Healthcare: Obstetrics and Gynecology



What is 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.

What causes 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

How is amenorrhea diagnosed?


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

How is amenorrhea treated?


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