If you’re female, 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 of your life, it may be a symptom of an underlying medical issue.
There are two main types of amenorrhea. Females who haven’t begun to menstruate by age 16 are diagnosed with primary amenorrhea. The term also applies to abnormalities in the reproductive track that prevent menstrual bleeding.
If you miss your monthly period for three straight months after having regular cycles for the previous nine months, you may have secondary amenorrhea. This type of amenorrhea is more common.
Causes of amenorrhea
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 functioning 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 ovarian syndrome
- uterine cancer or ovarian tumors
- benign ovarian cysts
- uterine scarring from 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 pregnancy, breast-feeding, and menopause. Starting, stopping, or changing birth control can also affect your menstrual cycles.
See your doctor if you’ve missed three periods in a row or you’re 16 years old and haven’t started menstruating yet. 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 that you’ve experienced
- when your last period was and how long your periods last
- any medications or other drugs that you use, including birth control
- any recent changes to your diet, exercise routine, or weight
- any 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.
Your doctor’s recommended treatment plan for amenorrhea will depend on its underlying cause.
If it’s linked to obesity, your doctor will likely recommend a weight-loss program. If it’s caused by extreme weight loss or excessive exercising, they’ll encourage you to gain weight or exercise less. They may also prescribe talk therapy, medications, or other treatments to help you manage depression, stress, or eating disorders.
To treat hormonal imbalances or issues with your thyroid gland, your doctor may prescribe medications, such as hormone replacements, or surgery. To treat ovarian or uterine cancer, they 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, try to maintain a normal weight, eat a well-balanced diet, exercise regularly, and learn to manage stress. Talk to your doctor about any concerns that you have about your menstrual cycle.
Outlook for amenorrhea
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 of fractures and osteoporosis. It can also make it harder to get pregnant.
In most cases, amenorrhea and its underlying causes are treatable. Ask your doctor for more information about your specific condition, treatment options, and long-term outlook.
Medically Reviewed by: Rachel Liberto, RN
Published By: Healthline Networks, Inc.