Gynecology

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Amenorrhea

What is amenorrhea?

Amenorrhea is when you don’t have your period for more than 3 cycles. There are 2 types:

  • Primary amenorrhea.  Your period never started in puberty.

  • Secondary amenorrhea.  This type often occurs later in life. Your periods used to be normal and regular. But they became more and more irregular or absent.

What causes amenorrhea?

There are many possible causes of amenorrhea, including:

  • Pregnancy. You don’t ovulate when you are pregnant. Your period stops during this time.

  • Ovulation problems.  This can cause very irregular or missed periods.

  • Anatomy problem at birth.  If your period hasn’t started by age 16, it may be due to this.

  • Eating disorder.  Your periods may stop if you have an eating disorder such as anorexia or bulimia.

  • A lot of exercise.  Your periods may stop if you exercise a lot. Or if you have low body fat.

  • Thyroid disorder.  Your periods may stop if your thyroid is underactive (hypothyroidism) or overactive (hyperthyroidism).

  • Obesity. Excess fat cells can change the process of ovulation.

What are the symptoms of amenorrhea?

Amenorrhea is when you don’t have your period for more than 3 cycles.

How is amenorrhea diagnosed?

A healthcare provider will ask about your health history. They will give you a physical exam. This includes a pelvic exam. They will look for health conditions that can cause the problem.

People with a uterus who haven’t had their first menstrual period by age 15 should have an exam right away. Early diagnosis and treatment is important.

How is amenorrhea treated?

Treatment for amenorrhea depends on the cause. It may include:

  • Progesterone hormone medicine

  • Birth control pills

  • Changes in diet to add more calories and fat

  • Calcium supplements to reduce bone loss

  • Treating an anatomy problem. This may mean having surgery.

Key points about amenorrhea

  • Amenorrhea means missing your period 3 cycles in a row.

  • Primary amenorrhea means not starting a period in puberty.

  • Secondary amenorrhea means your periods were normal, but have stopped.

  • Treatment depends on the cause. It may include hormones, diet changes, or surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you don’t take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Irina Burd MD PhD
Online Medical Reviewer: Stacey Wojcik MBA BSN RN
Date Last Reviewed: 10/1/2023
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