Amenorrhea in girls and teens

Also known as: amenorrhea, absent menstrual periods.

What is amenorrhea in teens?

Amenorrhea is a menstrual irregularity that is defined as a girl not having a menstrual period for three monthly cycles or longer. Most girls get their periods two years after the start of breast development and certainly by age 16.

Amenorrhea may fall into one of two categories:

Primary amenorrhea

When menstrual periods in an individual have not occurred by age 15, this is known as primary amenorrhea. Frequently, this lack of menstrual bleeding is due to hormone levels, although it can also be the result of anatomical problems in the body.

Secondary amenorrhea

When someone had a normal menstrual cycle in the past but then does not have three or more periods in a row, this is known as secondary amenorrhea. This is most frequently due to pregnancy, although hormonal issues can also lead to secondary amenorrhea. One type of secondary amenorrhea is known as hypothalamic amenorrhea (HA), and it occurs when the hypothalamus and pituitary glands do not function as they should.

What are the causes amenorrhea in teens?

There are many factors that might cause amenorrhea. These include:

  • pregnancy (a common cause of amenorrhea)
  • hormonal abnormalities (from a tumor in the brain called pituitary adenoma or tumors in the ovary or elsewhere causing abnormal hormone secretion)
  • polycystic ovary syndrome
  • low body weight (from eating disorders, over exercising, or thyroid disorder)
  • chronic illness
  • ovarian failure
  • some medications and over-the counter supplements/herbs.

Certain congenital birth defects or abnormalities of the reproductive system can also lead to amenorrhea by blocking the exit of blood. These include imperforate hymen (where the hymen completely covers the vagina) and vaginal septum, where a veil divides the mid-vagina just below the cervix, allowing no blood to pass.

What are the symptoms of amenorrhea in teens?

Primary amenorrhea, that is where the girl who reaches her 16th birthday has never had a period, requires a genetic, endocrinologic (hormonal) and anatomic workup. The pelvic organs are evaluated, usually with an ultrasound to make sure they are present and have developed normally. This can include ovarian function, the lining of the uterus and other parts of the female reproductive system.

Depending on the cause of no menstrual periods or of periods which began but have stopped, some teenage girls may experience pelvic pain, headache, vaginal dryness, voice changes, vision abnormalities, weight changes, alterations in breast size, acne or unusual hair growth/loss.

What are care and treatment options for amenorrhea in teens?

Treatment for amenorrhea in teens will vary depending on the cause. If there are anatomic abnormalities, most of these can be addressed with relatively simple surgeries to alleviate blockage. If the reproductive organs are normal, specific treatments include hormone treatments, oral contraceptives, and changes in diet and evaluation for a hormone-secreting tumor.

Reviewed by: Cathy Anne Burnweit, MD

This page was last updated on: May 22, 2024 01:58 PM

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