Amenorrhoea is the medical term for the absence of menstrual periods. It is described as primary if periods have never started, and second ary when normal menstruation is interrupted for four months or more.

Amenorrhoea does not necessarily mean you are ill but it does usually mean that you are not producing eggs and so cannot conceive.

What Causes Amenorrhoea?

Primary amenorrhoea is usually due to late onset of puberty, although it can also be caused by a disorder of the reproductive or hormonal system. The most common reason for secondary amenorrhoea is pregnancy. If the hormonal balance is interrupted for any other reason, however, periods may stop. So, for example, many women who breast-feed find that their periods do not start again until they wean their babies.

More seriously, amenorrhoea can be a side effect of being grossly underweight, such as with anorexia nervosa. This will be suspected if your weight is as much as 12kg (261b) below average for your height and frame. Stress, chronic ailments such as thyroid disease, and long-term medication with drugs such as antidepressants can also cause amenorrhoea, as can excessive physical training if it reduces body mass index (weight in kilograms divided
by height it-t metres) to less than 20. Amenorrhoea is, of course, a permanent condition after the menopause, or if you undergo a hysterectomy.

What Are The Symptoms of Amenorrhoea?

■ Primary amenorrhoea – a failure to start menstruation and pubertal development; no development of sexual characteristics such as body hair, breasts and pelvic broadening.
■ Secondary amenorrhoea – periods stop suddenly or gradually cease with each successive month until the flow dries up.

Should I See The Doctor?

The tendency to start menstruation late may be inherited, so if your mother started her periods late, don’t worry if you aren’t developing at the same rate as your friends. However, if you are 16 and have not yet menstruated, contact your doctor to check that there is no abnormality.

If your periods suddenly stop and you are sexually active pregnancy could be the cause, so do a pregnancy test first before contacting him. See your doctor if your periods have been absent for six months and you are not pregnant or menopausal.

What Will The Doctor Do?

■ If you have never had a period, your doctor will probably give you a physical examination and take a blood sample to measure the level of pituitary hormones. (The pituitary hormones include those responsible for menstruation.)
■ With secondary’ amenorrhoea, once pregnancy is excluded, you should receive a full medical examination by a specialist, and if you are taking any long-term medications, these should be checked and stopped if necessary.
■ Your doctor may arrange for you to have an X-ray or MRI scan to make sure that your pituitary gland is of normal appearance.
■ If you are not ovulating and wish to conceive, he may suggest that you take a course of fertility drugs or pituitary hormones.

What Can I Do For Amenorrhoea?

■ The lack of periods is not dangerous and in most cases there is no cause for alarm; be patient and they will start up naturally.
■ You may need to change your lifestyle to Correct any dietary or physical problem, if either is thought to be cause.

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