Amenorrhoea is the absence of menstrual periods. Apart from during childhood, pregnancy, breastfeeding and menopause, the absence of periods may be caused by a problem with the reproductive system. One of the most common causes of amenorrhoea is when the body’s hormones are disrupted.

The body’s ability to make the female sex hormones oestrogen and progesterone can be affected by a range of factors, including certain reproductive disorders, losing or putting on weight, emotional stress or exercising too much.

It may be physiological as before the menarche, after the menopause or in pregnancy, or it may be postoperative if the patient has had a hysterectomy.

Amenorrhoea can be divided into primary and secondary:

  • Primary amenorrhoea is when menses have not occurred by the time of the expected menarche. This may be taken as age 14 years in the absence of secondary sexual characteristics, but it is worth waiting until age 16 years if other features are developing normally.
  • Secondary amenorrhoea is when menstruation has previously occurred but it has stopped for at least six consecutive months.
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