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Absent Periods

(Absent Menses; Amenorrhea)

Definition

Menstruation, or a menstrual period, refers to the monthly process in which the uterus sheds blood and tissue because pregnancy did not occur.
Not having or missing a menstrual period is called amenorrhea. This condition is divided into 2 types:
Menstrual Flow
Menstrual Flow
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Causes

The most common cause of secondary amenorrhea is pregnancy. In non-pregnant women, it may be due to a variety of factors.

Risk Factors

Factors that may increase the risk of amenorrhea include:

Symptoms

The main symptom for primary amenorrhea is the absence of a menstrual period in a female by age 16 or older. The main symptom for secondary amenorrhea is 3 or more missed periods in a row in a woman who has previously had menstrual periods.

When Should I Call My Doctor?

Call your doctor if you:
  • Have not had your first period and are aged 16 years or older
  • Miss having your period

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment will depend on what is causing amennorrhea. Examples include:

Prevention

Amenorrhea may or may not be preventable, depending on the cause. Follow these general guidelines to prevent amenorrhea:

RESOURCES

The American Congress of Obstetricians and Gynecologists http://www.acog.org

Women's Health—US Department of Health and Human Services http://www.womenshealth.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

References

Amenorrhea. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 10, 2014. Accessed October 7, 2015.

Amenorrhea. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/amenorrhea.html. Updated February 2014. Accessed October 7, 2015.

Current evaluation of amenorrhea. American Society for Reproductive Medicine website. Available at: http://www.asrm.org/uploadedFiles/ASRM%5FContent/News%5Fand%5FPublications/Practice%5FGuidelines/Educational%5FBulletins/Current%5Fevaluation(1).pdf. Published 2008. Accessed October 7, 2015.

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