Health Library


What is amenorrhea?

If you don’t have your period for more than 3 cycles, it is called amenorrhea.  It may be classified as primary or secondary:

  • Primary amenorrhea.  Menstruation never begins at puberty.
  • Secondary amenorrhea. This type is due to some physical cause and usually of later onset. Your periods were at one time normal and regular but become increasingly abnormal and irregular or absent.

What causes amenorrhea?

There are several possible causes of amenorrhea, including:

  • Pregnancy. When you are pregnant, you don’t ovulate so your period stops temporarily.
  • Ovulation abnormality. Ovulation abnormalities are usually the cause of very irregular or frequently missed periods.
  • Birth defect, anatomical abnormality, or other medical condition. If your period hasn't started by age 16, it may be due to a birth defect, anatomical abnormality, or other medical condition.
  • Eating disorder. If you have anorexia and/or bulimia, you may develop amenorrhea. This is because your body weight can get too low to sustain a pregnancy. So, to protect the body, the reproductive system "shuts down" because it's severely malnourished.
  • Overexercise or strenuous exercise. If you exercise a lot, your periods may stop due to low body fat content.
  • Thyroid disorder. If you have an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism) your periods may stop.
  • Obesity. If you are overweight, you may have amenorrhea as a result of excess fat cells interfering with the process of ovulation.

What are the symptoms of amenorrhea?

If you don’t have your period for more than 3 cycles, it is called amenorrhea.

How is amenorrhea diagnosed?

Diagnosis begins with a medical history and a complete physical exam including a pelvic exam. Your health care provider will want to rule out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. Also, a diagnosis of amenorrhea requires that you miss at least 3 periods in a row, without being pregnant. Young women who haven't had their first menstrual period by age 15 should be evaluated promptly. Making an early diagnosis and starting treatment as soon as possible is very important.

How is amenorrhea treated?

Specific treatment for amenorrhea will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Cause of the condition (primary or secondary)
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Treatment for amenorrhea may include:

  • Hormone treatment (progesterone supplements)
  • Oral birth control pills (inhibits ovulation)
  • Dietary changes (to include increased caloric and fat intake)
  • Calcium supplements to reduce bone loss

Key points

  • Amenorrhea is characterized by missing your period 3 cycles in a row.
  • Primary amenorrhea means a girl doesn’t start menstruating when she reaches puberty.
  • Secondary amenorrhea means your periods were normal, but have stopped due to an underlying condition.
  • Treatment of amenorrhea depends on the cause but may include hormones, birth control pills, or dietary changes.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.