Absent Periods

Definition

Menstruation, or a menstrual period, refers to the monthly process in which the uterus sheds blood and tissue because pregnancy did not occur.

Not having or missing a menstrual period is called amenorrhea. The types are:

  • Primary—Menstruation has not begun in an adolescent around 16 years of age. Most females begin menstruating between 9-18 years of age, though the average is 12 years of age.
  • Secondary—A woman who has previously menstruated misses 3 or more periods in a row.

Menstrual Flow
Menstrual Flow
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Causes

The most common cause of secondary amenorrhea is pregnancy. In non-pregnant women, it may be due to a variety of factors.

Risk Factors

Factors that may increase the risk of amenorrhea include:

  • Dramatic weight loss (which can occur from extreme diets, eating disorders, or excessive exercise) or dramatic weight gain
  • Malnutrition
  • Birth defects, including lack of female reproductive organs
  • Chromosomal or hormonal abnormalities
  • Certain conditions, such as a thyroid disorder or pituitary tumor
  • Medications, such as certain contraceptives
  • Emotional distress
  • Uterine scarring

Symptoms

The main symptom for primary amenorrhea is the absence of a menstrual period in a female by age 16 years or older. The main symptom for secondary amenorrhea is 3 or more missed periods in a row in a woman who has previously had menstrual periods.

When Should I Call My Doctor?

Call your doctor if you:

  • Have not had your first period and are aged 16 years or older
  • Miss having your period

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests

Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment will depend on what is causing amennorrhea. Examples include:

  • Weight-related cause—A healthy caloric intake and exercise routine usually restores hormonal balance and menstruation.
  • Birth defect—Surgery may be needed.
  • Hormonal irregularity—Hormonal therapy may be needed.
  • Emotional distress—Relaxation techniques, therapy, and exercise may help to decrease stress.
  • Pituitary tumor—Surgery, radiation therapy, or medication may be needed.

Prevention

Amenorrhea may or may not be preventable, depending on the cause. Follow these general guidelines to prevent amenorrhea:

  • Maintain an appropriate level of body fat.
  • Get help for an eating disorder.
  • Treat conditions that can lead to amenorrhea, such as polycystic ovary syndrome, pituitary tumor, and hypothyroidism.

Revisions

Please note, not all procedures included in this resource library are available at Henry Ford Allegiance Health or performed by Henry Ford Allegiance Health physicians.

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