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Find out about what causes amenorrhea, and how it can be treated. Amenorrhea is the absence of menstrual bleeding in a woman of reproductive age.
There are two main types of amenorrhea:
Primary amenorrhea This is when a girl over age 15 has never had her period.
Secondary amenorrhea This is when a woman who has had regular periods stops having her period for six months or longer.
What Causes Amenorrhea?
Natural changes in the body can cause your periods to stop.
For instance, women stop menstruating during pregnancy and breastfeeding.
There are many potential causes and risk factors for amenorrhea. Sometimes the cause is unknown.
Causes and risk factors for amenorrhea include:
Obesity
Having very low body fat (less than 15 to 17 percent body fat)
Deficiency of leptin, a hormone that regulates appetite
Polycystic ovarian syndrome (PCOS)
Overactive thyroid gland
Extreme emotional stress
Excessive exercise
Use of some contraceptives (it can take several months for periods to start again after stopping certain forms of birth control)
Certain medications (certain antidepressants and blood pressure medicines can increase levels of a hormone that prevents ovulation)
Chemotherapy and radiation treatments for cancer
Noncancerous pituitary tumor
Scar tissue in the uterus (uterine fibroids, a cesarean section, or certain abortion procedures can scar the uterus)
Other causes of hormonal problems that may lead to amenorrhea include:
Long-term illness, such as heart disease or cystic fibrosis
Genetic defects or disorders
Problems with the ovaries
Amenorrhea Symptoms
The major symptom of amenorrhea is the absence of periods.
You may experience additional symptoms depending on the cause of your amenorrhea.
Other symptoms may include:
Weight gain or weight loss
Changes in breast size, or milky discharge from the breast
Acne
Hair loss
Increased facial hair growth
Headaches or vision changes
Pelvic pain
Amenorrhea Diagnosis
There are a number of steps your doctor will take to determine whether you have amenorrhea.
First, your doctor will ask you about your symptoms to get a better picture of your medical history.
Your doctor may also perform a pelvic exam and do a pregnancy test to rule out the possibility of pregnancy.
Tests for amenorrhea may include:
Blood tests to check your hormone levels
Genetic testing
Pelvic ultrasound
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Amenorrhea Treatment
The treatment your doctor recommends will depend on the cause of your amenorrhea.
Treatments for amenorrhea may include medications, surgery, lifestyle changes, or a combination of these measures.
Lifestyle changes may include:
Taking steps to reach a healthy weight and maintain that weight (if you're under- or overweight)
Interventions to reduce stress
If you're an athlete, modifying the way you train or eat
Medical treatments for amenorrhea may include:
Hormonal medications, such as birth control pills
Estrogen replacement therapy
Medications for PCOS
Surgical treatments for amenorrhea may include:
Removal of scar tissue in the uterus
Removal of noncancerous pituitary tumor
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