Amenorrhea is the absence of menstruation. Menstruation is a woman’s monthly period.

Primary amenorrhea is when a girl has not yet started her monthly periods, and she:

  • • Has gone through other normal changes that occur during puberty
  • • Is older than 15

Causes

Most girls begin menstruating between ages 9 and 18, with an average of around 12 years old. Primary amenorrhea typically occurs when a girl is older than 15, if she has gone through other normal changes that occur during puberty. Primary amenorrhea may occur with or without other signs of puberty.

Being born with incompletely formed genital or pelvic organs can lead to primary amenorrhea. Some of these defects include:

  • • Blockages or narrowing of the cervix
  • • Hymen that has no opening
  • • Missing uterus or vagina
  • • Vaginal septum (a partition that divides the vagina into two sections)

Hormones play a big role in a woman’s menstrual cycle. Hormone problems can occur when:

  • • Changes occur to the parts of the brain where hormones that help manage the menstrual cycle are produced
  • • The ovaries are not working correctly

Either of these problems may be due to:

  • • Anorexia (loss of appetite)
  • • Chronic or long-term illnesses, such as cystic fibrosis or heart disease
  • • Genetic defects or disorders
  • • Infections that occur in the womb or after birth
  • • Other birth defects
  • • Poor nutrition
  • • Tumors

In many cases, the cause of primary amenorrhea is not known.

Symptoms

A female with amenorrhea will have no menstrual flow. She may have other signs of puberty.

Exams and Tests

The doctor will perform a physical exam and ask questions about your medical history. A pregnancy test will be done. Blood test may be done as well.

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