Amenorrhea

Amenorrhea is the absence of a normal monthly period.

There are two types of amenorrhea:

• Primary amenorrhea is when a girl has never had a period. Most girls start their period by the time they are 16
• Secondary amenorrhea is when a girl who has had periods stops having them for several months. This is the most common type of amenorrhea.

Possible causes include:

• Pregnancy  
• Eating disorders and weight changes  
• Excess exercise (also called athletic amenorrhea)
• Polycystic ovary syndrome (PCOS) – the ovaries produce excessive amounts of male hormones, causing irregular periods and other symptoms
• Premature ovarian insufficiency (POI) – the ovaries do not make enough estrogen to cause periods 
• Obesity 
• Endocrine problems 
• Chronic illness such as Crohn's disease, cystic fibrosis, sickle disease, lupus and diabetes 
• Certain medications 
• Stress
• Depression
• Congenital defect of the reproductive tract

Diagnosis starts with a thorough medical history and physical exam, and possibly a pelvic exam.

Additional testing may include:

• Pregnancy test
• Blood tests
• Progestin challenge test (to check for lack of estrogen)
• Imaging tests
• Laparoscopy or hysteroscopy, to view internal organs

Treatment for amenorrhea will depend on the cause and may include lifestyle changes and medical treatment, including:

• Changes in your exercise habits 
• Changes in your diet
• Stress management
• Hormone therapy or other medications