Absent Periods

Menstruation, or a menstrual period, refers to the monthly process in which the uterus sheds blood and tissue in preparation for pregnancy. Not having or missing a menstrual period is called amenorrhea. This condition is divided into two types: Menstrual FlowCopyright © Nucleus Medical Media, Inc.

  • Causes

    The most common cause of secondary amenorrhea is pregnancy. If nonpregnant women, may be due to a variety of factors.

  • Definition

    Menstruation, or a menstrual period, refers to the monthly process in which the uterus sheds blood and tissue in preparation for pregnancy.

    Not having or missing a menstrual period is called amenorrhea. This condition is divided into two types:


    • Primary amenorrhea—when an adolescent female has not yet begun menstruation by around age 16 years

      • Most females begin menstruating between the ages 9-18, but age 12 is the average.
    • Secondary amenorrhea—when a woman who has previously menstruated misses three or more periods in a row

    Menstrual Flow
    Menstrual Flow
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will also be done.

    Tests may include:

    • Pregnancy test
    • Progestin challenge test to determine if a lack of estrogen is causing amenorrhea
    • Blood work to check hormone levels
    • Chromosome test to determine if there are any abnormalities

    Other tests that may be ordered include:

    • MRI scan
      of the pituitary gland
    • Ultrasound

  • Prevention

    Amenorrhea may or may not be preventable, depending on the cause. Follow these general guidelines to prevent amenorrhea:

    • Maintain an appropriate level of body fat.
    • Get help for an eating disorder.
    • Treat conditions that can lead to amenorrhea, such as polycystic ovary syndrome, pituitary tumor, and hypothyroidism.

  • Risk Factors

    Factors that may increase the risk of amenorrhea include:

    • Dramatic weight loss (eg, from extreme diets, eating disorders, or excessive exercise) or dramatic weight gain
    • Malnourishment
    • Birth defects (eg, lack of female reproductive organs)
    • Chromosomal or hormonal abnormalities

    • Certain conditions (eg, thryoid disorder,
      pituitary tumor
      )
    • Medicines (eg, certain
      contraceptives)
    • Emotional distress
    • Uterine scarring

  • Symptoms

    The main symptom for primary amenorrhea is the absence of a menstrual period in a female by age 16 or older. The main symptom for secondary amenorrhea is three or more missed periods in a row in a woman who has previously had menstrual periods.

  • Treatment

    Treatment will depend on what is causing amennorhea. Examples include:

    • Weight-related cause—A healthy caloric intake and exercise routine usually restores hormonal balance and menstruation.
    • Birth defect—Surgery may be needed.
    • Hormonal irregularity—Your doctor may prescribe hormonal therapy.
    • Emotional distress—Relaxation techniques (eg, deep breathing), therapy, and exercise may help to decrease stress.

    • Pituitary tumor—Surgery,
      radiation therapy
      ,
      or medicine
      may be needed.