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What is primary amenorrhea?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Primary amenorrhea is when a girl 16 or older has not received her first period, also known as beginning menstruation. Girls tend to start menstruation around the same time they enter puberty. In girls, puberty often begins between ages 9 and 18. The average age of menstruation is 12. The absence of a period can be a sign of a more serious condition, or it may be an indication of issues with eating habits or weight loss or gain.

Primary amenorrhea can be diagnosed by a body examination, blood tests, MRI or CT scans, and hormone testing. Your doctor may want to initially do an exam to look for signs that puberty has begun, as well as an exam of the pelvic area to look for reproductive anomalies. He or she will want to know about your family history and any drugs you are taking or have taken that might contribute to the problem. Blood tests may also be ordered to rule out pregnancy and check hormone levels.

Your risk for primary amenorrhea can increase if you have certain birth defects, a serious illness, or are drastically over- or underweight. There are certain chromosome issues that you are born with that increase your risk of having primary amenorrhea. This includes Turner's syndrome and Swyer's syndrome. Other physical birth defects increase the likelihood of having primary amenorrhea such as abnormal reproductive and genital formation that cause blockage or impair key parts of the menstruation cycle, making it impossible for your body to have a period.

Primary amenorrhea can be serious, depending on the cause and whether or not it is treatable. If primary amenorrhea is brought on by certain conditions, like Turner's syndrome, genetic disorders and chromosomal abnormalities, a cure will not be available. In instances where a cure is not possible, medications exist that allow a young woman to simulate a monthly period to feel more socially accepted. However, simulation will not allow her to reproduce. Hormone therapy may be used to help develop secondary sex characteristics (breasts, body hair, etc.), and to prevent health problems related to low hormone levels (such as osteoporosis or heart disease).

A young woman who is hoping to be able to conceive children at some point will find that primary amenorrhea makes it impossible to conceive without significant medical intervention. In the situation where the underlying cause of primary amenorrhea is treatable, most young women will be able to recover from having an absent period and appear as if they just had delayed puberty. In most cases, their long-term fertility will not be affected.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.