What is Amenorrhea?

Amenorrhea is when menstrual periods stop or never begin. It may be diagnosed if someone misses three or more periods in a row or has not started menstruating by the mid-teen years. This condition can be temporary or related to an underlying health concern.

There are two main types. Primary amenorrhea occurs when periods never start, while secondary amenorrhea happens when periods stop after being regular.

Symptoms

The main sign of amenorrhea is missing menstrual periods. Depending on the cause, other changes in the body may also be present.

Common causes include:

• Pregnancy
• Hormone imbalances that affect ovulation
• Thyroid conditions
• Low body weight or eating disorders
• High levels of physical activity
• Obesity
• Conditions like polycystic ovary syndrome (PCOS)
• Structural differences in reproductive organs

In some cases, lifestyle factors and medical conditions work together to disrupt the menstrual cycle.

How is it diagnosed?

Your healthcare provider will begin by discussing your health history and menstrual patterns. A physical exam, including a pelvic exam, may be performed.

Testing often includes:

• A pregnancy test
• Blood tests to check hormone levels and thyroid function
• Imaging, such as ultrasound, if needed

Early evaluation is especially important for teens who have not started menstruation by age 15.

How is it treated?

Treatment focuses on the underlying cause and often begins with simple, noninvasive approaches.

Common options include:

• Hormone therapy to help regulate the menstrual cycle
• Birth control pills to support cycle balance
• Nutrition and lifestyle adjustments to restore healthy body weight
• Managing conditions like thyroid disorders or PCOS

In rare cases, procedures may be needed if there is a structural concern. Many people see improvement once the root cause is addressed.