Secondary Amenorrhea

What Is Secondary Amenorrhea?

Secondary amenorrhea is the absence of menstrual periods in a woman of reproductive age who previously had regular menstrual cycles. Where primary amenorrhea is an absence of menstrual periods beginning at an age when menses usually begins, secondary amenorrhea is a cessation of menses that has already begun.

Secondary amenorrhea has many potential causes, including lifestyle, diet, emotional stress, underlying medical conditions, hormonal imbalances, and/or use of certain medications. In some cases, the cause of secondary amenorrhea may be elusive.

What Are the Symptoms of Secondary Amenorrhea?

The primary symptom of secondary amenorrhea is the absence of menstrual cycles. Secondary amenorrhea may be accompanied by a variety of additional symptoms, such as weight gain or loss, acne, excessive body or facial hair, and/or swollen breasts.

What Causes Secondary Amenorrhea?

The cause of secondary amenorrhea can be simple or complex and vary from woman to woman. Some of the most common causes of secondary amenorrhea include:

  • Lifestyle: Stress, or an inadequate or excessive amount of exercise, can affect the body’s ability to produce hormones vital for menstruation.
  • Diet: An inadequate or excessive intake of food can trigger amenorrhea.
  • Hormonal imbalances: Hormonal imbalances can be caused by a variety of medical conditions such as polycystic ovary syndrome (PCOS) or thyroid dysfunction. Imbalances can also be caused by the use of certain medications.
  • Underlying medical conditions: Medical conditions such as diabetes, autoimmune disease, or pituitary tumors can interfere with normal hormone production.

Diagnosing Secondary Amenorrhea

A doctor will perform a physical exam and review a patient’s medical history, including past menstrual cycles, to begin the diagnosis of secondary amenorrhea. Blood or urine tests may be ordered to determine the presence of hormones that regulate the menstrual cycle, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). An imaging test such as an ultrasound may also be used to assess uterine size and texture and to confirm the presence or absence of a pregnancy.

Treating Secondary Amenorrhea

Treatment for secondary amenorrhea depends on the underlying cause. Lifestyle modifications, such as reducing stress, may be recommended for psychological causes. Medications to counter hormonal imbalances, such as birth control pills or insulin for diabetes, may be prescribed. In cases of underlying medical conditions, such as PCOS or autoimmune disease, medications to control symptoms or lifestyle modifications may be recommended.