A woman who has amenorrhea has either never had a menstrual period or has stopped having periods.
There are two categories of amenorrhea: Primary amenorrhea is not having had a period by age 16.Secondary amenorrhea is the absence of periods in a woman who previously had regular menstrual cycles.
To have a period, a woman must have a normal, healthy: uterus, cervix (opening to the uterus), vagina, and ovariespituitary gland, a structure in the brain that produces hormones to stimulate the ovaries to produce sex hormoneshypothalamus, a structure within the skull that controls much of the body's hormone production
An abnormality in any of these may keep a woman from having a period.
Amenorrhea is not a disease. It is a symptom of any of a variety of health conditions.
Because it is often caused by a hormone imbalance, other symptoms may also be present, including: weight gainexcess body and facial hairbreast milk secretionchanges in sex driveacne
Primary amenorrhea is usually due to late puberty rather than to any permanent condition. The reason for this delay is generally not known, though it may be a family trait.
Other possible causes are: a genetic disorder, such as Turner's syndromea hormonal problem, such as an improperly functioning thyroid gland
Pregnancy is the most common reason for secondary amenorrhea. A woman's periods may also stop temporarily due to: breastfeedingbirth control pillsthe birth control shot, such as medroxyprogesterone acetatelevonorgestrel implants
A woman's periods may not start up again for a while after she stops using birth control pills, shots or implants. Usually, periods will start again within 3 to 6 months.
Secondary amenorrhea may also be linked to: depressionemotional stresspoor nutritiondrugs, such as tranquilizers or antidepressantsrapid weight loss or gainchronic systemic illnesses, such as kidney failure or cancertoo much exerciserecent surgerya hormonal imbalance, such as polycystic ovary syndrome (PCOS)
By maintaining a healthy lifestyle, a woman may be able to avoid secondary amenorrhea. A woman should: avoid smoking and alcohol or substance abusemaintain a healthy weight by adjusting her diettry to balance work and recreationlower her stress levels
If this seems too difficult, she should ask for guidance from friends, family, or healthcare professionals.
Amenorrhea is generally not life threatening, but it may be linked to certain health conditions. When a woman reports it, her healthcare professional will take a medical history and do a physical exam. He or she may also recommend: a pregnancy testhormone testsspecial blood tests if a girl has not developed breasts or pubic hair by age 14blood tests if a girl or woman has breast discharge, headaches, vision changes, too much body hair or weight
These tests measure: HCG hormone, which is a marker for pregnancyfollicle-stimulating hormone (FSH), which is important in regulating the menstrual cycleestradiol level, the main estrogen in the bodythyroid functionprolactin, a hormone associated with certain tumors or thyroid gland abnormalitieschromosome abnormalities that may prevent menstruation
Some tumors of the pituitary gland may cause elevated prolactin levels. Special X-rays of the head can show tumors in the pituitary.
Long-term amenorrhea and estrogen-deficiency may raise a woman's risk of excess bone loss and osteoporosis. This makes bones more likely to break. A woman who wishes to become pregnant may be resistant to drugs that help induce ovulation.
If PCOS is causing the amenorrhea, long-term effects include: obesityexcess face and body hairacneinfertilityovarian cysts, or fluid-filled sacsa higher risk of uterine cancer
There are no risks to others.
If amenorrhea has lasted less than 6 months, a woman may not need treatment unless a related problem is suspected, or abnormalities are seen: in her hormone levelson X-ray or ultrasound
Depending on the cause of amenorrhea, treatment varies. Diet and exercise generally correct abnormal periods due to obesity. Stress management and not exercising excessively also helps.
Because ovaries are not producing eggs or certain hormones, a woman may be given: birth control pillshormone therapy (HT) if she has reached menopauseshort-term oral progesterone pills or ovulation-inducing agents, such as clomiphene, for infertility
Birth control pills and HRT drugs contain estrogen and progesterone or sometimes progesterone alone. The hormones may be used to: induce a periodprevent bone loss
Surgery may be required for: tumorsovarian cystsdefects in the uterus or vagina
Rarely, surgery is done when chromosome abnormalities are found.
Hormones may cause minor side effects such as: breast tendernessnauseaheadachesPMS symptomsabdominal bloating
Occasionally, more serious side effects can occur with hormone therapy including blood clots, liver tumors, and endometrial cancer. Though these are quite rare, it is important for women to discuss the risks and benefits of hormone therapy with their healthcare professional.
Drugs to induce ovulation may trigger: hot flashesheadachesovarian cystsmid-cycle pain
When a younger woman has amenorrhea, normal periods often resume within a few years. Most women who are diagnosed and treated early can avoid surgery by taking hormones. If a woman wishes to become pregnant and not ovulating is the only infertility problem facing the couple, a success rate of 70% to 80% is possible.
After a woman stops taking birth control pills, she may not experience a period for 2 to 3 months, or sometimes up to or more than a year. If an unusual stress or illness has temporarily stopped a woman's periods, the problem will usually resolve on its own. It may recur at a later date.
If a woman misses more than one period, she should talk with her healthcare professional. It helps to: discuss any medicines or supplements she is takingkeep a record of periods, marking down length, days between cycles, frequency, and flow patternsfind out if there is a family history of infertility, ovarian cysts, or irregular cycles