BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAbsent menstrual periods - secondaryAmenorrhea - secondary; No periods - secondary; Absent periods - secondary; Absent menses - secondary; Absence of periods - secondaryAbsence of a woman's monthly menstrual period is called amenorrhea. Secondary amenorrhea is when a woman who has been having normal menstrual cycles stops getting her periods for 6 months or longer. Causes Secondary amenorrhea can occur due to natural changes in the body. For example, the most common cause of secondary amenorrhea is pregnancy. Breastfeeding and menopause are also common, but natural causes.Women who take birth control pills or who receive hormone shots such as Depo-Provera may not have any monthly bleeding. When they stop taking these hormones, their periods may not return for more than 6 months.You are more likely to have absent periods if you:Are obese Exercise too much and for long periods of time Have very low body fat (less than 15% to 17%) Have severe anxiety or emotional distress Lose a lot of weight suddenly (for example, from strict or extreme diets or after gastric bypass surgery) Gastric bypass surgeryGastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you...ImageRead Article Now Book Mark Article Other causes include:Brain (pituitary) tumors Drugs for cancer treatment Medicines to treat schizophrenia or psychosis SchizophreniaSchizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearl...ImageRead Article Now Book Mark Article Overactive thyroid gland Overactive thyroid glandHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article Polycystic ovarian syndrome Polycystic ovarian syndromePolycystic ovary syndrome (PCOS) is a condition in which a woman has increased levels of male hormones (androgens). Many problems occur as a result ...ImageRead Article Now Book Mark Article Reduced function of the ovaries Also, procedures such as a dilation and curettage (D and C) can cause scar tissue to form. This tissue may cause a woman to stop menstruating. This is called Asherman syndrome. Scarring may also be caused by some severe pelvic infections.D and CD and C (dilation and curettage) is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilation (D) is a widening of ...ImageRead Article Now Book Mark Article Asherman syndromeAsherman syndrome is the formation of scar tissue in the uterine cavity. The problem most often develops after uterine surgery.ImageRead Article Now Book Mark Article Symptoms In addition to having no menstrual periods, other symptoms can include:Breast size changes Weight gain or weight loss Weight gainUnintentional weight gain is when you gain weight without trying to do so and you are not eating or drinking more.ImageRead Article Now Book Mark Article Weight lossUnexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...Read Article Now Book Mark Article Discharge from the breast or change in breast size Acne and increased hair growth in a male pattern Vaginal dryness Voice changes If amenorrhea is caused by a pituitary tumor, there may be other symptoms related to the tumor, such as vision loss and headache.HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Exams and Tests A physical exam and pelvic exam must be done to check for pregnancy. A pregnancy test will be done.Pregnancy testA pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG or hCG). HCG is a hormone produced during pregnancy. It ap...ImageRead Article Now Book Mark Article Blood tests may be done to check hormone levels, including:Estradiol levels Estradiol levelsAn estradiol test measures the amount of a hormone called estradiol in the blood. Estradiol is one of the main types of estrogens.Read Article Now Book Mark Article Follicle stimulating hormone (FSH level) Follicle stimulating hormoneThe follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on t...Read Article Now Book Mark Article Luteinizing hormone (LH level) Luteinizing hormoneThe LH blood test measures the amount of luteinizing hormone (LH) in blood. LH is a hormone released by the pituitary gland, located on the undersid...Read Article Now Book Mark Article Prolactin level Prolactin levelProlactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.Read Article Now Book Mark Article Serum hormone levels, such as testosterone levels Hormone levelsBlood or urine tests can determine the levels of various hormones in the body. This includes reproductive hormones, thyroid hormones, adrenal hormon...ImageRead Article Now Book Mark Article TestosteroneA testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. The test described...Read Article Now Book Mark Article Thyroid stimulating hormone (TSH) Thyroid stimulating hormoneA TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...ImageRead Article Now Book Mark Article Other tests that may be performed include:CT scan or MRI scan of the head to look for tumors CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article MRI scan of the headA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Biopsy of the lining of the uterus Biopsy of the lining of the uterusEndometrial biopsy is the removal of a small piece of tissue from the lining of the uterus (endometrium) for examination.ImageRead Article Now Book Mark Article Genetic testing Ultrasound of the pelvis or hysterosonogram (pelvic ultrasound that involves putting saline solution inside the uterus) HysterosonogramTransvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix and