Amenorrhea Health Article

Amenorrhea

Amenorrhea is the absence of menstruation.

There are two types of amenorrhea, primary and secondary. Primary amenorrhea is delayed menarche (the first menstrual period) and is defined as any one of three conditions:

1.) absence of menarche by age 16 with otherwise normal pubertal development (development of breasts and/or pubic hair)

2.) absence of menarche by age 14 with delayed pubertal development

3.) absence of menarche two years after puberty is otherwise completed

Family history should be taken into consideration in any adolescent with primary amenorrhea. Mothers who started to menstruate late will often have daughters who also menstruate late.

Secondary amenorrhea is the absence of menstruation after menarche has taken place. Although it is not uncommon for menstrual periods to be irregular during early adolescence, periods usually become regular with in 18 months after the first one. After that time, it is considered abnormal for an adolescent to miss three consecutive periods.

Pregnancy

An adolescent with amenorrhea most likely does not have a serious underlying medical problem. Even so, all teenagers with amenorrhea should seek medical care, and an adolescent who has had sexual intercourse even once and then missed a period should assume she is pregnant until a reliable pregnancy test proves otherwise. It should be noted that spotting, or even bleeding, is not unusual during early pregnancy. In addition, it is possible for a girl to conceive before she has had even one period.

Other causes of amenorrhea

If pregnancy is ruled out as the cause of an adolescent's amenorrhea, a doctor will consider several other causes. After pregnancy, the most common reason for amenorrhea (both primary and secondary) is that the ovaries are not receiving appropriate messages from the hypothalamus and the pituitary gland. When this happens, the ovaries do not produce adequate amounts of hormones to trigger menstruation.

Less common causes of amenorrhea include pituitary tumor or a problem with the ovaries or uterus. In most cases, however, amenorrhea does not indicate a serious medical problem, and regular periods will resume without any treatment.