TeenHealthFX - Answers - Amenorrhea

Females: Your Period / Question
Published: July 31, 2009

Dear TeenHealthFX,

I am 15 years old and pretty sure that I have amenorrhea. I am in ballet and recently lost 10 pounds. I have not had a period in several months, and I know that it's a result of the weight loss, however, I don't know what to do about it. I am not planning to lose any more weight and I am not underweight ( 5'2 and 110 lbs), so will my body eventually adjust to the new weight and continue normal cycles again? I really don't want to gain weight just to have a period. It's not like I am unhealthy, I eat very well, so should I just wait for my period?

Signed: Amenorrhea - What Do I Do?

Dear Amenorrhea - What Do I Do?,

For our readers who may not know, amenorrhea refers to the absence of menstruation. Primary amenorrhea refers to never starting menstruation and being over 16 years old; secondary amenorrhea occurs when you were previously menstruating, but then stopped having periods for 3-6 months or longer.

Given that you had been menstruating, but have not had your period for several months, it sounds like you are experiencing secondary amenorrhea. There are many possible causes of secondary amenorrhea, one of which could be the rigorous exercise regimen you must have with your ballet. However, it is important to meet with a doctor so that he/she can determine the exact cause of your amenorrhea and can devise an effective treatment plan based on that cause. FX does not suggest that you wait around and see what happens with your period as untreated amenorrhea can have serious consequences such as infertility, osteoporosis, and cardiovascular disease.

If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-6475 for an appointment or contact your local teen health center or Planned Parenthood. You can also contact your insurance company for a list of in-network providers.

For more information on Amenorrhea, please read below:

Causes of Secondary Amenorrhea:

· Pregnancy: This is one of the most common causes of amenorrhea in women who are healthy and sexually active.

· Contraceptives: Some women find that while they are taking birth control pills, or for a few months after stopping birth control pills, they do not have their periods.

· Breast-feeding: It is common for mothers who breast-feed to experience amenorrhea for many months. However, nursing mothers should know that it is still possible to get pregnant during this time.

· Stress: Mental stress can temporarily alter the functioning of the hypothalamus, an area of the brain that controls the hormones that regulate your menstrual cycle – so ovulation and menstruation can stop as a result.

· Medication: Some anti-depressants, anti-psychotics, and chemotherapy drugs can contribute to amenorrhea.

· Hormonal imbalance: Polycystic ovary syndrome (PCOS) can cause high and sustained levels of estrogen and androgen, rather than the fluctuating levels seen in the normal menstrual cycle. This results in a decrease of pituitary hormones that can lead to ovulation and menstruation stopping.

· Low body weight: Excessively low body weight interrupts the hormonal balance in the body, thus interfering with menstruation. Many girls and women suffering from eating disorders, such as anorexia and bulimia, deal with amenorrhea.

· Excessive exercise: Athletes such as ballet dancers, long-distance runners, or gymnasts often experience amenorrhea. The stress, low-body fat, and high energy expenditure can all contribute to stop menstruation.

· Thyroid malfunction: An underactive thyroid can often affect menstruation

· Pituitary tumor: A benign (noncancerous) tumor in the pituitary gland that can cause an overproduction of prolactin, which can interfere with menstruation.

· Uterine scarring: Scar tissue that builds up in the lining of the uterus, very often as a result of some type of uterine medical procedure

· Primary ovarian insufficiency: Ovarian supply of eggs diminishes before the age of 40

When To See A Doctor Related For Primary or Secondary Amenorrhea:

· You’ve never had a menstrual period and are 16 or older.

· You’ve previously menstruated, but have missed three or more periods in a row.

Treating Amenorrhea

Treatment depends on what is causing the amenorrhea. Lifestyle changes may be indicated if the cause if related to weight loss, stress levels of physical activity. Oral contraceptives may be prescribed if you have PCOS or hypothalamic amenorrhea. Amenorrhea caused by thyroid or pituitary disorders may also be treated with prescription medications.

Lifestyle and Home Remedies

Your doctor may discuss with you certain lifestyle changes that will help your period to resume its normal cycle. Ways to maintain a healthy lifestyle that your doctor may discuss with you might include:

· Making changes in your diet and activity level that allow you to maintain a healthy weight.

· Creating a healthy balance in work/schoolwork, exercise, recreation and rest.

· Healthier methods of decreasing stress and conflict in your life.

· Keeping a calendar before and after your doctor appointments to track any changes in your cycle. You should record the date your period starts, how long it lasts, and whether it was accompanied by any problematic symptoms.

Possible Consequences of Not Treating Amenorrhea

Amenorrhea is a condition that should be taken seriously and should be addressed as soon as possible with a medical health professional. Untreated amenorrhea is associated with significant long-term morbidity, especially in young women. Early recognition and treatment will significantly minimize complications later in life.

The consequences of untreated amenorrhea can include:

· Infertility

· Decreased bone mineral density or osteoporosis

· Cardiovascular disease

· Failure to go through puberty (if the disorder arises early in life)

General Recommendations As To When To See A Healthcare Provider Regarding Your Period (per Planned Parenthood)

See a medical care provider if you:

· bleed much longer than usual

· bleed much heavier than usual

· do not start menstruating by 16

· have severe pain during or before your period

· have unusual bleeding between periods

· suddenly feel sick or get a fever when using tampons

· use more than one pad or tampon every 2 hours

· your period or PMS keeps you from doing what you would normally do

· your period stops or suddenly becomes irregular

Signed: TeenHealthFX