St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Secondary amenorrhea

    Amenorrhea - secondary; No periods - secondary; Absent periods - secondary; Absent menses - secondary; Absence of periods - secondary

    Secondary amenorrhea occurs when a woman who has been having normal menstrual cycles stops getting her periods for 6 or more months.

    Women who are pregnant, breastfeeding, or in menopause are not considered to have secondary amenorrhea.

    Causes

    Women who are taking birth control pills or who receive hormone shots such as Depo-Provera may not have any monthly bleeding. When they stop taking these hormones, their periods may not return for more than 6 months.

    You are more likely to have amenorrhea if you:

    • Are obese
    • Exercisetoo muchand for long periods of time
    • Have very low body fat (less than 15% - 17%)
    • Have severe anxiety or emotional distress
    • Lose a lot of weight suddenly (such as withstrict or extremediets or after gastric bypass surgery)

    Other causes include:

    • Brain (pituitary) tumors
    • Chemotherapy drugs for cancer
    • Drugs used to treat schizophrenia or psychosis
    • Overactive thyroid gland
    • Polycystic ovarian syndrome
    • Reduced function of the ovaries

    Also, procedures such as a dilation and curettage (D and C) can lead to scar tissue formation that may cause a woman to stop menstruating. This is called Asherman syndrome. Scarring may also be caused by some severe pelvic infections.

    Symptoms

    In addition to having no menstrual periods, other symptoms can include:

    • Breast size changes
    • Weight gain or weight loss
    • Discharge from the breast (galactorrhea) or change in breast size
    • Increased hair growth in a "male" pattern (hirsutism) and acne
    • Vaginal dryness
    • Voice changes

    If amenorrhea is caused by a pituitary tumor, there may be other symptoms related to the tumor, such as vision loss and headache.

    Exams and Tests

    A physical exam and pelvic exam must be done to check for pregnancy. A pregnancy test will be done.

    Blood tests may be done to check hormone levels, including:

    • Estradiol levels
    • Follicle stimulating hormone (FSH level)
    • Luteinizing hormone (LH level)
    • Prolactin level
    • Serum hormone levels such as testosterone levels
    • Thyroid stimulating hormone (TSH)

    Other tests that may be performed include:

    • CT scan or MRI scan of the headto look for tumors
    • Biopsy of the lining of the uterus
    • Genetic testing
    • Ultrasound of the pelvis or hysterosonogram

    Treatment

    Treatment depends on the cause of the amenorrhea. Normal monthly periods usually return after the condition is treated.

    A lack of menstrual period due to obesity, vigorous exercise, or weight loss may respond toa change in exercise routine or weight control.

    Outlook (Prognosis)

    The outlook depends on the cause of amenorrhea.Many of the conditions that cause secondary amenorrhea will respond to treatment.

    When to Contact a Medical Professional

    Call for an appointment with your primary health care provider or women's health provider if you have missed more than one period so that you can get diagnosed and treated, if necessary.

    References

    Lobo RA. Primary and secondary amenorrhea and precocious puberty: etiology, diagnostic evaluation, management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 38.

    Bulun SE. The physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 17.

    BACK TO TOP

    • Secondary amenorrhea

      illustration

    • Normal uterine anatomy (...

      illustration

      • Secondary amenorrhea

        illustration

      • Normal uterine anatomy (...

        illustration

      A Closer Look

        Self Care

          Tests for Secondary amenorrhea

            Review Date: 5/31/2012

            Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
            adam.com

            A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


            Back  |  Top
            About Us
            Contact Us
            History
            Mission
            Locations & Directions
            Quality Reports
            Annual Reports
            Honors & Awards
            Community Health Needs
            Assessment

            Newsroom
            Services
            Brain & Spine
            Cancer
            Heart
            Maternity
            Orthopedics
            Pulmonary
            Sleep Medicine
            Urgent Care
            Women's Services
            All Services
            Patients & Visitors
            Locations & Directions
            Find a Physician
            Tour St. Luke's
            Patient & Visitor Information
            Contact Us
            Payment Options
            Financial Assistance
            Send a Card
            Mammogram Appointments
            Health Tools
            My Personal Health
            mystlukes
            Spirit of Women
            Health Information & Tools
            Clinical Trials
            Health Risk Assessments
            Employer Programs -
            Passport to Wellness

            Classes & Events
            Classes & Events
            Spirit of Women
            Donate & Volunteer
            Giving Opportunities
            Volunteer
            Physicians & Employees
            For Physicians
            Remote Access
            Medical Residency Information
            Pharmacy Residency Information
            Physician CPOE Training
            Careers
            Careers
            St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
            Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile