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The A to Z of Fertility: Amenorrhea

Amenorrhea is the absence of menstruation or menstrual flow when a woman is of childbearing age and not pregnant.Amenorrhea is the absence of menstruation or menstrual flow when a woman is of childbearing age and not pregnant. It seriously affects female fertility.

When menstruation does not occur, people generally think that it is liked to pregnancy but there are many reasons why a woman may not menstruate. When amenorrhea occurs because a woman has never had periods, it is called primary amenorrhea, and may be due to the following causes:

  • Imperforate hymen
  • Genital tract abnormalities
  • Hormonal disturbances
  • Absence of uterus
  • Congenital defects in the female reproductive system.

When amenorrhea occurs in women who have menstruated before, it is known as secondary amenorrhea and may be due to the following reasons:

  • Pregnancy
  • Stress
  • Uterine disease
  • Ovarian disease
  • Psychological trauma
  • Problems with the hypothalamus or pituitary gland
  • Severe weight loss
  • Diseases that affect overall functioning of the body, such as thyroid, diabetes, tuberculosis, etc.
  • Hormonal imbalance (such as polycystic ovary syndrome)
  • Excessive physical exercise
  • Menopause (women over the age of 45) and early menopause
  • Use of oral and other types of contraception
  • Uterine scarring, usually from procedures such as dilation and curettage

What factors or causes can stop the menstruation cycle?

  • Stress
  • Eating disorders
  • Severe weight loss

What are the symptoms of secondary amenorrhea?

  • Head ache
  • Galactorrhea (women who lactate when they are not pregnant)
  • Loss of sight
  • Considerable weight increase or loss
  • Vaginal dryness
  • Increased hair growth (hirsutism)
  • Vocal changes
  • Changes in breast size
  • Pain cycles without menstruation bleeding

When is it advisable to see a specialist?

  1. If a woman has never had a menstrual period and is aged 16 or over, or if she is aged 14 and has not begun puberty.
  2. If a woman has had periods but has stopped menstruating for three or more consecutive periods.

If a woman has amenorrhea and wants to get pregnant, some of the following tests must be performed:

  • Progesterone withdrawal (taking hormones for 7 to 10 days to trigger bleeding)
  • Prolactin level
  • Serum hormone and testosterone levels
  • Thyroid function studies, including TSH (thyroid stimulating hormone)
  • FSH (follicle stimulating hormone level)
  • LH (luteinizing hormone level)
  • Pelvic ultrasound
  • A CT head scan can be performed a pituitary tumour is suspected.

Recommendations by the fertility experts at ProcreaTec International Fertility Centre include:

  1. It is important to lead a healthy lifestyle and make sure you have a healthy and balanced diet. Do not overlook changes in weight and do not do too much sport. Practice relaxation techniques to help lower stress levels.
  2. For women with polycystic ovary syndrome or athletic amenorrhea, hormonal contraceptives may be prescribed to treat the problem.
  3. If the absence of menstruation is caused by a systemic disorder, meaning it affects the whole body, menstrual function usually returns to normal after the primary disorder is cured. For example, if a woman has a disease of the thyroid or pituitary gland, these conditions must be medicated.
  4. Young women with primary amenorrhea caused by congenital defects may need medication and/or surgery. In addition, the family and patient will require support and information about sexual development.
  5. Assisted reproduction treatments such as egg donation, can help women suffering from amenorrhea to get pregnant.

About the author


At ProcreaTec, we understand the road toward a healthy pregnancy is not always easy. Through this blog, we want to reach out to all who are struggling on the path of infertility to find support. If you have any questions or would like to tell us about your situation, you can comment on the posts or send us an e-mail.
If you would like to learn more about our clinic, we invite you to visit our website
ProcreaTec: converting patients into parents.

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