Amenorrhea
Absence of menstrual periods outside of pregnancy, breastfeeding or menopause - a condition that needs evaluation to protect long-term reproductive and hormonal health.
Overview & Clinical Approach
Amenorrhea is the absence of menstrual periods in a woman during her reproductive years, apart from natural causes such as pregnancy, breastfeeding and menopause.
Menstruation is a natural monthly cycle that usually starts around the age of 12 and continues until about 50–51 years. During each cycle, the uterine lining builds up and is shed as menstrual bleeding if pregnancy does not occur.
Women normally do not get their periods during pregnancy, breastfeeding (lactational amenorrhoea) and after menopause. When periods are absent outside of these natural causes, the condition is known as amenorrhea.
Primary Amenorrhea occurs when a girl does not get her first period by age 16 with poorly developed secondary sexual characteristics. Secondary Amenorrhea occurs when a woman with previously regular cycles stops menstruating for 6 months.
Common Symptoms
- Absence of menstrual periods outside of pregnancy/menopause
- Lack of breast development in young girls (Primary Amenorrhea)
- Excess facial or body hair (hirsutism)
- Vaginal dryness
- Galactorrhoea: Milky discharge from nipples
Primary Causes & Risk Factors
- Hereditary factors and genetic disorders (e.g. Turner's syndrome) for primary amenorrhea
- Congenital Müllerian defects affecting uterine development
- Stress, depression, low BMI, eating disorders or heavy exercise for secondary amenorrhea
- Hypothyroidism, Asherman's syndrome, or prolactin-secreting pituitary tumours
- Stopping oral contraceptive pills or certain birth control methods
- Certain psychiatric medications or chronic long-term illnesses
Diagnostic Procedures
- Physical examination to assess secondary sexual characteristics and abnormalities
- Detailed medical history including menstrual pattern, weight changes, medications and stress levels
- Blood tests for thyroid, prolactin, FSH, LH and oestrogen levels
- Pelvic ultrasound to check for structural or anatomical issues; X-ray or imaging if needed
Treatment Steps
Hormonal Evaluation
Blood tests identify thyroid, prolactin or other endocrine causes behind the missed periods.
Hormone Replacement / Medication
Targeted medicines correct hormonal imbalances and treat identified endocrine disorders.
Lifestyle & Nutritional Correction
Stress management, adequate rest, proper diet and a moderate exercise regime address weight- or lifestyle-related causes.
Surgical Correction
Where structural abnormalities like Müllerian defects or Asherman's syndrome are found, surgery restores normal menstrual function where possible.
Key Treatment Benefits
- Hormonal & pelvic ultrasound screening for accurate diagnosis
- Thyroid & prolactin profile evaluation
- Individualised cycle restoration guidance and counselling
- Focus on long-term reproductive and bone health
- Experienced gynaecologists for adolescent & adult care
Consultation for Amenorrhea
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