Amenorrhea Explained: Causes, Diagnosis & Treatment in 2025

What Is Amenorrhea? Understanding Menstrual Absence

Key Facts

• Amenorrhea refers to the absence of menstrual periods. It can be classified into two types: primary amenorrhea, where menstruation has not started by age 16, and secondary amenorrhea, where menstruation stops after having previous cycles.
• Causes vary widely, including natural physiological states, lifestyle factors, and hormonal imbalances.
• Consulting a healthcare provider is essential as underlying causes may require targeted treatment, often leading to resolution of symptoms.

Amenorrhea is medically defined as the lack of menstrual bleeding. If a girl has not begun menstruating by 16 years of age, or if a woman misses her periods for three to six months, amenorrhea may be diagnosed.

Common causes include pregnancy, breastfeeding, and menopause. Additionally, lifestyle factors such as exercise intensity and body weight can influence menstrual cycles.

Hormonal disruptions or reproductive system issues may also contribute.

Seeking medical evaluation for amenorrhea helps identify the root cause and appropriate management.

Types of Amenorrhea

There are two primary forms of amenorrhea:

Primary Amenorrhea: Absence of menstruation by age 16 despite normal development.

Secondary Amenorrhea: Cessation of menstruation for three months or more in women who previously had regular cycles.

Both types typically respond well to appropriate interventions.

Common Causes of Amenorrhea

Amenorrhea may result from various factors, including natural physiological changes and medical conditions:

• Natural Causes: Pregnancy, breastfeeding, and menopause are frequent natural causes.
• Lifestyle Factors: Excessive physical activity, stress, and abnormal body fat percentages may disrupt menstrual cycles.
• Hormonal Imbalances: Conditions affecting the pituitary or thyroid glands, low estrogen, or elevated testosterone can cause amenorrhea.
• Genetic Disorders: Syndromes such as Turner or Sawyer can delay menstruation.
• Medications: Antipsychotics, antidepressants, chemotherapy drugs, and antihypertensives may impact menstrual regularity.
• Contraceptive Changes: Sudden cessation of birth control pills can lead to temporary absence of periods.
• Physical Abnormalities: Structural issues from birth defects, tumors, or infections affecting reproductive organs may cause amenorrhea.
• Rare Conditions: Asherman’s syndrome, involving uterine scarring post-surgery, can prevent menstruation.

When to See a Doctor

Adolescents who have not begun menstruating by 16, or those over 14 without any signs of puberty (breast development, pubic hair), should seek medical advice.

Women missing three or more consecutive periods also need evaluation.

What to Expect During a Medical Appointment

Your healthcare provider will perform a physical examination and ask detailed questions about your menstrual history, lifestyle, and symptoms.

A pregnancy test is standard if menstruation has been absent for three months.

If negative, further diagnostic tests may include:

• Blood tests to evaluate hormone levels such as prolactin, luteinizing hormone, and follicle-stimulating hormone.
• Ultrasound imaging to inspect reproductive organs for abnormalities.
• CT scans to detect masses or tumors affecting glands or organs.

Treating Amenorrhea

Treatment targets the underlying cause. Hormonal therapies can restore balance when imbalances are present.

Surgical interventions may be necessary to remove cysts, scar tissue, or lesions interfering with menstruation.

Lifestyle modifications involving diet and exercise adjustments may also be recommended, often with guidance from nutrition experts.

Next Steps

Schedule a consultation to determine the cause of amenorrhea. Follow your treatment plan and attend follow-up visits.

Always communicate with your healthcare provider if symptoms persist or worsen despite treatment.

For further reading, consult the original English resource.

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