Amenorrheais a medical term that describes the absence of periods when you are not pregnant.
An evaluation by agynecologistand/orendocrinologistmay be needed to pinpoint the underlying cause.
Primary Amenorrhea
Primary amenorrhea is the absence of periods since you were born.
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It is diagnosed when a female has had no period by age 15.
Turner Syndrome
Turner syndromeis a genetic disorder characterized by a missing or partially missing Xchromosome.
Amenorrhea is characteristic of this condition.
Around one of every 5,000 female births results in MRKH syndrome.
The cause is thought to be genetic, though no gene has yet been linked to the disorder.
Around 15% of cases of primary amenorrhea are due to MRKH syndrome.
Uterine transplants have been performed in a number of people, but it is highly experimental.
Intersex individuals who have female reproductive organs may or may not experience amenorrhea.
It is diagnosed after all other causes of primary amenorrhea have been excluded.
The cause of delayed puberty may be genetic as it tends to run in families.
Even so, many cases areidiopathic(of unknown origin).
The treatment can vary, with some girls requiring no treatment and others being given hormones to stimulate puberty.
Girls who are chronically underweight may also experience delayed puberty.
Dietary and medical interventions, including therapy, may be needed to increase weight and help kickstart puberty.
Secondary Amenorrhea
Secondary amenorrheaoccurs when you have normal periods but suddenly stop having them.
It refers to the prolonged cessation of menstruation outside of pregnancy or menopause.
Pregnancyshould be ruled out before proceeding with looking for further causes of secondary amenorrhea.
This is largely due to a part of the brain called thehypothalamusthat synchronizes your periods.
This leads to what is called functional hypothalamic amenorrhea, the most common cause of secondary amenorrhea.
Anorexia nervosa is treated with therapy and medications.
Treating hyperthyroidism withthyroid-suppressing treatmentsand hypothyroidism withthyroid hormonescan help remedy amenorrhea.
Medications
Amenorrhea can sometimes be drug-induced.
Estrogen therapies are among the most common causes.
There are also non-hormonal drugs that can cause suppression of the HPO axis or indirectly affect hormone production.
Your comfort and consent are important, and you are in control of the exam.
Because there are so many possible causes for missed periods, more than one test may be needed.
Summary
There are manyreasons why you may have no periods(amenorrhea).
A Word From Verywell
There are many benign reasons for not having a period for months.
However, there are also a few serious causes of amenorrhea.
Klein DA, Paradise SL, Reeder RM.Amenorrhea: a systematic approach to diagnosis and management.Am Fam Physician.
2019;100(1):39-48.
Samal R, Habeebullah S.Primary amenorrhea: A clinical review.Int J Reprod Contracept Obstet Gynecol.
2015;7:865870. doi:10.2147/IJWH.S75637
American Academy of Pediatrics.Explaining disorders of sexual development and intersexuality.
Naroji S, Gomez-Lobo V, Finlayson C.Primary amenorrhea and differences of sex development.Semin Reprod Med.
2022 Jun 30;40(1-02):1622. doi: 10.1055/s-0042-1753551
Butler G, Purusnothaman P.Delayed puberty.Minerva Pediatr.
2020 Dec;72(6):484-490. doi:10.23736/S0026-4946.20.05968-X
Ryterska K, Kordek A, Zaleska P.Has menstruation disappeared?
Functional hypothalamic amenorrheawhat is this story about?Nutrients.
2019 Sep;42(9):1001-1010. doi:10.1007/s40618-019-01013-w
Yale Medicine.Amenorrhea.
American Congress of Obstetricians and Gynecologists.Should my teen see an Ob-Gyn?
Here’s what I tell parents.
Office on Womens Health.Polycystic ovary syndrome.
De Leo S, Lee SY, Braverman LE.Hyperthyroidism.Lancet.
