What is Amenorrhea? Causes, Symptoms & Diagnosis

Periods are more than just a sign of fertility — they also reflect that your hormones and overall health are in balance. However, sometimes periods may stop suddenly, or in some girls, they may not start at all. This condition is known as amenorrhoea.

Many women ignore missed periods, assuming they’re just due to “stress” or “hormonal imbalance”. But missed periods can also be linked to conditions such as PCOS, thyroid problems, or other hormonal issues, which are increasingly common today. Let’s take a closer look at what amenorrhoea means.

What is Amenorrhoea?

Amenorrhoea is a medical condition in which a person does not get their menstrual period. It is classified into two types: primary amenorrhoea and secondary amenorrhoea.

• Primary amenorrhoea occurs when you reach the age of 15 but still haven’t had your first period.
• Secondary amenorrhoea occurs when menstruation has already begun but then stops completely for three months or longer.

It is important to understand that amenorrhoea is a symptom, not a disease. It may result from hormonal imbalances, lifestyle factors, or medical conditions.

What Causes Amenorrhoea?

Amenorrhoea can occur for several reasons, including natural causes, lifestyle factors, or underlying medical conditions.

Natural Causes (Normal) 

• Pregnancy: The most common reason for missing periods.
• Breastfeeding: Many women do not get periods while nursing — this is normal.
• Menopause: The natural end of periods, usually between ages 45 and 55.

Lifestyle-Related Causes

• Stress: Work, studies, or family responsibilities can disrupt hormone balance.
• Excessive exercise: Overtraining through gym workouts, dance, or sports can cause periods to stop.
• Sudden weight changes: Rapid weight loss, crash dieting, or obesity can disturb hormones.
• Poor nutrition: Skipping meals or lacking essential nutrients such as iron and vitamins may contribute to amenorrhoea.

Medical Causes

• PCOS (Polycystic Ovary Syndrome): One of the most common causes in young women.
• Thyroid disorders: Both overactive and underactive thyroids can affect cycles.
• Pituitary gland issues: Tumours or hormone imbalances may disrupt menstruation.
• Primary ovarian insufficiency: When the ovaries stop functioning normally before age 40.
• Uterine scarring (Asherman’s Syndrome): This can develop after repeated abortions, C-sections, or uterine surgeries.
• Cancer treatments:Chemotherapy or radiation may damage ovarian function.
• Chronic illnesses: Conditions such as diabetes, tuberculosis, or coeliac disease can also lead to amenorrhoea.

Types of Amenorrhoea

Primary amenorrhoea

• This occurs when you reach age 15 (or it has been about five years since puberty changes such as breast development began) and your first period still hasn’t arrived. 
• Often, the cause is linked to genetic factors or conditions that develop later and affect the reproductive system.

Secondary amenorrhoea

• This occurs when your periods used to come regularly, but then they suddenly stop. 
• If cycles were previously regular, missing periods for three months counts as secondary amenorrhoea. 
• If cycles were irregular, doctors usually diagnosed amenorrhoea after six months without menstruation.
•  Common reasons include pregnancy, breastfeeding, stress, or chronic health conditions.

Symptoms of Amenorrhoea

Missing periods is the main symptom, but other signs may include:

• Acne or oily skin
• Extra hair growth on the face or body
• Sudden weight gain or loss
• Headaches or vision problems
• Milky discharge from breasts
• Vaginal dryness or hot flushes
• Thinning hair or hair loss
• Weakness or bone pain

Many women feel hesitant to discuss these symptoms, but ignoring them can affect both fertility and long-term health.

How is Amenorrhoea Diagnosed?

Your doctor may ask:

• When did your periods start?
• Were your cycles regular before?
• Could you be pregnant?
• Have you experienced stress, exercise changes, or weight changes recently?
• Is there any family history of delayed puberty or infertility?

Common Tests

Your gynaecologist may recommend tests such as:

• Pregnancy test: The first step in ruling out pregnancy.
• Blood tests: To check hormones like thyroid, prolactin, oestrogen, and progesterone.
• Ultrasound: To detect PCOS, ovarian cysts, or uterine abnormalities.
• MRI or CT scan: Recommended if pituitary problems are suspected.
• Genetic testing: Sometimes done for primary amenorrhoea to check for chromosomal causes.

Treatment Options for Amenorrhoea

If periods have stopped for natural reasons such as pregnancy, breastfeeding, or menopause, treatment is usually not required.

For other causes, treatment depends on the underlying issue and may include:

• Adjusting diet and exercise to support a healthy weight
• Stress management techniques
• Modifying exercise intensity or frequency
• Hormone-based medications, prescribed by your healthcare provider
• Surgery, in rare cases

Doctors may also recommend treatments to ease side effects linked to amenorrhoea, including:

• Oestrogen therapy for hot flashes or vaginal dryness
• Calcium and vitamin D supplements to maintain bone strength
• Strength or resistance training to improve muscle and bone health

Final Thoughts

Amenorrhoea may sound concerning, but in many cases it is treatable. Whether it’s primary (when periods never begin) or secondary (when periods stop after starting), early diagnosis is key.

In India, cultural taboos and social hesitation often prevent women from seeking medical help. But your health matters more than stigma. With timely medical advice, lifestyle adjustments, and appropriate treatment, it is often possible to restore regular periods and maintain overall well-being.

FAQs

Can you get pregnant if you have amenorrhoea?

Yes. Depending on the cause, pregnancy is still possible if ovulation continues.

How long can amenorrhoea last?

It may last a few months or even years, depending on lifestyle, medical, or natural factors.

What tests are done to diagnose amenorrhoea?

Pregnancy tests, hormone blood tests, ultrasounds, and sometimes MRI or genetic tests.

Is amenorrhoea the same as menopause?

No. Menopause is the natural, permanent end of periods, while amenorrhoea is a temporary absence that can often be treated.

Can amenorrhoea be cured naturally?

Yes, if it is caused by stress, poor diet, or lifestyle issues. Healthy changes can often restore cycles.

Can certain medicines cause amenorrhoea?

Yes. Some medicines, such as those for thyroid, blood pressure, or hormonal problems, may affect menstruation. Always consult your doctor if you notice this.

Can amenorrhoea be a sign of a serious condition?

Yes. Repeatedly missing periods, especially if accompanied by pain, discharge, or other unusual symptoms, may indicate an underlying condition. Seek medical advice in such cases.