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Alternative Names Return to topMissed periods; Lack of menses; Periods - missed; Amenorrhea
Definition Return to top
Absent menstruation means no menstrual flow, or period. Absent menstruation may be:
Absent menstruation is called amenorrhea.
Considerations Return to top
Many perfectly healthy females begin to menstruate later than most (the average age is about 13).
Pregnancy is often the first thought when a period is missed, but there are many reasons for having a late period. The rate of primary amenorrhea in the United States is less than 1%. The rate 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:
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.
For amenorrhea caused by normal delay of menstruation onset, have patience until age 16. However, keep in mind that the delay is only normal if the girl displays some signs of puberty, such as breast development by age 14.
Call your doctor to determine if you may be pregnant.
A proper diet is recommended for a missed period caused by drastic weight loss or obesity.
If your missed period is the result of too much exercise, cutting back to a more conservative workout program can help.
When to Contact a Medical Professional Return to top
Call your health care provider if:
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. (See: Pregnancy test)
The doctor will perform a physical exam and ask questions about your medical history. Questions may include:
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.
References Return to top
Master-Hunter T, Heiman DL. Amenorrhea: evaluation and treatment. Am Fam Physician. 2006;73:1374-1382.Update Date: 6/26/2008 Updated by: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.