When a woman of child-bearing age does not menstruate, it is known as amenorrhoea. It can occur after the woman has already been menstruating for some time and then stops for at least three months; this is referred to as secondary amenorrhoea. Or a girl might not get her first period prior to turning 16, in which case it is called primary amenorrhoea. Both types are typically a symptom indicating an underlying issue, and speaking to a doctor may be appropriate to determine the cause. There can be many reasons that women may fail to menstruate, some of them harmless and others more serious.
In cases of primary amenorrhoea, there are several issues that can delay development and stop the onset of menstruation. Sometimes girls are genetically predisposed to start their periods later. Diseases or disorders can affect the glands that regulate menstruation, such as the pituitary and the hypothalamus. Certain chromosomal problems may lead to depleted ovaries and lack of ovulation. Some girls may have an abnormally structured vagina which blocks menstruation, or may even lack some or all reproductive organs.
The most common reason for secondary amenorrhoea in healthy women is pregnancy. If a woman is sexually active and stops menstruating, a pregnancy test is often the best first step to figure out what is happening. Normally women will not have a period throughout pregnancy and also while breastfeeding, when lactational amenorrhoea can serve as a method of contraception.
Certain health issues can lead to secondary amenorrhoea. Hormonal disorders that affect glands such as the pituitary, thyroid, or hypothalamus may be to blame. Polycystic ovarian syndrome may stop ovulation, leading to a loss of periods. Some chronic diseases like tuberculosis may also impact menstruation.
Several other factors can also lead a previously established period to stop. Certain medications can stop a woman's menstruation, and in the case of certain contraceptives, this may even be the desired outcome. Women who are extremely overweight or underweight may stop menstruating. Extreme stress can also play a role. Athletes who exercise at a highly intense level may expend so much energy that their bodies do not have enough left to maintain a normal cycle.
Treatment for amenorrhoea depends on the underlying cause, and sometimes no treatment is necessary. If it is a symptom of disease, a doctor should help the patient determine the appropriate course of treatment. Changes in diet, exercise, or situation may be necessary. In certain cases, for example if the woman had a hysterectomy, the condition is permanent.
