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Amenorrhoea (Absent Periods)
Fertility General Gynaecology 

Amenorrhea refers to the absence of menstrual periods in females. Amenorrhea is an abnormal event in a female’s life except during childhood, pregnancy, breastfeeding and menopause.

Amenorrhea can either be primary or secondary.

Primary Amenorrhea

Primary amenorrhoea is said to occur when periods have not started by the age of 15 or within three to five years of attaining puberty (development of secondary sexual characteristics such as developing breast and pubic hair) or, the failure of onset of puberty (no signs of secondary sexual characteristics such as developing breasts and pubic hair) by the age of 13. 

Secondary Amenorrhea

One is said to have secondary amenorrhoea when periods have stopped for about three months or more after normal puberty and menstruation.

Causes of Amenorrhea

Depending on the type of amenorrhea, the causes of amenorrhea are divided into two.

Causes of primary amenorrhoea

Causes of primary amenorrhea include:

  • Turner’s syndrome is the most common cause of primary amenorrhea.
  • Genetic or chromosomal abnormality with the ovaries.
  • Pituitary gland disorders
  • Problems with the hypothalamus 
  • Structural abnormalities with the reproductive organs such as the ovaries, uterus, cervix, and vagina.
  • Müllerian agenesis 
  • Polycystic ovary syndrome
  • Congenital adrenal hyperplasia
  • Hypothyroidism 
  • Eating disorders
  • Stress
  • Excessive exercise (elite athlete)


Causes of secondary amenorrhoea

A range of factors can affect how the hypothalamus works and cause amenorrhoea, including:

  • Pregnancy
  • Breastfeeding
  • Menopause
  • Some birth control methods
  • Emotional stress
  • Extreme weight gain or weight loss
  • Exercising too much (elite athletes)
  • Certain therapies and medications used to treat cancer (chemotherapy), mental health disorders, etc.
  • Polycystic ovary syndrome
  • Hypothyroidism
  • Hyperandrogenaemia
  • Hyperprolactinaemia
  • Premature ovarian insufficiency
  • Chronic illness

Risk factors for amenorrhea include:

  • Family history of amenorrhea or early menopause
  • Genetic or chromosomal condition that predisposes you to amenorrhea
  • Being underweight or obese
  • Eating disorder
  • Poor diet
  • Stress
  • Excessive exercising
  • Chronic illness


Treatment for amenorrhoea

Treatment for amenorrhoea depends on the cause and could include:

  • Treating the underlying medical condition
  • Hormone therapy
  • Det therapy to gain weight
  • Surgery
  • Stress management
  • Avoiding certain activities such as excessive exercising, etc.


You can make an appointment with Dr Kenny on 07 3188 5000.

This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.

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