Amenorrhea

During your appointment, your doctor will perform a pelvic exam to check for any problems with your reproductive organs. If you've never had a period, your doctor may examine your breasts and genitals to see if you're experiencing the normal changes of puberty.

Amenorrhea can be a sign of a complex set of hormonal problems. Finding the underlying cause can take time and may require more than one kind of testing.

Tests

A variety of blood tests may be necessary, including:

Pregnancy test. This will probably be the first test your doctor suggests, to rule out or confirm a possible pregnancy.

Thyroid function test. Measuring the amount of thyroid-stimulating hormone (TSH) in your blood can determine if your thyroid is working properly.

Ovary function test. Measuring the amount of follicle-stimulating hormone (FSH) in your blood can determine if your ovaries are working properly.

Prolactin test. Low levels of the hormone prolactin may be a sign of a pituitary gland tumor.

Male hormone test. If you're experiencing increased facial hair and a lowered voice, your doctor may want to check the level of male hormones in your blood.

Hormone challenge test

For this test, you take a hormonal medication for seven to 10 days to trigger menstrual bleeding. Results from this test can tell your doctor whether your periods have stopped due to a lack of estrogen.

Imaging tests

Depending on your signs and symptoms — and the result of any blood tests you've had — your doctor might recommend one or more imaging tests, including:

Ultrasound. This test uses sound waves to produce images of internal organs. If you have never had a period, your doctor may suggest an ultrasound test to check for any abnormalities in your reproductive organs.

Magnetic resonance imaging (MRI). MRI uses radio waves with a strong magnetic field to produce exceptionally detailed images of soft tissues within the body. Your doctor may order an MRI to check for a pituitary tumor.

Scope tests

If other testing reveals no specific cause, your doctor may recommend a hysteroscopy — a test in which a thin, lighted camera is passed through your vagina and cervix to look at the inside of your uterus.

If your period stopped because of menopause or pregnancy, your provider will not need to treat it. In other cases, your treatment will depend on the cause and may include:

Losing weight through dieting and exercise (if excess weight is the cause).

Gaining weight through an individualized diet plan (if extreme weight loss is the cause).

Stress management techniques.

Changing exercise levels.

Hormonal treatment (medication), as prescribed by your healthcare provider.

Surgery (in rare cases).

In addition, your healthcare provider may recommend some treatments to help with the side effects of amenorrhea:

Estrogen therapy to relieve hot flashes and vaginal dryness.

Calcium and vitamin D supplements to keep bones strong.

Strength training.

Amenorrhea may be a symptom of anorexia nervosa, an eating disorder. If you or a loved one has this condition, talk to a healthcare provider immediately so you can get the right treatment.

Will I need surgery for amenorrhea?

Surgery for amenorrhea is rare. Your healthcare provider may recommend it if you have:

Genetic or chromosomal problems.

Pituitary tumor.

Uterine scar tissue.