Amenorrhea
Amenorrhea
Amenorrhea is the medical term for the absence of menstruation in someone of reproductive age. It is classified into two main types:
Types
- Primary Amenorrhea:
- No menstrual periods by age 15 in someone with normal growth and secondary sexual characteristics, or by age 13 if there are no secondary sexual characteristics1346.
- Causes include hormonal imbalances, genetic or anatomical abnormalities (such as congenital absence of the uterus or ovaries), or developmental delays126.
- Secondary Amenorrhea:
- Absence of menstruation for three months in someone who previously had regular periods, or six months in someone with a history of irregular periods1346.
- The most common cause is pregnancy, but it can also result from breastfeeding, menopause, certain medications (like contraceptives or some antidepressants), hormonal imbalances (such as thyroid disorders or polycystic ovary syndrome), significant weight loss, excessive exercise, stress, or chronic illnesses12356.
Symptoms and Associated Signs
While the main symptom is missing periods, other signs may include:
- Milky nipple discharge
- Hair loss or excess facial hair
- Headaches or vision changes
- Pelvic pain
- Acne
- Changes in breast size13
Diagnosis
Diagnosis involves a detailed medical history, physical exam, and laboratory tests to assess hormone levels (such as FSH, LH, prolactin, thyroid hormones, and androgens). Imaging or genetic testing may be needed for primary amenorrhea or if an anatomical problem is suspected46.
When to Seek Medical Advice
Consult a healthcare provider if you:
- Miss three or more periods in a row
- Have never had a period by age 15
- Develop other symptoms like nipple discharge, vision changes, or excessive hair growth13
Summary Table
| Type | Definition | Common Causes |
|---|---|---|
| Primary Amenorrhea | No periods by age 15 (with normal development) or by 13 (no development) | Genetic, hormonal, anatomical |
| Secondary Amenorrhea | No periods for 3+ months (regular cycles) or 6+ months (irregular cycles) | Pregnancy, menopause, hormones, medications, stress, weight changes |
Amenorrhea is a symptom, not a disease, and can indicate a range of underlying health issues. Evaluation and treatment depend on identifying and addressing the underlying cause123456.
References:
- Liu X, Zhang Y, Chen B, et al. “Mesenchymal Stem Cells as a Promising Therapeutic Approach for Female Infertility: A Review of Recent Advances.” Frontiers in Cell and Developmental Biology. 2022;10:956274.
DOI: 10.3389/fcell.2022.956274
