What causes amenorrhea?

There are several possible reasons for primary amenorrhea, including disorders of the ovaries, genetic defects, or an infection contracted while still in the womb or shortly after birth.

The leading cause of secondary amenorrhea is pregnancy. Doctors consider all females with amenorrhea, primary or secondary, to be pregnant until proven otherwise. Secondary amenorrhea may also be caused by the use of hormone-releasing contraceptive devices that can lighten or stop the menstrual periods. Secondary amenorrhea may also be caused by anxiety or other emotional strain, excessive exercise, eating disorders, obesity, or rare conditions such as tumors. Women with body fat of less than 15% often experience amenorrhea.

Hormonal causes of amenorrhea

Amenorrhea may be caused by hormonal imbalances including:

  • Changes in your levels of estrogen or progesterone
  • Complications from hormone-releasing contraceptives (birth control pill, patch or injection; intrauterine devices)
  • Genetic or inherited conditions
  • Hyperthyroidism (overactive thyroid)
  • Hypothyroidism (underactive thyroid)
  • Polycystic ovary syndrome
  • Premature ovarian failure
  • Turner syndrome (female disorder involving a missing or incomplete sex chromosome)

Other causes of amenorrhea

Amenorrhea can also be caused by conditions that damage the ovaries, the uterus, or the organs that regulate hormone production by the ovaries. Examples include:

  • Asherman’s syndrome (the formation of scar tissue in the uterus after medical procedures or infections)
  • Side effects of some medications, such as chemotherapy drugs for cancer

Psychological causes of amenorrhea

Amenorrhea can also be caused by psychological disturbances including:

  • Anorexia nervosa
  • Anxiety
  • Bulimia
  • Depression
  • Stress

Physical causes of amenorrhea

Amenorrhea can also be caused by physical changes in your body including:

  • Breastfeeding
  • Excessive exercise
  • Low body fat (less than 15%)
  • Low body weight
  • Obesity
  • Rapid weight loss from a restrictive diet

Serious or life-threatening causes of amenorrhea

In some cases, amenorrhea may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a medical professional. These include:

  • Cancer of the pelvic organs, brain, or adrenal glands
  • Ectopic pregnancy
  • Pituitary tumor

Questions for diagnosing the cause of amenorrhea

To diagnose your condition, your doctor or licensed health care provider will ask you several questions related to your amenorrhea including:

  • Are you pregnant?
  • Are you in menopause?
  • Have you ever had a menstrual period?
  • Have you noticed any changes in your menstrual periods?
  • Have you missed any menstrual periods?
  • Do you have spotting or bleeding between menstrual periods?
  • Do you have any other symptoms, such as fatigue, rapid heart rate, dizziness, or loss of vision?

What are the potential complications of amenorrhea?

Because amenorrhea can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Cancer of the uterus
  • Inability to participate normally in activities
  • Infertility
  • Withdrawal or depression

References:

  1. Amenorrhea - primary. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001218.htm.
  2. Secondary amenorrhea. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/001219.htm.
  3. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
INTRODUCTION

What is amenorrhea?

Amenorrhea is the complete absence of menstruation or menstrual periods. That’s different than oligomenorrhea (less frequent periods). There are two types of amenorrhea: primary and secondary. Primary amenorrhea typically denotes the lack of occurrence of the first menstrual period by 16 years of age. Women who have been menstruating regularly and whose periods then stop for at least three... Read more about amenorrheaintroduction

SYMPTOMS

What other symptoms might occur with amenorrhea?

Amenorrhea may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the endocrine system may also involve other body systems.

Common symptoms that may occur along with amenorrhea

Amenorrhea may accompany other common symptoms including:

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Aug 9, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.