What Is Amenorrhea? - Definition, Causes, Symptoms & Treatment

Instructor: Marisela Duque

Marisela teaches nursing courses at the college level. She also works as a unit educator, teaching experienced nurses about changes in nursing practice.

After completing this lesson, you will be able to define amenorrhea and describe its causes, symptoms and treatment. A short quiz follows the lesson to test your new knowledge.

A Case of Amenorrhea

Kathy is a busy business owner that runs her own food truck called Nacho Mamas, which sells fresh Mexican goodies. Business is booming, and Kathy is always on the run. Between booking events, publicizing her business and cooking, she barely has time to take it all in. Her hair is permanently in a bun, her wardrobe consists solely of uniform shirts, and no matter how hard she tries, she always smells a little like salsa. Despite her hectic schedule, she loves her job and continues to work hard.

One day, Kathy stumbles upon her stash of maxi pads and tampons that she hid in her truck three months ago, in case of an emergency. The hair on the back of her neck stands at attention as she slowly realizes that she cannot remember the date of her last period. 'It must be at least three months ago!' she exclaims to herself in a panic.

Kathy has amenorrhea. Quickly, she closes up shop and drives the food truck to the nearest convenience store. She purchases three pregnancy tests (you can never be too sure) and takes them right there in the convenience store. Yup, you guessed it; there is a little nacho on the way!

Defining Amenorrhea

Amenorrhea (uh-men-o-REE-uh) is the medical term for not having a period for three months in a row (secondary amenorrhea) or not having a first period by age fifteen (primary amenorrhea). As in Kathy's case, the most common cause of amenorrhea is pregnancy. If this is happening to you, don't freak out yet! There are many other things that can cause missed periods, including birth defects, hormone changes, medications and weight loss. So hold off on picking the nursery furniture until you are sure.

Causes

As we discussed above, there are things besides pregnancy that can cause amenorrhea. Birth defects, such as blockage of the cervix (the opening of the uterus/womb), a missing uterus or a vaginal septum (a rare anomaly where the vagina is divided in two), are sometimes the reason for primary amenorrhea.

There are also genetic conditions, such as XY gonadal dysgenesis, that cause a woman's ovaries to develop abnormally. This is because women with this condition have one X and one Y chromosome (instead of the usual XX).

Sometimes women are born with all the right equipment, but something happens, and it stops working. Acquired conditions that cause amenorrhea include uterine infection, surgery and tumors.

Hormones are also commonly to blame. This is because hormones control a woman's cycle, much like a conductor directs the flow of an orchestra. When your hormones get out of whack, so does your period. Things that can cause hormone fluctuations include extreme weight loss (such as with eating disorders like anorexia), breastfeeding, menopause, stress, over-exercising and problems with your thyroid or pituitary glands (hormone-making glands).

Chronic health conditions, such as thyroid disease, cystic fibrosis, polycystic ovarian syndrome and cancer, can also be a cause of amenorrhea. Other times, the medications used to treat these or other health conditions are to blame. Medications that can disturb your usual cycle include birth control, corticosteroids, chemotherapy, antipsychotics, antidepressants and blood pressure and/or allergy medicines.

Symptoms

The primary symptom of amenorrhea is absence of menstruation. Depending on the cause, there may be other symptoms present. These can include:

  • Headaches
  • Vision changes
  • Acne
  • Hair growth in unwanted areas (such as facial hair)
  • Nausea
  • Enlarged thyroid (goiter)
  • Skin changes
  • Breast changes (such as swelling or nipple discharge)
  • Hair loss
  • Pelvic pain

Treatment Options

Treatment for amenorrhea depends on the cause. For example, if your problem is caused by a medication (like corticosteroids), discontinuing the medicine should help your cycle return to normal. In cases of pregnancy, like our friend Kathy above, menstruation returns after delivery. In cases where structural blockage or tumors are to blame, surgery may correct the problem. Persons with thyroid or pituitary problems can be treated with medication. Sometimes birth control pills can help to regulate your hormones and restart your period.

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