pelvic area. Transvaginal means across or through the ...ImageRead Article Now Book Mark Article Treatment Treatment depends on the cause of amenorrhea. Normal monthly periods most often return after the condition is treated.A lack of menstrual period due to obesity, vigorous exercise, or weight loss may respond to a change in exercise routine or weight control (gain or loss, as needed).ObesityOverweight and obesity mean having a weight than is higher than what is healthy for a given height. A person may be overweight from extra muscle, bo...ImageRead Article Now Book Mark Article Outlook (Prognosis) The outlook depends on the cause of amenorrhea. Many of the conditions that cause secondary amenorrhea will respond to treatment. When to Contact a Medical Professional See your primary health care provider or women's health care provider if you have missed more than one period so you can get diagnosed and treated, if needed.Open ReferencesReferencesBulun SE. Physiology and pathology of the female reproductive axis. In Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, et al. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.Lobo RA. Primary and secondary amenorrhea and precocious puberty. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 36.Magowan BA, Owen P, Thomson A. The normal menstrual cycle and amenorrhoea. In: Magowan BA, Owen P, Thomson A, eds. Clinical Obstetrics and Gynaecology. 4th ed. Elsevier; 2019:chap 4.AllVideoImagesTogSecondary amenorrhea - illustration Secondary amenorrhea is the cessation of menstrual flow for a period of 6 months or more in the absence of pregnancy, breastfeeding or menopause. Extreme weight gain or loss, certain medications, as well as anxiety can be the root cause of amenorrhea. Treatment can range from behavior modification for excessive exercise to medication to surgery in the presence of disease. Secondary amenorrheaillustrationNormal uterine anatomy (cut section) - illustration The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.Normal uterine anatomy (cut section)illustrationAbsence of menstruation (amenorrhea) - illustration Amenorrhea is the lack of menstrual flow and can be a normal occurrence or a sign of malfunction or disease. In primary amenorrhea, menstruation does not begin when expected (by the age of 16). Secondary amenorrhea occurs when the normal established menstrual cycle is shut down for 6 or more months due to a condition other than pregnancy, breastfeeding or menopause. Absence of menstruation (amenorrhea)illustrationSecondary amenorrhea - illustration Secondary amenorrhea is the cessation of menstrual flow for a period of 6 months or more in the absence of pregnancy, breastfeeding or menopause. Extreme weight gain or loss, certain medications, as well as anxiety can be the root cause of amenorrhea. Treatment can range from behavior modification for excessive exercise to medication to surgery in the presence of disease. Secondary amenorrheaillustrationNormal uterine anatomy (cut section) - illustration The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.Normal uterine anatomy (cut section)illustrationAbsence of menstruation (amenorrhea) - illustration Amenorrhea is the lack of menstrual flow and can be a normal occurrence or a sign of malfunction or disease. In primary amenorrhea, menstruation does not begin when expected (by the age of 16). Secondary amenorrhea occurs when the normal established menstrual cycle is shut down for 6 or more months due to a condition other than pregnancy, breastfeeding or menopause. Absence of menstruation (amenorrhea)illustrationA Closer Look Menstrual disorders - InDepth(In-Depth)Premenstrual syndrome - InDepth(In-Depth)Narcolepsy - InDepth(In-Depth)Related Information Menopause(Condition)Stress and your health(Symptoms)D and C(Surgery)Incidence(Special Topic)Menopause - InDepth(In-Depth)Anxiety disorders - InDepth(In-Depth) Review Date: 4/19/2022 Reviewed By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Absent menstrual periods - secondaryAmenorrhea - secondary; No periods - secondary; Absent periods - secondary; Absent menses - secondary; Absence of periods - secondaryAbsence of a woman's monthly menstrual period is called amenorrhea. Secondary amenorrhea is when a woman who has been having normal menstrual cycles stops getting her periods for 6 months or longer. Causes Secondary amenorrhea can occur due to natural changes in the body. For example, the most common cause of secondary amenorrhea is pregnancy. Breastfeeding and menopause are also common, but natural causes.Women who take birth control pills or who receive hormone shots such as Depo-Provera may not have any monthly bleeding. When they stop taking these hormones, their periods may not return for more than 6 months.You are more likely to have absent periods if you:Are obese Exercise too much and for long periods of time Have very low body fat (less than 15% to 17%) Have severe anxiety or emotional distress Lose a lot of weight suddenly (for example, from strict or extreme diets or after gastric bypass surgery) Gastric bypass surgeryGastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat. After the surgery, you...ImageRead Article Now Book Mark Article Other causes include:Brain (pituitary) tumors Drugs for cancer treatment Medicines to treat schizophrenia or psychosis SchizophreniaSchizophrenia is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearl...ImageRead Article Now Book Mark Article Overactive thyroid