Amenorrhea in Teens
Amenorrhea is when a girl’s
menstrual bleeding (period) doesn’t occur. There are 2 types:
Primary amenorrhea. This type is when the first menstrual
bleeding at puberty doesn’t occur by age 15. This problem may be lifelong.
Secondary amenorrhea. This type is when normal menstrual
bleeding stops occurring for 3 months or more. It 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
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 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. The provider will give your teen a
physical exam. The physical exam may include a pelvic exam. Your teen may also have
tests, such as:
Blood tests. These look at hormone levels and check for
Pelvic ultrasound. This painless test uses sound waves to
create images of the inside of the body. It can show physical problems of the
The healthcare provider may also
need to look for other menstrual disorders, health problems, or medicines that may
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 healthcare provider 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
- Changes in diet or exercise
- Treatment of an eating disorder
- Calcium supplements to reduce bone
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. Your 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
When to Call a Healthcare Provider
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
- 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 healthcare 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
healthcare provider after office hours. This is important if your child becomes ill
and you have questions or need advice.