Amenorrhea is the absence of menstrual periods.

  • Some women never go through puberty.
  • So periods never start.
  • This disorder is called primary amenorrhea.
  • In other women, periods start at puberty, then stops.
  • Amenorrhea is normal only before puberty, during pregnancy, while breast-feeding and menopause.


  • Primary amenorrhea may be caused by a birth defect in which the uterus or fallopian tubes do not develop normally or by a chromosomal disorder, such as turner syndrome.
  • Primary amenorrhea can also result from malfunction of the hypothalamus, pituitary gland or ovaries.
  • Sometimes it results from the malfunction of the thyroid gland.
  • Young women who are very thin, particularly who have anorexia nervosa, may never menstruate.
  • Secondary amenorrhea may result from malfunction of the hypothalamus, pituitary gland, ovaries, thyroid gland, adrenal glands, or almost any part of the reproductive tract.
  • Malfunction of these organs may result from a tumour, an auto immune disorder or use of certain drugs. This includes hallucinogenic drugs, chemotherapeutic drugs and antidepressant drugs.
  • Cushing’s syndrome and polycystic ovarian syndrome may cause periods to stop or be irregular.
  • Other causes of secondary amenorrhea include a hydatidiform mole and Asherman’s syndrome.
  • Stress due to internal or situational concerns may cause secondary amenorrhea, because interferes with brain’s control of the ovaries.
  • Exercising too much or too little may also affect the brain’s control of ovaries.
  • Either behaviour can cause the brain to signal the pituitary gland to decrease its production of hormones that stimulate the ovaries.
  • As a result, ovaries produce less estrogen and periods stop.


  • Amenorrhea may or may not be accompanied by other symptoms, depending on the cause.


  • Primary amenorrhea is diagnosed when periods have not started by the age of 16.
  • Girls who have no signs of puberty by the age of 13 or who have not started having periods within 5 years of starting puberty are evaluated for possible problems.
  • Secondary amenorrhea is diagnosed when a woman of reproductive age has had no menstrual periods for at least 3 months.
  • A physical examination can help doctors determine whether puberty occurred normally and may provide evidence of the cause of amenorrhea.
  • Other procedures may be needed to confirm or identify the cause.
  • Hormone levels in the blood may be measured.
  • X – Rays of the skull may be taken to look for a pituitary tumour.
  • Computed tomography, magnetic resonance imaging or Ultrasonography may be used to look for the tumour in the ovaries or adrenal glands.


  • The underlying disorder is treated if possible. For example, a tumour is removed if it is the cause.
  • Some disorders such as Turner syndrome and other genetic disorders cannot be cured.
  • If a girl’s periods have never started and all test results are normal, she is examined every 3 to 6 months to monitor the progression of puberty.
  • Progestin and sometimes estrogen may be given to start her periods and to stimulate the development of secondary sexual characteristics, such as breasts.

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By |2017-12-20T12:53:51+00:00November 24th, 2017|Disease/pathological condition, Women's health|0 Comments

About the Author:

B. Pharm (K.L.E. society's S.V.V. Patil College of Pharmacy, Bengaluru) M. Pharm (Maharishi Arvind Institute of Pharmacy, Jaipur)

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