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Amenorrhea - primary

• Overview
• Symptoms
• Treatment

Alternative Names:

Primary amenorrhea; No periods; Absent periods; Absent menses

Treatment:

Treatment depends on the cause of the missing period. Primary amenorrhea caused by birth defects may require medications (hormones), surgery, or both.

If the amenorrhea is caused by a tumor in the brain ( pituitary tumor ), the tumor is usually treated with a drug called bromocriptine. Surgery to remove the tumor may also be necessary. Radiation therapy is usually only performed when other treatments have not worked.

If the condition is caused by a body-wide (systemic) disease, treatment of the disease may allow menstruation to begin.

Expectations (prognosis):

Overall the outlook is good, depending on the cause of the amenorrhea. If the amenorrhea is caused by one of the following conditions, there is a good possibility of correcting the amenorrhea through medication, lifestyle change, or surgery:

• Normal delay of onset (up to age 14 or 15)
• Drastic weight reduction (resulting from poverty or fad dieting)
• Hypoglycemia
• Extreme obesity
• Hypogonadotropic hypogonadism
• Chronic illness
• Malnutrition
• Congenital heart disease (cyanotic)
• Hyperthyroidism
• Imperforate hymen
• Adrenogenital syndrome

If the amenorrhea is caused by one of the following conditions, it is unlikely that the amenorrhea can be corrected by any method:

• Congenital abnormalities of the genital system
• Gonadal dysgenesis
• Turner's syndrome (XO)
• Testicular feminization syndrome
• True hermaphroditism
• Cystic fibrosis
• Craniopharyngioma
• Prader-Willi syndrome

If the amenorrhea cannot be corrected, it is sometimes possible to create a pseudomenstruation with medications to help the young woman feel more like her friends or family.

Complications:

Emotional distress or crisis about being different from friends or family can occur.

Calling your health care provider:

Call your health provider if your daughter is older than age 16 and has not yet begun menstruating.

References:

Stenchever A. Comprehensive Gynecology . 4th ed. St. Louis, Mo: Mosby; 2001:1109-1119.

Rakel P, ed. Conn ’s Current Therapy 2005 . 57th ed. Philadelphia, Pa: WB Saunders; 2005:1291-1293.

• Review Date: 5/10/2006
• Reviewed By: Melanie N. Smith, M.D., Ph.D., Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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