Amenorrhea is a menstrual condition characterized by absent menstrual periods for more than three monthly menstrual cycles, and may be classified as primary or secondary. Primary amenorrhea occurs when menstruation fails to start puberty; secondary amenorrhea is due to some physical cause and usually occurs after normal periods have begun but become increasingly irregular or absent. It is one of many conditions sometimes caused by hormone irregularities, which can be labeled by the more general term, Dysfunction Uterine Bleeding – DUB.
Ovulation abnormalities are usually the cause of very irregular or frequently missed menstrual periods. If a young woman has not started to menstruate by the age of 16 then a birth defect, anatomical abnormality, or other medical condition may be suspected.
Diagnosis begins with a gynecologist evaluating a patient’s medical history and a complete physical examination including a pelvic examination. A diagnosis of amenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, a diagnosis of amenorrhea requires that a woman has missed at least three consecutive menstrual cycles, without being pregnant. Young women who have not had their first menstrual period by the age of 16 should be evaluated promptly: making an early diagnosis and starting treatment as soon as possible is very important.
Specific treatment for amenorrhea will be determined by your doctor based on what is believed to be the cause. Most of the conditions that cause secondary amenorrhea will respond to treatment. In most cases, doctors will induce menstruation in non-pregnant women who have missed two or more consecutive menstrual periods, because of the danger posed to the uterus if the non-fertilized egg and endometrium lining are not expelled. Without this monthly expulsion, the risk of uterine cancer increases.