Amenorrhea in Teens

Also known as: amenorrhea, absent menstrual periods.

What is amenorrhea in teens?

Amenorrhea 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 be “primary” (where menstruation never starts), or “secondary” (when periods have begun, but then stop).

What causes amenorrhea in teens?

There are many causes of this condition. 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)
  • low body weight (from eating disorders, over exercising, or thyroid disorder)
  • chronic illness
  • 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 signs/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.

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 amenorrhea in teens care options?

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 10, 2023 10:33 AM

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