Amenorrhea

( Absent periods, No periods)
Menstruation first occurs when girl reaches puberty from ages 9 to 16. The menstrual cycle is interrupted during pregnancy and breastfeeding, and stops after menopause or hysterectomy ( surgical removal of uterus). Absent periods are abnormal and will affect fertility. However, for some women, normal duration between menstrual periods may be more than 30 days.

Symptoms
* Menstrual periods never start.
* Interrupted periods, menstrual periods abruptly stops after previous regular periods.

Complications
* Inability to get pregnant.

Common causes
Primary amenorrhea ( no periods, menstrual periods never start):
* Delayed puberty
- Heredity factors
- Hormonal disorder
- Missing female sex chromosome, in rare cases.
* Congenital defects ( no uterus, or vagina from birth, imperforate hymen ).
* Severe illness in childhood.
Secondary amenorrhea ( interrupted periods ):
* After stopping oral contraceptive pills.
* Emotional stress ( anorexia, nervosa, depression).
* Strenuous physical activity.
* Hormonal disorders.
* Severe weight loss, starvation.
* Obesity.
* Disorder of the reproductive organs (e.g., tumors).
* Disease ( e.g., diabetic, chronic kidney disease).
* Certain medicines.

What you can do
* Consult a doctor if you have never menstruated by age 16 or have suddenly stopped menstruating for no reason.

What you doctor can do for you
* Rule out pregnancy.
* Determine the cause and treat it.
* Refer you to a psychiatrist or psychologist for therapy, if the cause is emotional or psycholgical in origin.