Amenorrhea: Types, causes, and treatment

Amenorrhea is when menstruation is absent during the reproductive years, between puberty and menopause.

It is not a disease, and it does not mean that a person is infertile, but it can be a sign of a health problem that needs some attention.

Around puberty, menstruation begins, and then it normally occurs about once a month until the age of 50 years. At this time, periods stop altogether, as menopause begins.

During pregnancy, menstruation also stops, and it is common for it to stop during breastfeeding, too.

If menstruation does not occur at times when people normally expect it to, this is amenorrhea.

Types of amenorrhea

There are two types of amenorrhea: primary and secondary.

Primary amenorrhea

Amenorrhea is a lack of menstruation
Amenorrhea refers to a lack of menstruation, either because periods never started or because they stop.

Primary amenhorrea is when periods do not start during puberty.

According to the National Institutes of Health, if periods do not start by the age of 16 years, the person should seek medical help.

Primary amenorrhea is rare. In the United States, it affects fewer than 0.1 percent of individuals.

Secondary amenorrhea

This is when periods start, but then they cease to occur.

This is normal during pregnancy or while breastfeeding, but it may also mean that there is a problem.

In the U.S., secondary amenorrhea is thought to affect around 4 percent of women during their lifetime.

One missing period is not usually a sign of a health problem, although many people will ask for a pregnancy test if this happens.

A doctor will consider secondary amenorrhea if an individual:

used to have regular periods and then does not have any for 3 months

used to have irregular periods and then does not have any for 6 months

Reasons for amenorrhea include pregnancy
Reasons for amenorrhea include pregnancy, changes in weight and exercise, medication, and some health conditions.

Menstruation may stop for a number of reasons.

These include:

a gynecological disorder

serious illness

physical stress

having a very low body mass index (BMI)

When BMI falls below 19, the risk of developing secondary amenorrhea increases significantly.

Weight loss, exercise, and stress

Serious weight loss can result from a physical illness or an eating disorder.

Stringent exercise can cause secondary amenorrhea. It is common among competitive long-distance runners and professional ballet dancers.

Severe emotional upheaval or extreme stress can also cause a woman’s periods to stop.


Some medications, such as progesterone-only contraceptives and a number of psychiatric drugs may cause periods to stop.

Other medications that affect menstruation include:


cancer chemotherapy


blood pressure drugs

allergy medications

Long-term health conditions

Amenorrhea can also result from a long-term illness, such as:

polycystic ovary syndrome (PCOS)

premature ovarian failure

thalamic pituitary problems

Pituitary problems or an underactive thyroid can lead to a hormone imbalance, and this can result in menstrual problems.

These could be due to:

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