Amenorrhea is the absence of menstruation — one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as do girls who haven’t begun menstruation by age 15.
The most common cause of amenorrhea is pregnancy. Other causes of amenorrhea include problems with the reproductive organs or with the glands that help regulate hormone levels. Treatment of the underlying condition often resolves amenorrhea.
Following are the symptoms of amenorrhea:
- Milky nipple discharge
- Hair loss
- Vision changes
- Excess facial hair
- Pelvic pain
- Change in breast size
The main causes of primary amenorrhea include family history, genetics, and lifestyle. Women with the following factors are more at risk:
- a family history of amenorrhea or early menopause
- a genetic or chromosomal defect. These can affect your ovary function and menstrual cycle. Turner syndrome is one example.
- severely over or under weight
- an eating disorder
- an extreme exercise pattern
- a poor diet
Pregnancy, breastfeeding, and menopause can cause secondary amenorrhea. Other possible causes include:
- some birth controls, such as pills, injections, or intrauterine devices. These can affect your menstrual cycle during and after use.
- some medicines for depression and blood pressure
- chemotherapy and radiation treatment
- polycystic ovary syndrome (PCOS)
- fragile X syndrome (caused by the FMR1 gene) or fragile X-associated primary ovarian insufficiency (FXPOI)
- problems with your thyroid or pituitary gland
- hypothalamic disease
- uterine scar tissue.
Factors that may increase your risk of amenorrhea may include:
- Family history. If other women in your family have experienced amenorrhea, you may have inherited a predisposition for the problem.
- Eating disorders. If you have an eating disorder, such as anorexia or bulimia, you are at higher risk of developing amenorrhea.
- Athletic training. Rigorous athletic training can increase your risk of amenorrhea
Complications of amenorrhea may include:
- Infertility. If you don’t ovulate and have menstrual periods, you can’t become pregnant.
- Osteoporosis. If your amenorrhea is caused by low estrogen levels, you may also be at risk of osteoporosis — a weakening of your bones.