues related to extreme exercise or dieting, such as anorexia nervosa. Hormone and gland-related issues can be treated with prescription medication or other specific treatment plans. Surgery may be needed if amenorrhea is caused by structural issues or tumors.
For primary amenorrhea, certain medications, herbs, or alternative therapies can help stimulate menstruation. Your doctor will tell you about appropriate options.
Amenorrhea is usually treatable, depending on the underlying issue. While missing a period may not seem like a health crisis, stopping menstruation carries some health risks. The main risk is loss of bone density. This can lead to fractures. Untreated amenorrhea can lead to osteoporosis later in life. Amenorrhea can also make getting pregnant difficult.
To prevent amenorrhea, attempt to maintain a normal weight, exercise regularly, learn to manage stress, and live a healthy life. Make a habit of getting regular pelvic exams, including a Pap smear. Talk to your doctor about any concerns you have about your menstrual cycle.