gland Overactive thyroid glandHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article Polycystic ovarian syndrome Polycystic ovarian syndromePolycystic ovary syndrome (PCOS) is a condition in which a woman has increased levels of male hormones (androgens). Many problems occur as a result ...ImageRead Article Now Book Mark Article Reduced function of the ovaries Also, procedures such as a dilation and curettage (D and C) can cause scar tissue to form. This tissue may cause a woman to stop menstruating. This is called Asherman syndrome. Scarring may also be caused by some severe pelvic infections.D and CD and C (dilation and curettage) is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilation (D) is a widening of ...ImageRead Article Now Book Mark Article Asherman syndromeAsherman syndrome is the formation of scar tissue in the uterine cavity. The problem most often develops after uterine surgery.ImageRead Article Now Book Mark Article Symptoms In addition to having no menstrual periods, other symptoms can include:Breast size changes Weight gain or weight loss Weight gainUnintentional weight gain is when you gain weight without trying to do so and you are not eating or drinking more.ImageRead Article Now Book Mark Article Weight lossUnexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...Read Article Now Book Mark Article Discharge from the breast or change in breast size Acne and increased hair growth in a male pattern Vaginal dryness Voice changes If amenorrhea is caused by a pituitary tumor, there may be other symptoms related to the tumor, such as vision loss and headache.HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...ImageRead Article Now Book Mark Article Exams and Tests A physical exam and pelvic exam must be done to check for pregnancy. A pregnancy test will be done.Pregnancy testA pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG or hCG). HCG is a hormone produced during pregnancy. It ap...ImageRead Article Now Book Mark Article Blood tests may be done to check hormone levels, including:Estradiol levels Estradiol levelsAn estradiol test measures the amount of a hormone called estradiol in the blood. Estradiol is one of the main types of estrogens.Read Article Now Book Mark Article Follicle stimulating hormone (FSH level) Follicle stimulating hormoneThe follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on t...Read Article Now Book Mark Article Luteinizing hormone (LH level) Luteinizing hormoneThe LH blood test measures the amount of luteinizing hormone (LH) in blood. LH is a hormone released by the pituitary gland, located on the undersid...Read Article Now Book Mark Article Prolactin level Prolactin levelProlactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.Read Article Now Book Mark Article Serum hormone levels, such as testosterone levels Hormone levelsBlood or urine tests can determine the levels of various hormones in the body. This includes reproductive hormones, thyroid hormones, adrenal hormon...ImageRead Article Now Book Mark Article TestosteroneA testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. The test described...Read Article Now Book Mark Article Thyroid stimulating hormone (TSH) Thyroid stimulating hormoneA TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...ImageRead Article Now Book Mark Article Other tests that may be performed include:CT scan or MRI scan of the head to look for tumors CT scanA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article MRI scan of the headA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Biopsy of the lining of the uterus Biopsy of the lining of the uterusEndometrial biopsy is the removal of a small piece of tissue from the lining of the uterus (endometrium) for examination.ImageRead Article Now Book Mark Article Genetic testing Ultrasound of the pelvis or hysterosonogram (pelvic ultrasound that involves putting saline solution inside the uterus) HysterosonogramTransvaginal ultrasound is a test used to look at a woman's uterus, ovaries, tubes, cervix and pelvic area. Transvaginal means across or through the ...ImageRead Article Now Book Mark Article Treatment Treatment depends on the cause of amenorrhea. Normal monthly periods most often return after the condition is treated.A lack of menstrual period due to obesity, vigorous exercise, or weight loss may respond to a change in exercise routine or weight control (gain or loss, as needed).ObesityOverweight and obesity mean having a weight than is higher than what is healthy for a given height. A person may be overweight from extra muscle, bo...ImageRead Article Now Book Mark Article Outlook (Prognosis) The outlook depends on the cause of amenorrhea. Many of the conditions that cause secondary amenorrhea will respond to treatment. When to Contact a Medical Professional See your primary health care provider or women's health care provider if you have missed more than one period so you can get diagnosed and treated, if needed.Open ReferencesReferencesBulun SE. Physiology and pathology of the female reproductive axis. In Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, et al. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.Lobo RA. Primary and secondary amenorrhea and precocious puberty. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 36.Magowan BA, Owen P, Thomson A. The normal menstrual cycle and amenorrhoea. In: Magowan BA, Owen P, Thomson A, eds. Clinical Obstetrics and Gynaecology. 4th ed. Elsevier; 2019:chap 4.