Amenorrhea - primary

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Primary amenorrhea

Normal uterine anatomy (cut section)

Amenorrhea - primary

Alternative Names:

Primary amenorrhea; No periods; Absent periods; Absent menses
Treatment:

Treatment depends on the cause of the amenorrhea. Primary amenorrhea caused by developmental abnormalities (which may result when the parts of the female reproductive system did not form properly before birth) may require hormonal supplementation, surgery, or both.

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Pituitary tumors, located in the brain, are usually treated with bromocriptine, a drug that inhibits the abnormally high prolactin secretion caused by these tumors. Surgical removal may also be necessary. Radiation therapy is usually reserved for situations in which other medical or surgical treatment regimens are not successful.

In any case, support and counseling for the patient and family is necessary. This will address specific concerns and provide guidance regarding anticipated sexual development.

For women who do not have other reproductive abnormalities, work up for amenorrhea is delayed until after age 16.

If the condition is caused by 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.