Amenorrhea - primary

Alternative names:

absent menses; absent periods; no periods; primary amenorrhea

Treatment:

Treatment depends on the cause of the amenorrhea.
Pituitary tumors are usually treated with bromocriptine, a drug that inhibits prolactin secretion. Surgery removal may also be suggested. Radiation therapy is usually reserved for situations where other medical or surgical treatment regimens are not successful.

Young women with primary amenorrhea, found to be caused by developmental abnormalities, may require hormonal supplementation, surgery, or both. In any case, psychosocial support and counseling for the patient and family is necessary to address specific concerns and provide guidance regarding anticipated sexual development. If the problem causing the amenorrhea is not correctable, than the patient and health care provider should consider the possibility of creating pseudo-menstruations. This is a menstrual period that is caused by hormonal treatment rather than natural causes.

For amenorrhea caused by normal delay of menstruation onset, have patience until age 16.

Expectations (prognosis):

Overall the prognosis 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 intervention:

• congenital abnormalities of the genital system
• gonadal dysgenesis
• Turner's syndrome (XO)
• testicular feminization syndrome
• true hermaphroditism
• cystic fibrosis
• craniopharyngioma
• Prader-Willi syndrome

Note: If the amenorrhea cannot be corrected, as long as there is a uterus, it may be possible to create a pseudo-menstruation with medications to help the young woman feel more like her friends and/or family.

Complications:

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

Calling your health care provider:

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