©2018 WebMD, Inc. All rights reserved. eMedicineHealth does not provide medical advice, diagnosis or treatment. See Additional Information.

Symptoms and Signs of Amenorrhea

Doctor's Notes on Amenorrhea

Amenorrhea is the absence of menstruation. It may be considered primary or secondary. Primary amenorrhea describes when a female has not developed menstrual periods. Secondary amenorrhea is the absence of menstrual periods in a woman who had been menstruating but later stops menstruating for three or more months in the absence of pregnancy, lactation, cycle suppression with hormonal contraceptive (birth control) pills, or menopause.

Amenorrhea is a symptom of an underlying condition rather than a disorder in and of itself. Symptoms that may accompany amenorrhea include galactorrhea (breast milk production in a woman who is not pregnant or breastfeeding), headache, or reduced peripheral vision can be a sign of an intracranial tumor. If increase hair growth in a “male pattern” accompanies amenorrhea this may be due to excess androgen (a male hormone). Symptoms such as vaginal dryness, hot flashes, night sweats, or disordered sleep that accompany amenorrhea may be a sign of ovarian insufficiency or premature ovarian failure. Anxiety may be associated with amenorrhea in women with psychiatric illness. Weight gain or weight loss may also occur.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Amenorrhea Symptoms

Amenorrhea is a symptom of an underlying disorder rather than a condition in and of itself. Additional symptoms may be present depending on the associated condition.

  • Galactorrhea (breasts produce milk in a woman who is not pregnant or breastfeeding), headache, or reduced peripheral vision can be a sign of an intracranial tumor.
  • Increased hair growth in a male pattern (hirsutism) may be caused by excess androgen (a hormone that encourages development of male sex characteristics).
  • Vaginal dryness, hot flashes, night sweats, or disordered sleep may be a sign of ovarian insufficiency or premature ovarian failure.
  • Noticeable weight gain or weight loss may be present.
  • Excessive anxiety may be present in women with associated psychiatric abnormalities.

Amenorrhea Causes

Amenorrhea can result because of an abnormality in the hypothalamic-pituitary-ovarian axis, anatomical abnormalities of the genital tract, or functional causes.

Hypothalamic causes

  • Craniopharyngioma (a brain tumor near the pituitary gland)
  • Kallmann syndrome (deficiency of gonadotropins, which are hormones capable of promoting growth and function of reproductive organs)
  • Nutritional deficiency
  • Low body weight or growth delay

Pituitary causes

  • Prolactinemia (high blood levels of prolactin, a hormone that stimulates secretion of milk from the breasts during breastfeeding) - possibly caused by prolactinoma (a tumor of the pituitary gland secreting the hormone prolactin)
  • Disorders related to other pituitary tumors (for example, Cushing syndrome, acromegaly, or thyroid-stimulating hormone)
  • Postpartum pituitary necrosis (death of pituitary cells after a woman delivers a baby)
  • Autoimmune hypophysitis (cells of the pituitary gland destroyed by the body’s own defense system)
  • Craniopharyngioma (a tumor within the pituitary gland)
  • Pituitary radiation
  • Sarcoidosis (a generalized disease which may affect the pituitary)

Ovarian causes

  • Anovulation (lack of the release of an egg)
  • Hyperandrogenemia (high blood levels of male hormones)
  • Polycystic ovary syndrome (hormonal disorder affecting women of reproductive age)
  • Premature ovarian failure
  • Turner syndrome (a genetic disorder characterized by underdeveloped ovaries, failure to menstrate, and short stature)
  • Pure gonadal dysgenesis (defective development of the ovary)
  • Autoimmune oophoritis (cells of the ovaries destroyed by the body’s own defense system)
  • Fragile X premutation
  • Radiation or chemotherapy
  • Galactosemia (an inherited disorder in which galactose, a type of sugar, accumulates in the blood)
  • Anatomical abnormalities of the genital tract
  • Intrauterine adhesions
  • Imperforate hymen (a hymen in which there is no opening, the membrane completely closes off the vagina)
  • Transverse vaginal septum (a dividing wall or membrane in the vagina)
  • Aplasia (absence of an organ or tissue) of the vagina, the cervix, or the uterus

Functional causes

Eating Disorders Anorexia, Bulimia, Binge Eating Slideshow

Eating Disorders Anorexia, Bulimia, Binge Eating Slideshow

Eating disorders are illnesses characterized by unhealthy behaviors associated with food or eating, such as starving, overeating, or binging.


Types of Eating Disorders

  • Binge eating
  • Anorexia nervosa
  • Bulimia nervosa
  • Night eating syndrome
  • Pica
  • Rumination disorder
Without treatment, many of these conditions can lead to serious health risks.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

CONTINUE SCROLLING FOR RELATED SLIDESHOW