Amenorrhea in Teens

Amenorrhea is when a girl’s
menstrual bleeding (period) doesn’t occur. There are 2 types:

  • Primary amenorrhea. This is when the
    first menstrual bleeding at puberty doesn’t occur by age 15. This problem may be
  • Secondary amenorrhea. This is when
    normal menstrual bleeding stops occurring for 3 months or more. This may be because
    of a physical cause, and usually happens later in life.

Amenorrhea can have many causes,

  • Ovulation problems. This can cause
    irregular or missed menstrual periods.
  • Thyroid disorder. In many cases, a
    thyroid gland that is underactive or overactive can cause missed periods.
  • Obesity. Girls who are overweight may
    have changes in ovulation due to body fat. This can cause missed periods.
  • A lot of exercise. Some girl athletes
    don’t have menstrual periods because of low amounts of body fat.
  • Eating disorder. Girls with anorexia
    or bulimia may have amenorrhea if their body weight is too low.
  • Pituitary adenoma. This is a tumor
    that grows in the brain. It may cause problems with the normal function of hormones.
    This can prevent ovulation and cause missed periods.
  • Physical problem (birth defect). If a
    girl has not started to menstruate by age 15, it may be from a problem with how the
    reproductive system formed before birth.
  • Pregnancy. Menstrual periods stop
    during pregnancy.

A teen is more at risk for
amenorrhea for any of the below reasons:

  • Being an athlete
  • Being overweight
  • Having an eating disorder
  • Having a thyroid disorder
  • Having ovulation problems

The main symptom is no menstrual
bleeding when it’s expected.

The symptoms of amenorrhea can be
like other health conditions. Make sure your teen sees her healthcare provider for a

A healthcare provider diagnoses
amenorrhea in these cases:

  • No menstrual bleeding for 3 months or
    more in a girl with previously normal periods
  • No menstrual bleeding for 6 months or
    more in a girl with irregular periods
  • No menstrual bleeding by age 15

The healthcare provider will ask
about your teen’s symptoms and health history. He or she will give your teen a physical
exam. The physical exam may include a pelvic exam. Your teen may also have tests, such

  • Blood tests. These look at hormone
    levels and check for pregnancy.
  • Pelvic ultrasound. This painless test
    uses sound waves to create images of the inside of the body. It can show physical
    problems of the reproductive system.

The healthcare provider may also
need to look for other menstrual disorders, health problems, or medicines that may be
causing or making the condition worse.

Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on the cause and how
severe the condition is.                                         

Your teen may need to see a
gynecologist. This is a doctor who treats the female reproductive system. Treatment for
amenorrhea may include:

  • Hormone treatment with
  • Hormone treatment with birth control
    pills (oral contraceptives) 
  • Medicine to treat thyroid
  • Surgery for birth defects or other
    physical problems
  • Changes in diet or exercise
  • Treatment of an eating disorder
  • Calcium supplements to reduce bone
    loss (osteoporosis)

Talk with your child’s healthcare
provider about the risks, benefits, and possible side effects of all treatments.

Possible complications include:

  • Thinning bones. If amenorrhea is
    caused by low estrogen, this can also lead to thinning of bones (osteoporosis) over
    time. You teen’s healthcare provider may advise her to take calcium supplements.
  • Loss of fertility. If amenorrhea is
    caused by lack of ovulation, this means pregnancy may be difficult or not possible in
    the future.

Some preventable causes include
eating habits and weight loss or weight gain. Talk with your child’s healthcare

Call the healthcare provider if
your child has:

  • Symptoms that don’t get better, or get
  • New symptoms
  • Amenorrhea is when a girl’s menstrual
    bleeding (period) doesn’t occur.
  • Primary amenorrhea is when the first
    menstrual bleeding at puberty doesn’t occur by age 15. Secondary amenorrhea is when
    normal menstrual bleeding stops occurring for 3 months or more.
  • Amenorrhea has many causes, including
    hormone problems, eating habits and exercise, or a birth defect.
  • Your teen may need blood tests and a
    pelvic ultrasound.
  • Treatment may be done with hormones or
    other medicines, changes in diet or exercise, and calcium supplements.
  • A girl with amenorrhea may have
    thinning bones (osteoporosis) over time, and loss of fertility.

Tips to help you get the most from
a visit to your child’s healthcare provider:

  • Know the reason for the visit and what
    you want to happen.
  • Before your visit, write down
    questions you want answered.
  • At the visit, write down the name of a
    new diagnosis, and any new medicines, treatments, or tests. Also write down any new
    instructions your provider gives you for your child.
  • Know why a new medicine or treatment
    is prescribed and how it will help your child. Also know what the side effects
  • Ask if your child’s condition can be
    treated in other ways.
  • Know why a test or procedure is
    recommended and what the results could mean.
  • Know what to expect if your child does
    not take the medicine or have the test or procedure.
  • If your child has a follow-up
    appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s
    provider after office hours. This is important if your child becomes ill and you have
    questions or need advice.