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Missed Periods (Amenorrhea)

What is amenorrhea?
Amenorrhea is when a woman does not have her periods.

There are two kinds of amenorrhea. The first kind is when you haven't had your period at all by the time you are 16 years old. The second kind is when you are used to having periods and you stop having them for 3 months in a row or longer.

What is the cause?
If you have never had a period:
If you've never had periods, you may have late puberty. This may happen if you are very thin or very athletic. Some of the other causes may be:

  • You have a hormone problem.
  • There is a problem with your uterus, vagina, or ovaries.

It's a good idea to get a checkup. Your health care provider can make sure you do not have any of these problems.

If you've had periods before:
A missed period may be caused by pregnancy, breast-feeding, or birth control pills.

Your periods could have stopped for many other reasons. It may have to do with your emotions. You may:

  • live with a lot of stress
  • be sad or depressed
  • take medicine, which might affect your periods, for nervousness or depression

You may have a problem with your glands. You may:

  • have a tumor in the brain or an ovary or other glands
  • have a cyst in an ovary
  • have a problem with your thyroid
  • make too much prolactin (a hormone)

You may have other health problems. You might:

  • have a chronic illness
  • have a brain injury
  • have a problem with your uterus
  • have an IUD containing progesterone
  • have had chemotherapy or radiation therapy
  • have had an injury from surgery
  • have primary ovarian failure (cause is unknown)

And finally you may:

  • not get enough to eat
  • exercise every day for hours at a time
  • smoke a lot
  • have lost or gained weight suddenly

After a certain age, usually after 45, your periods will permanently stop. This is called menopause. Your periods will also stop if your uterus is taken out by surgery.

What are the symptoms?
Other symptoms you may have will depend on why your period has stopped.

How is it diagnosed?
When you don't have your periods, most of the time it does not mean you have a serious disease. But it's not always easy to figure out why they have stopped. Work with your health care provider. Do what he or she advises.

You will need to:

  • tell your provider your medical history
  • have a pelvic exam
  • have blood tests, X-rays, scans, or other tests as needed

How is it treated?
Your treatment depends on what is causing the problem. You may not even need treatment. Or:

  • You may just need to eat and exercise in a different way.
  • You may need to learn to manage stress at work, home, or school.
  • You may need to take hormone medicine, like birth control pills.
  • You may need surgery.

Your health care provider will talk to you about what treatment will be best for you.

When will my periods come back?
If you have no periods because you have had your uterus taken out or because of menopause, your periods will never come back.

If you have just stopped taking birth control pills, shots, or implants, your periods may come back in a few weeks. It could take as long as a year or more.

If you've been sick or under a lot of stress, most likely your periods will start back after a time.

How can I take care of myself?
If you miss more than 2 periods in a row, see your health care provider. Tell your provider about any medicines you are taking.

If your periods don't come every month, keep a record of them. Write down:

  • the dates that they start
  • how long they last
  • how heavy the flow is
  • problems you may have with them

If you have no periods at all, try to remember and write down:

  • when you had your last period
  • how long it lasted
  • how heavy or light the flow was

Try to find out if any woman in your family has had a problem similar to yours.

Follow your health care provider's advice.

What can be done to help prevent missing a period?
To keep your periods normal, it is important to stay healthy:

  • Eat and exercise to keep a healthy weight.
  • Don't use alcohol or street drugs.
  • Medicines like sleeping pills can also make your periods stop.
  • Don't smoke.
  • Get the help you need to lower stress and problems in your life.
  • Talk to your friends, family, or a counselor for support.
  • Try to balance your work, play, and rest.