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(Absent Menses; Amenorrhea)
- Primary—Menstruation has not begun in an adolescent around 16 years of age. Most females begin menstruating between 9-18 years of age, though the average is 12 years of age.
- Secondary—A woman who has previously menstruated misses 3 or more periods in a row.
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- Dramatic weight loss (which can occur from extreme diets, eating disorders, or excessive exercise) or dramatic weight gain
- Birth defects, including lack of female reproductive organs
- Chromosomal or hormonal abnormalities
- Certain conditions, such as a thyroid disorder or pituitary tumor
- Medications, such as certain contraceptives
- Emotional distress
- Uterine scarring
When Should I Call My Doctor?
- Have not had your first period and are aged 16 years or older
- Miss having your period
- Blood tests
- Urine tests
- Weight-related cause—A healthy caloric intake and exercise routine usually restores hormonal balance and menstruation.
- Birth defect—Surgery may be needed.
- Hormonal irregularity—Hormonal therapy may be needed.
- Emotional distress—Relaxation techniques, therapy, and exercise may help to decrease stress.
- Pituitary tumor—Surgery, radiation therapy, or medication may be needed.
- Maintain an appropriate level of body fat.
- Get help for an eating disorder.
- Treat conditions that can lead to amenorrhea, such as polycystic ovary syndrome, pituitary tumor, and hypothyroidism.
- Reviewer: EBSCO Medical Review Board Beverly Siegal, MD, FACOG
- Review Date: 09/2017
- Update Date: 08/08/2014