Amenorrhea - primary

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Normal uterine anatomy (cut section)

Primary amenorrhea

Primary amenorrhea; No periods; Absent periods; Absent menses

Treatment depends on the cause of the missing period. Primary amenorrhea caused by birth defects may require medications (hormones), surgery, or both.

If the amenorrhea is caused by a tumor in the brain (pituitary tumor), the tumor is usually treated with a drug called bromocriptine. Surgery to remove the tumor may also be necessary. Radiation therapy is usually only performed when other treatments have not worked.

If the condition is caused by a body-wide (systemic) disease, treatment of the disease may allow menstruation to begin.

Overall the outlook is good, depending on the cause of the amenorrhea. If the amenorrhea is caused by one of the following conditions, there is a good possibility of correcting the amenorrhea through medication, lifestyle change, or surgery:

• Normal delay of onset (up to age 14 or 15)
• Drastic weight reduction (resulting from poverty or fad dieting)
• Hypoglycemia
• Extreme obesity
• Hypogonadotropic hypogonadism
• Chronic illness
• Malnutrition
• Congenital heart disease (cyanotic)
• Hyperthyroidism
• Imperforate hymen
• Adrenogenital syndrome

If the amenorrhea is caused by one of the following conditions, it is unlikely that the amenorrhea can be corrected by any method:

• Congenital abnormalities of the genital system
• Gonadal dysgenesis
• Turner's syndrome (XO)
• Testicular feminization syndrome
• True hermaphroditism
• Cystic fibrosis
• Craniopharyngioma
• Prader-Willi syndrome

If the amenorrhea cannot be corrected, it is sometimes possible to create a pseudomenstruation with medications to help the young woman feel more like her friends or family.

Emotional distress or crisis about being different from friends or family can occur.

Call your health provider if your daughter is older than age 16 and has not yet begun menstruating.

Review Date: 05/10/2006
Reviewed By: Melanie N. Smith, M.D., Ph.D., Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.