Amenorrhea: What Does it Mean When I Miss My Period?

Amenorrhea is almost a taboo subject, because no one wants to be the first to admit something might be wrong down there. In fact, we're practically taught that periods are mysterious things that cause trauma and often get out of whack for no apparent reason. The cultural myths we've created surrounding menstruation often keep women from accessing important information about how our bodies function. If you've missed periods, there's a cause. If you've missed three in a row, you have what's called amenorrhea.

What is Amenorrhea?

There are two types of amenorrhea: primary and secondary. Primary amenorrhea refers to a woman over the age of sixteen who has not yet had a menstrual period. Secondary amenorrhea refers to a woman who has had periods in the past but has not menstruated for three months in a row. For secondary amenorrhea to be considered problematic, the woman must not be pregnant or menopausal.

What Causes Amenorrhea?

Primary amenorrhea happens very infrequently in Western women, and is usually a result of an abnormal physiology or severe malnutrition. This means that when Western women experience amenorrhea, it is because they were born without an organ (i.e. a uterus) crucial to menstruation, purposeful starvation (i.e. anorexia), or dehabilitating childhood poverty (i.e. no food). Primary amenorrhea occurs more frequently in the developing world, where starvation and severe malnourishment are still serious threats to many peoples.

It is much more difficult to diagnose causes of secondary amenorrhea, which is the more common of the two. About one percent of women experience secondary amenorrhea at some point in their lives, but diagnosis of the cause is still something medical professionals struggle with. This is probably because some of the causes are lifestyle induced, while the others are medically based.

Extreme psychological and lifestyle factors figure pretty heavily into whether or not a woman menstruates regularly. Gaining or losing a significant amount of weight can make a woman stop menstruating, particularly if weight loss is accompanied by anorexia. A serious, prolonged illness will sometimes stop a woman's menstrual cycle, even if the illness is not glandular or reproductive in nature. Depression, shock, drug use, and vigorous exercise will prevent a woman from menstruating if sustained for a long period of time. Many female athletes when training for events like the Olympics will stop menstruating. Other lifestyle factors include breastfeeding a new baby, and discontinuing the use of hormonal birth control.

Of course, amenorrhea is often caused by purely medical conditions as well. Problems with the hypothalamus or pituitary gland can cause secondary amenorrhea, because both release regulatory hormones into the bloodstream. Discharge from the nipples indicates an overabundance of the hormone prolactin, which may occur if you are taking a prescription for a psychological disorder. Your doctor will also want to make sure your thyroid and adrenal glands are functioning properly, as both need to be in balance for a normal menstrual cycle.

It goes without saying that amenorrhea also could mean something has gone wrong within your reproductive system. Sometimes amenorrhea can indicate premature failure of the ovaries. In this case, the amenorrhea will be experienced with other symptoms of menopause like hot flashes and decreased libido. If you have had any procedure done that involves your uterus, particularly after giving birth, that may also cause amenorrhea.

By far and away, though, most women who find themselves experiencing amenorrhea are pregnant.

I'm Experiencing Amenorrhea. What Do I Do Now?

If you are sixteen years old and have not yet menstruated, or have previously menstruated but have not had a period for three consecutive months, you need to see a doctor. Make an appointment to see your gynecologist or at a local clinic like Planned Parenthood. You will probably be given a pregnancy test to rule that out as a possible cause. Before you go, write down everything you know about your menstrual cycle, including the date of your last period and the amount and duration of menstruation. If possible, find out if anyone in your family has a history of secondary amenorrhea and what caused it. Also, keep track of any other symptoms you may have, even if they seem completely unrelated. The more information you can give your doctor, the more quickly she will be able to find a cause.

What Else Can I Do to Help?

Anything you do to help get your period back on track should not take the place of a doctor visit. While you wait for your appointment, though, there are some steps you can take that may make a difference.

Make sure you are eating properly. Limit your caffeine, nicotine, and alcohol intakes. Get enough sleep, eat properly, and exercise a bit. These are all things you know you should be doing anyway for your general well being, but if you're not, now you've got a reason to start. If you suspect your problem may be more psychological that medical, make an appointment to see a counselor, and talk to people you trust about your feelings in the meantime.

As far as herbal remedies go, fennel is often used to treat menstrual irregularity, and may help kick-start your period. I can't emphasize enough, though, that even if you start menstruating before your doctor's appointment, you still need to go.