General Information
Primary--Absence of menstruation in a young woman who is at least 16 years old
or has reached age 14 with a lack of normal growth or absence of secondary sexual
development. Secondary--Cessation of menstruation in a woman who has previously
menstruated.
BODY PARTS INVOLVED--Endocrine system; reproductive system.
SEX OR AGE MOST AFFECTED--Females over age 16.
SIGNS & SYMPTOMS
- Lack of menstrual periods after puberty. Most girls begin menstruating by age 14.
- Absence of menstrual periods for 3 months in a female who has menstruated at least once.
CAUSES--
RISK INCREASES WITH--See Causes.
HOW TO PREVENT
- Use drugs only if prescribed by your doctor.
- Reduce strenuous athletic activities.
- Medical treatment for underlying disorders.
- Maintain proper nutrition and body weight.
What To Expect
DIAGNOSTIC MEASURES--
- Laboratory studies, such as a buccal smear (cells scraped from inside the cheek for
chromosome studies), blood tests of hormone levels, thyroid and adrenal function tests.
- Pregnancy test and surgical diagnostic procedures, such as laparoscopy, hysteroscopy or
dilatation and curettage.
APPROPRIATE HEALTH CARE
- Psychotherapy or counseling, if needed.
- Surgery (minor) to create an opening in the hymen, if necessary, or to correct
abnormalities of the reproductive system (sometimes).
POSSIBLE COMPLICATIONS--Psychological distress about sexual development. May
experience estrogen deficiency symptoms, such as hot flashes, vaginal dryness. May affect
fertility.
PROBABLE OUTCOME--
- Primary--The absence of menstruation is not a health risk and is usually curable with
hormone treatment or removal of the underlying cause. Treatment may be delayed to age 18
unless the cause can be identified and treated.
- Secondary--If from pregnancy or breast-feeding, menstruation will resume when these
conditions cease. If from discontinuing use of oral contraceptives, periods should begin
in 2 months to 2 years. If from menopause, periods will become less frequent or may never
resume. If from endocrine disorders, hormone replacement usually causes periods to resume.
If from eating disorders, successful treatment of the disorder is necessary. If from
diabetes or tuberculosis, menstruation may never resume. If from strenuous exercise,
periods usually resume when exercise decreases.
How To Treat
GENERAL MEASURES--
- Seek help in resolving emotional stress.
- Don't use mood-altering, mind-altering stimulants or sedative drugs.
MEDICATION--Your doctor may prescribe progesterone (hormone) treatment to induce
bleeding. If bleeding begins when progesterone is withdrawn, the reproductive system is
functioning. If progesterone withdrawal does not induce bleeding, gonad stimulants such as
clomiphene or gonadotrophins may be used.
ACTIVITY--No restrictions.
DIET--If overweight or underweight, a change in diet to correct the problem is
recommended.
Call Your Doctor If
- You are 16 years old and have never had a period or periods have stopped for 3 months.
- Periods don't begin in 6 months, despite treatment, or new symptoms develop.
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