Amenorrhea

What is amenorrhea?

Amenorrhea (pronounced "a-men-or-RE-ah") means simply the absence of menstrual periods. There are two types of amenorrhea — primary and secondary:

  • Primary amenorrhea means that your daughter hasn’t had a period by age 15 or three years after starting breast development.
  • Secondary amenorrhea means that she has had a period before, but stops having them.

On its own, neither of these types of amenorrhea is a disease, but may be caused by  a hormone imbalance,  weight loss, excessive exercise, pregnancy, medications, stress and a myriad of other problems. This is why it’s important to encourage your daughter to see a health care professional if she’s stopped getting her periods, or is late in starting them.  

The most important thing is to figure out the cause of the late periods: 

  • She may be fine and just a little late with regulating her periods. 
  • She may a hormone imbalance called polycystic ovary syndrome and needs to be checked for cholesterol and diabetes.
  • She may have an ovary or thyroid problem and need hormones. 
  • Or she may have low estrogen levels from excessive exercise or low weight, and may be at risk for low bone mass.

Without enough estrogen, not only do menstrual cycles stop, but also the body is prevented from being able to absorb calcium to build strong bones.  This can result in low bone mass. Very little bone mass is added after you are 20 years old, which means that the teen years are very important for getting the right amount of bone for your lifetime.

Everyone, teen girls especially, needs the right balance of exercise, body weight, calcium intake, vitamin D, and estrogen levels to have healthy bones.

How we care for amenorrhea

The Adolescent and Young Adult Reproductive Endocrinology Program and Division of Gynecology at Boston Children’s Hospital recognize the special needs of adolescents, and create a place where they can receive expert care for amenorrhea.