Amenorrhea happens when you miss your monthly menstrual periods. Amenorrhea is the absence of menstrual bleeding.
It’s normal not to have a period during pregnancy or after menopause. But if you miss periods at other times, it may be a symptom of an underlying medical issue.
There are two main types of amenorrhea. Those who haven’t begun to menstruate by age 16 may have primary amenorrhea. The term also applies to abnormalities in the reproductive tract that prevent menstrual bleeding.
If you miss your monthly period for 3 straight months after having regular cycles for the previous 9 months, you may have secondary amenorrhea. This type of amenorrhea is more common.
Amenorrhea has many potential causes.
For instance, primary amenorrhea can result from structural problems with your sex organs. It may be a sign of underdeveloped or malfunctioning ovaries.
Issues with your pituitary or thyroid glands can result in secondary amenorrhea. When working properly, these glands produce the hormones needed for menstruation.
Other possible causes of secondary amenorrhea include:
- anorexia nervosa
- extreme weight loss
- exercising too much
- polycystic ovary syndrome (PCOS)
- ovarian cancer
- noncancerous ovarian cysts
- uterine scarring from D and C (dilation and curettage)
- removal of your ovaries or uterus
- issues with your thyroid gland
- hormonal imbalances
- stress or depression
- use of certain drugs, such as some antipsychotics
Natural causes of secondary amenorrhea include:
Starting, stopping, or changing birth control can also affect your menstrual cycle.
See your doctor if you’ve missed three periods in a row or you’re 16 years old and haven’t started menstruating. It may be a sign of an underlying medical condition that requires treatment.
To diagnose the cause of your missed periods, your doctor will first rule out pregnancy and menopause. They’ll likely ask you to describe your symptoms and medical history. It’s important to tell them about:
- any symptoms you’ve experienced
- when your last period was
- how long your periods last
- medications or other drugs you use, including birth control, supplements, and over-the-counter medications
- recent changes to your diet, exercise routine, or weight
- emotional challenges in your life
Your doctor may perform a pelvic exam. They may also order diagnostic tests, such as urine, blood, or imaging tests, to help them make a diagnosis.
Your doctor’s recommended treatment plan for amenorrhea will depend on its underlying cause. If you don’t already have an OB-GYN, you can browse doctors in your area through the Healthline FindCare tool.
If it’s linked to obesity, your doctor will likely recommend a weight loss program. If extreme weight loss or excessive exercising is the reason, they’ll encourage you to gain weight or exercise less.
To help you manage your mental health, your doctor may also prescribe talk therapy, medications, or other treatments.
To treat issues with your thyroid gland, your doctor may prescribe medications like hormone replacements or recommend surgery.
For ovarian cancer, your doctor may recommend a combination of medications, radiation therapy, and chemotherapy.
Medication or surgery to treat other conditions that can cause amenorrhea are also options.
To prevent amenorrhea, aim to:
- maintain a healthy weight
- eat a well-balanced diet
- exercise regularly
- learn to manage stress
Talk to your doctor about any concerns you have about your menstrual cycle.
While missing a period may not seem like a health crisis, it can carry health risks. If it’s linked to hormonal changes, it may affect your bone density, raising your risk for fractures and osteoporosis. It can also make it harder to get pregnant if you’re trying.
In most cases, amenorrhea and its underlying causes are treatable. Ask your doctor for more information about your condition, treatment options, and long-term outlook.