What is secondary amenorrhea?

By Teen Health Source

Amenorrhea (pronounced uh-men-o-REE-uh)  refers to the lack of periods or menstruation. There are a few types of amenorrhea, the first is primary amenorrhea which refers to someone not menstruating by the age of 15, and another called secondary amenorrhea which is what we’ll be talking about here.

Secondary amenorrhea is when someone has previously menstruated (gotten their period) but has missed 3 or more periods in a row. Periods are mostly controlled by hormones and any significant hormonal changes can cause them to increase, decrease, or stop completely.

Our hormones can be affected by all sorts of things ranging from our diet, to our stress levels, to what medications we take, and even certain medical conditions. This post will talk about some of the more common causes, and what sort of symptoms to look out for. 

Symptoms

Although everyone experiences symptoms differently, and many symptoms of amenorrhea can be caused by other issues, some common ones to look out for are:

• vaginal dryness
• hair loss
• headaches
• changes in vision
• nipple discharge
• pelvic pain
• hot flashes
• acne (especially a dramatic increase in a short period of time)
• excess body hair

What causes secondary amenorrhea?

• Certain things can be expected to cause amenorrhea over the course of someone’s like like pregnancy, lactation, or menopause. 
• Other causes of secondary amenorrhea are related to unusual hormonal changes brought on by:
  • Birth control (hormonal IUD, progestin-only pill, or depo provera)
  • Medications 
  • Malnutrition (including eating disorders)
  • Rapid weight gain or weight loss 
  • Stress
  • Excessive exercise 
  • Polycystic ovary syndrome 
  • Glandular issues 
  • Damage to the endometrium (the lining shed during a period) preventing it from growing

It’s also possible for periods to stop due to a structural issue like a blockage of the pathway menstrual blood exits through. These are usually because of genital tract defects like an imperforate hymen (a hymen with no opening) or vaginal septum (a barrier that separates the vagina into two canals)

How do you treat secondary amenorrhea?

What to do depends on the underlying cause. In most cases, it’s recommended to see a clinician so they can figure out the issue. First, they will likely rule out pregnancy, then, clinicians will gather as much of your medical history as necessary and conduct a thorough physical examination (blood tests, pelvic exam, MRI, etc.)

Depending on the cause they find, clinicians may provide birth control pills or other hormonal medication to reset the menstrual cycle, or prescribe other medications to rebalance your hormones.

Further Reading

• Teen Health Source – Period Basics
• Healthline – Secondary Amenorrhea
• Mayo Clinic – Amenorrhea

If you have questions about this topic, feel free to contact one of our peer educators. [Link]

Last Updated: October 2023