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What is Amenorrhea?

Amenorrhea is the term used for the absence of menses (periods). It is either primary or secondary.

  • Primary amenorrhea is classified as not starting menses by age 16.
  • Secondary amenorrhea is absence of menstruation for three cycles after having had a menstrual period for longer than two years.

Causes of Amenorrhea

The most common cause of amenorrhea is pregnancy. It is important to determine if you are pregnant in order to get early care.

Other causes may be related to hormones. The hormones in our bodies control the menstrual cycle. If there is an abnormality with the release of the hormones or the body's ability to correctly use or make those hormones, a problem with the menstrual cycle results.

Sometimes, the absence of reproductive organs (uterus, cervix or vagina) may be the cause of amenorrhea.

In some cases, increased activity, medications, weight changes or stress may alter the body's ability to release appropriate hormones to have menses. It is something that can be determined by your healthcare provider.

Risks of Amenorrhea

The cause of amenorrhea will determine the risks. The most concerning risk is that of infertility (problems with getting pregnant). There may be other concerns related to incorrect release of hormones. This is important because hormones control more than the menstrual cycle, such as growth and puberty. There may be something blocking hormone release, such as a tumor, that should be removed in order to minimize risks of other problems.

Diagnosis of Amenorrhea

Your child's healthcare provider will do a complete exam to determine the cause of the absent menstrual cycle; this includes questions related to your medical history. The physical exam will include checking private areas for determination of normal pubertal development.

Blood is often obtained in order to check hormone levels and other things that may have an effect on the menstrual cycle.

In some cases, an ultrasound may be performed to look at internal body parts for abnormalities.

Treatment of Amenorrhea

Treatment is aimed at correcting the problem with menstruation. Lifestyle changes alone may help the body resume appropriate menstrual cycles. Removal of stressors or discontinuing certain medications may be suggested.

Use of artificial hormones with oral contraceptive tablets or other long-acting contraceptives may be used.

Sometimes, surgery is the only option to help the body return to regular cycles.

In all cases, close supervision with your healthcare provider is required to find the best treatment options available.

Last Updated 01/2022

Reviewed By Julie Snider, RN

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For more information or to schedule an appointment, contact Pediatric and Adolescent Gynecology at Cincinnati Children's.

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