No Menstrual Period (Amenorrhea)

Definition

Amenorrhea is the medical term for the absence of menstruation. There are two types of amenorrhea, primary and secondary. Primary amenorrhea refers to delayed menarche (the first menstrual period) and is defined as any one of three conditions:

• the absence of menarche by age 16 in a girl with otherwise normal pubertal development (development of breasts and/or pubic hair)
• the absence of menarche by age 14 combined with delayed pubertal development
• the absence of menarche two years after puberty is otherwise completed

Secondary amenorrhea is defined as the absence of menstruation after menarche has taken place. Although it is not uncommon for a girl's menstrual periods to be irregular during early adolescence, most girls' periods usually become regular within 18 months after the first one. After that time, it is considered abnormal for an adolescent to miss three consecutive periods.

Symptoms

Amenorrhea may be associated with the symptoms of other disorders; for example, girls with an eating disorder will often have eroded tooth enamel, tiny pinpoint hemorrhages around the eyes, an abnormal heart rhythm, low blood pressure, and other signs of frequent vomiting. Girls whose amenorrhea is part of the female athlete triad may have a record of bone fractures or other evidence of bone mineral loss. Hot flashes and night sweats may indicate premature ovarian failure. Headaches or visual disturbances may suggest a brain tumor.