Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2013;87(11):online

See related article on amenorrhea.

What is amenorrhea?

Amenorrhea (say: “ay-MEN-or-REE-uh”) is a condition in which your menstrual periods don't start during puberty, or they stop before you reach menopause.

What causes amenorrhea?

Anything that disrupts your normal hormone levels can cause amenorrhea. This could be from losing weight, being on a diet, or extreme exercise or stress. This may also happen if you have an abnormal vagina, uterus, or ovaries. But, this does not always mean that the problem is permanent. You may also have problems if your ovaries aren't working, or if there are issues with your thyroid gland or pituitary gland.

What tests will my doctor order?

First, your doctor will ask about your medical history and current symptoms. Your doctor may run tests if you have not had your first period by age 15, or if you miss three or more periods in a row. It might be important to know when your mother's or sister's menstrual periods first started, and if they had normal periods. Next, your doctor will check for signs of abnormal hormone levels. He or she may also order lab tests. In some cases, the doctor may order an ultrasound of your pelvis.

How is amenorrhea treated?

It depends. Sometimes, your doctor may recommend that you lose or gain weight. This might involve changes in your diet and exercise. Your doctor may also prescribe medicine to help with bone health and hormone levels. Some women may need extra calcium and vitamin D.

How can I protect myself?

  • Keep a journal of when your periods start and how many days they last.

  • Keep a healthy weight with a well-balanced diet. Try to exercise five days a week for 20 to 60 minutes each day. Running, walking, and biking are good options.

  • Remember, it is still possible to become pregnant even if your periods are not regular.

Where can I get more information?

Your doctor

American Academy of Family Physicians

Mayo Clinic

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