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
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 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
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 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
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
Loss of fertility. If amenorrhea is
caused by lack of ovulation, this means pregnancy may be difficult or not possible
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 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.