What is Secondary Amenorrhea

Secondary amenorrhea occurs when a female who was previously having menstrual periods has not had them for 3–6 months. A menstrual period is the monthly shedding of the lining of the uterus.

Menstruation involves the passing of blood, tissue, fluid, and mucus through the vagina. The flow of blood usually occurs during 3–7 consecutive days each month.

This condition has many causes. In many cases, treating the underlying cause will return menstrual periods back to a normal cycle.

What are the causes?

The most common cause of this condition is pregnancy. Other causes include:

• Malnutrition.
• Cirrhosis of the liver.
• Conditions of the blood.
• Diabetes.
• Epilepsy.
• Chronic kidney disease.
• Polycystic ovary disease.
• Stress or anxiety.
• A hormonal imbalance.
• Ovarian failure.
• Medicines.
• Extreme obesity.
• Cystic fibrosis.
• Low body weight or drastic weight loss.
• Early menopause.
• Removal of the ovaries or uterus.
• Contraceptive pills, patches, or vaginal rings.
• Cushing syndrome.
• Thyroid problems.

What increases the risk?

You are more likely to develop this condition if:

• You have a family history of this condition.
• You have an eating disorder.
• You do extreme athletic training.
• You have a chronic disease.
• You abuse substances such as alcohol or cigarettes.

What are the signs or symptoms?

The main symptom of this condition is a lack of menstrual periods for 3–6 months.

How is this diagnosed?

This condition may be diagnosed based on:

• Your medical history.
• A physical exam.
• A pelvic exam to check for problems with your reproductive organs.
• A procedure to examine the uterus.
• A measurement of your body mass index (BMI).
• Tests, such as:
  • Blood tests that measure certain hormones in your body and rule out pregnancy.
  • Urine tests.
  • Imaging tests, such as an ultrasound, CT scan, or MRI.

How is this treated?

Treatment for this condition depends on the cause of the amenorrhea. It may involve:

• Correcting dietary problems.
• Treating underlying conditions.
• Medicines.
• Lifestyle changes.
• Surgery.

If the condition cannot be corrected, it is sometimes possible to trigger menstrual periods with medicines.

Follow these instructions at home:

Lifestyle

• Maintain a healthy diet. Ask to meet with a registered dietitian for nutrition counseling and meal planning.
• Maintain a healthy weight. Talk to your health care provider before trying any new diet or exercise plan.
• Exercise at least 30 minutes 5 or more days each week. Exercising includes brisk walking, yard work, biking, running, swimming, and team sports like basketball and soccer. Ask your health care provider which exercises are safe for you.
• Get enough sleep. Plan your sleep time to allow for 7–9 hours of sleep each night.
• Learn to manage stress. Explore relaxation techniques such as meditation, journaling, yoga, or tai chi.

General instructions

• Be aware of changes in your menstrual cycle. Keep a record of when you have your menstrual period. Note the date your period starts, how long it lasts, and any problems you experience.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your periods do not return to normal after treatment.

Summary

• Secondary amenorrhea is when a female who was previously having menstrual periods has not gotten her period for 3–6 months.
• This condition has many causes. In many cases, treating the underlying cause will return menstrual periods back to a normal cycle.
• Talk to your health care provider if your periods do not return to normal after treatment.