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Amenorrhea is the absence of menstrual periods. Primary amenorrhea refers to when a girl has not started her period within three years of breast development or has not experienced a period by age 15. Secondary amenorrhea is defined as no menstrual period for three cycles after already having monthly menstrual periods, or no menstruation for six months if a girl was already experiencing irregular menstrual cycles.
Absent periods can cause stress and confusion for young girls and their families. Children's Hospital Colorado provides the medical expertise in pediatric and adolescent gynecology to ease your stress.
Many factors can cause amenorrhea. In girls who have never had a period before, it is important to make sure that the female reproductive structures are normal. A blockage or absence of any part of the vagina or uterus can prevent the onset of periods.
Other amenorrhea causes include weight gain or loss, physical and emotional stress, highly competitive athletics, endocrine conditions such as polycystic ovarian syndrome (PCOS), high prolactin level, adrenal problems, thyroid conditions and chronic medical concerns like diabetes and celiac disease. Primary ovarian insufficiency, a condition that causes the ovaries to work abnormally, is another cause of amenorrhea.
Amenorrhea occurs for many different reasons and has many potential risk factors. Common risk factors include:
If you would like to learn more about amenorrhea, visit:
The two primary signs of amenorrhea are:
Other signs and symptoms depend on the cause of amenorrhea, and include:
Diagnosis starts with a careful medical history, a physical exam and lab tests to detect any potential underlying hormone issues. In some cases, a pelvic exam and/or ultrasound is necessary.
Our care team will determine the best approach for each patient.
Determining the underlying cause of absent periods is important, and our team works to do just that. The most important aspects of a correct amenorrhea diagnosis are a detailed medical history, basic physical exam and lab testing.
Our care team will ask a number of questions relating to common amenorrhea symptoms such as menstrual cycles, weight loss and family medical history. A physical exam will include comparing weight and height to growth charts and checking other developmental markers. Lab tests are typically used to detect pregnancy or particular hormones. When necessary, we will perform an X-ray to establish bone age or a pelvic ultrasound to evaluate the uterus and ovaries.
If your daughter has never had a period before, it is important to look at the outside of the vagina. A complete, internal pelvic exam is not typically necessary.
Amenorrhea treatment varies depending on its cause. Our multidisciplinary care team works together to determine the best treatment plan for your family. Potential treatment approaches are listed below:
Our gynecologists are part of the Polycystic Ovarian Syndrome Clinic at Children's Colorado, which is the only clinic of its kind in the Rocky Mountain region. Specialists at this clinic include endocrinologists, gynecologists, dermatologists, psychologists and lifestyle experts. We coordinate with this team on any issue affecting menstrual concerns.
We understand that amenorrhea typically occurs at a time when girls are experiencing a lot of change and can be very stressful. Our board-certified pediatric and adolescent gynecologists have the specialized training and experience in reproductive health issues to put your family at ease. We will carefully explain amenorrhea, discuss the various options for treatment and support your family with follow-up visits and consultation with our colleagues in other specialties as needed.
We work with a multidisciplinary team to ensure your daughter is receiving the best care for her particular symptoms. Absent menstruation in girls and adolescents is unique to this particular age, so you want a care team that specializes in child and adolescent care. You will find that specialization at Children's Colorado.