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Secondary Amenorrhea

What is Secondary Amenorrhea?

Cessation of menstruation for at least 3 months in a woman who has previously menstruated.

Absence of menstrual periods for 3 or more months in a woman who has menstruated at least once.

Pregnancy (if the woman has had sexual intercourse).
Breast-feeding an infant.
Discontinuing use of birth-control pills.
Menopause (if the woman is over 35 and not pregnant).
Emotional stress or psychological disorder.
Surgical removal of the ovaries or uterus.
Disorder of the endocrine system, including the pituitary, hypothalamus, thyroid, parathyroid, adrenal and ovarian glands.
Diabetes mellitus.
Tuberculosis.
Obesity, anorexia nervosa or bulimia.
Strenuous program of physical exercise, such as longdistance running.

If your amenorrhea is caused by an underlying disease, such as tuberculosis, diabetes or anorexia nervosa, obtain treatment for the primary disorder.
If the cause of your amenorrhea is unknown, there are no specific preventive measures.
Maintain proper nutrition and body weight.

To aid in diagnosis, laboratory studies, such as a pregnancy test, blood studies of hormone levels and Pap smear are usually necessary. Surgical diagnostic procedures such as laparoscopy or hysteroscopy may be recommended.
Dilatation and curettage, often referred to as D & C (dilation of the cervix and a scraping out of the uterus with a curette) may be performed.
Treatment of underlying disorder if one is diagnosed.
Psychotherapy or counseling, if amenorrhea is related to stress.
Keep a record of menstrual cycles to aid in early detection of recurrent amenorrhea.

Therapeutic trial of progesterone and/or estrogen. If bleeding occurs after progesterone is withdrawn, the reproduction system is functional.
Other drugs to treat underlying disorder may be prescribed.

No restrictions.

Usually no special diet.
If overweight or underweight, a change in diet to correct the problem is recommended.

None expected if no serious underlying cause can be discovered.
May experience estrogen deficiency symptoms, such as hot flushes, vaginal dryness.
May affect fertility.

Amenorrhea is not a threat to health. Whether it can be corrected varies with the underlying cause:

If from pregnancy or breast-feeding, menstruation will resume when these conditions cease.
If from discontinuing use of oral contraceptives, periods should begin in 2 months to 2 years.
If from menopause, periods will become less frequent or may never resume. Hysterectomy also ends menstruation permanently.
If from endocrine disorders, hormone replacement usually causes periods to resume.
If from eating disorders, successful treatment of that disorder is necessary for menstruation to resume.
If from diabetes or tuberculosis, menstruation may never resume.
If from strenuous exercise, periods usually resume when exercise decreases.

You or a family member has symptoms of amenorrhea.
Periods don't resume in 6 months, despite treatment.
New, unexplained symptoms develop. Hormones used in treatment may produce side effects.