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Alternative Names Return to top
Missed periods; Lack of menses; Periods - missed; AmenorrheaDefinition Return to top
The absence of menstruation means no menstrual flow. Absent menstruation may be primary (no menstruation before age 16) or secondary (menstruation begins at the appropriate age, but later stops for more than 3 cycles or 6 months).
Absent menstruation is called amenorrhea.
Considerations Return to top
Many perfectly normal females begin to menstruate later than most (the median age is 12.8).
Pregnancy is often the first thought when a period is missed, but there are many reasons for having a late period.
The incidence of primary amenorrhea in the United States is less than 1%. The incidence of secondary amenorrhea (due to some cause other than pregnancy) is about 4% in the general population.
Symptoms associated with amenorrhea depend on the cause and may include the following:
Causes Return to top
Causes of primary amenorrhea:
Factors that can disrupt normal menstruation include:
Causes of secondary amenorrhea:
Home Care Return to top
Treatment depends on the cause.
When to Contact a Medical Professional Return to top
What to Expect at Your Office Visit Return to top
The first step is to rule out pregnancy. This is done with a urine or blood test.
Next, the doctor will perform a physical exam and ask questions about your medical history, which may include the following:
Tests that may be performed include:
Treatment depends on the cause of the amenorrhea. Your doctor may tell you to make lifestyle changes if the absent menstruation is due to weight changes, physical activity, or stress level. If you have polycystic ovarian syndrome or athletic amenorrhea, you may be given hormonal contraceptives to treat the problem.
If the absent menstruation is caused by another systemic disorder, normal menstrual function usually returns after the primary disorder is treated. For example, if the primary disorder is thyroid or pituitary disease, medicines will be prescribed.
Young women with primary amenorrhea that is caused by birth defects may require medicine, surgery, or both. In any case, psychosocial support and counseling for the patient and family is necessary to address specific concerns and provide guidance regarding anticipated sexual development.
Update Date: 6/6/2006 Updated by: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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Page last updated: 09 September 2008 |