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

What causes missed periods?

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

Without enough estrogen, not only do menstrual cycles stop, but the body does not absorb enough calcium to build strong bones. This can result in low bone mass. Since very little bone mass is added after women are 20 years old, the teen years are very important for building the right amount of bone for a lifetime.

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

What are the symptoms of amenorrhea?

Amenorrhea is a symptom — missing periods. Depending on what’s causing your daughter’s amenorrhea, she may have other symptoms, too, including excess hair growth, acne, headaches, and pain.

What causes amenorrhea?

Amenorrhea can have many different causes — that’s why it’s so important that a teen girl with amenorrhea be checked out by an expert. Some of the causes of primary and secondary amenorrhea overlap, and some are completely different. Some common causes include:

How we care for amenorrhea

The Division of Gynecology and the Reproductive Endocrinology and Polycystic Ovary Syndrome (PCOS) Program at Boston Children’s Hospital recognize the special needs of adolescents and creates a place where they can receive expert care for amenorrhea.