Secondary Amenorrhea

Secondary amenorrhea is the stopping of menstrual flow for 3–6 months in a female who has previously had periods. There are many possible causes. Most of these causes are not serious. Usually, treating the underlying problem causing the loss of menses will return your periods to normal.

CAUSES

Some common and uncommon causes of not menstruating include:

  • Malnutrition.

  • Low blood sugar (hypoglycemia).

  • Polycystic ovary disease.

  • Stress or fear.

  • Breastfeeding.

  • Hormone imbalance.

  • Ovarian failure.

  • Medicines.

  • Extreme obesity.

  • Cystic fibrosis.

  • Low body weight or drastic weight reduction from any cause.

  • Early menopause.

  • Removal of ovaries or uterus.

  • Contraceptives.

  • Illness.

  • Long-term (chronic) illnesses.

  • Cushing syndrome.

  • Thyroid problems.

  • Birth control pills, patches, or vaginal rings for birth control.

RISK FACTORS

You may be at greater risk of secondary amenorrhea if:

  • You have a family history of this condition.

  • You have an eating disorder.

  • You do athletic training.

DIAGNOSIS

A diagnosis is made by your health care provider taking a medical history and doing a physical exam. This will include a pelvic exam to check for problems with your reproductive organs. Pregnancy must be ruled out. Often, numerous blood tests are done to measure different hormones in the body. Urine testing may be done. Specialized exams (ultrasound, CT scan, MRI, or hysteroscopy) may have to be done as well as measuring the body mass index (BMI).

TREATMENT

Treatment depends on the cause of the amenorrhea. If an eating disorder is present, this can be treated with an adequate diet and therapy. Chronic illnesses may improve with treatment of the illness. Amenorrhea may be corrected with medicines, lifestyle changes, or surgery. If the amenorrhea cannot be corrected, it is sometimes possible to create a false menstruation with medicines.

HOME CARE INSTRUCTIONS

  • Maintain a healthy diet.

  • Manage weight problems.

  • Exercise regularly but not excessively.

  • Get adequate sleep.

  • Manage stress.

  • Be aware of changes in your menstrual cycle. Keep a record of when your periods occur. Note the date your period starts, how long it lasts, and any problems.

SEEK MEDICAL CARE IF:

Your symptoms do not get better with treatment.