(Absent Menses; Amenorrhea)
DefinitionMenstruation, or a menstrual period, refers to the monthly process in which the uterus sheds blood and tissue to prepare for pregnancy.Not having or missing a menstrual period is called amenorrhea. This condition is divided into two types:
- Primary amenorrhea—when an adolescent female has not yet begun menstruation by around age 16 years
- Most females begin menstruating between the ages 9-18, but age 12 is the average.
- Secondary amenorrhea—when a woman who has previously menstruated misses three or more periods in a row
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CausesThe most common cause of secondary amenorrhea is pregnancy. In nonpregnant women, it may be due to a variety of factors.
Risk FactorsFactors that may increase the risk of amenorrhea include:
- Dramatic weight loss (such as from extreme diets, eating disorders, or excessive exercise) or dramatic weight gain
- Birth defects, including lack of female reproductive organs
- Chromosomal or hormonal abnormalities
- Certain conditions such as thryoid disorder and pituitary tumor
- Medications such as certain contraceptives
- Emotional distress
- Uterine scarring
SymptomsThe main symptom for primary amenorrhea is the absence of a menstrual period in a female by age 16 or older. The main symptom for secondary amenorrhea is three or more missed periods in a row in a woman who has previously had menstrual periods.
When Should I Call My Doctor?Call your doctor if you:
- Have not had your first period and are aged 16 years or older
- Miss having your period
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