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):

• Medications may shrink certain types of tumors.
• 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.

If the amenorrhea is due to low weight because of anorexia or too much exercise, periods will often begin when the weight returns to normal or the exercise level is decreased.

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 chance that it can be corrected with medication, lifestyle changes, or surgery:

• Adrenogenital syndrome
• Chronic illness
• Congenital heart disease
• Drastic weight reduction
• Hypogonadotropic hypogonadism
• Imperforate hymen or vaginal septum
• Malnutrition
• Normal delay of onset (up to age 14 or 15)
• Obesity
• Overactive thyroid

Periods are unlikely to start on their own if the amenorrhea was caused by one of the following conditions:

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

If the amenorrhea cannot be corrected, it is sometimes possible to create a menstrual-like situation (pseudomenstruation) with medications. Medicines can help you feel more like your friends or family, and will also protect the bones from becoming too thin (osteoporosis).

Complications:

• Emotional distress due to feeling different from friends or family, or worrying you might not be able to have children
• Osteoporosis and increased risk of fractures

Calling your health care provider:

Call your health provider if your daughter is older than age 16 and has not yet begun menstruating, or if she is 14 and shows no other signs of puberty.