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Amenorrhea - primary - Overview

Alternative Names

Primary amenorrhea; No periods; Absent periods; Absent menses

Definition of Amenorrhea - primary:

Amenorrhea is the absence of menstruation. Primary amenorrhea is not considered to have occurred until a girl is beyond age 16, if she has undergone other normal changes that occur during puberty.

Causes, incidence, and risk factors:

Most girls begin menstruating between ages 9 and 18, with an average around 12 years old. Primary amenorrhea is not considered to have occurred until a girl is beyond age 16, if she has undergone other normal changes that occur during puberty. Primary amenorrhea may occur with or without other signs of puberty.

There are many possible causes of primary amenorrhea:

Adrenogenital syndrome
Chromosomal abnormalities such as Turner syndrome or Sawyer syndrome
Congenital heart disease (cyanotic)
Congenital adrenal hyperplasia
Craniopharyngioma
Chronic (long term) illnesses
Cushing's disease
Cystic fibrosis
Extreme weight loss
Genital abnormalities present since birth (absence of the uterus or vagina, vaginal septum, cervical stenosis, imperforate hymen)
Gonadal dysgenesis
Hypoglycemia
Hypothyroidism and hyperthyroidism
Hypogonadotropic hypogonadism
Hyperprolactinemia
Malnutrition
Obesity
Prader-Willi syndrome
Pregnancy
Polycystic ovarian disease
Testicular feminization
True hermaphroditism
Tumors of the pituitary or adrenal glands
Tumors of the ovaries

Primary amenorrhea

Normal uterine anatomy (cut section)

Reviewed last on: 6/26/2008
Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lobo RA. Abnormal Uterine Bleeding: Ovulatory and Anovulatory Dysfunctional Uterine Bleeding, Management of Acute and Chronic Excessive Bleeding. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 37.

Master-Hunter T. Amenorrhea: Evaluation and Treatment. Am Fam Physician. Apr. 2006; 73(8): 1374-82.

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