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Reasons for an absent or late period may include stress, hormonal imbalances, emotional distress, and more. For some, an absent period isn’t a regular occurrence or typically much cause for concern. But for others, periods can be absent for months, or even years. This is known as amenorrhea.

What is amenorrhea?

Referred to as the absence of menstruation, amenorrhea is the medical term for missing at least three menstrual periods.

Amenorrhea symptoms 

Depending on the cause of amenorrhea, you might also experience these symptoms:

  • Hair loss
  • Headache
  • Vision changes
  • Excess facial hair
  • Pelvic pain
  • Acne

Primary amenorrhea

There are two types of amenorrhea. The first is primary amenorrhoea, which is when you haven’t started your period by the age of 15. Fluctuating hormone levels are a common cause of primary amenorrhea but it could also be due to anatomical problems. 

Secondary amenorrhea 

Secondary amenorrhea is defined by the absence of three or more consecutive periods if you usually have regular periods or alternatively, no periods for a year if you have irregular periods. 

During the course of your life, you may experience amenorrhea for perfectly natural reasons, such as being pregnant and breastfeeding.

What causes amenorrhea?

Besides pregnancy and breastfeeding, common causes of multiple missed periods are:


Birth control pills may affect your period cycles. Even after you stop taking birth control pills, it may take some time before your cycle returns to normal. Contraceptives that are injected or implanted and some types of intrauterine devices may also cause amenorrhea.

Low body weight

Extremely low body weight (about 10% below normal) may interrupt many hormonal functions like ovulation in the body. Those who have an eating disorder such as anorexia or bulimia often have amenorrhea due to the hormone changes. The opposite is also true: obesity may be a precursor to amenorrhea as well.

Excessive exercise

Athletes who participate in activities that require strenuous training may find their menstrual cycles disrupted as well. This is due to low body fat, stress, and high energy output. The AFPA estimates that up to 45% of female athletes experience menstrual irregularity. 


Stress can affect your hypothalamus function, which is what controls the hormones that regulate your menstrual cycle.

Hormonal imbalances

Many types of medical problems can cause hormonal imbalances:

  • Polycystic ovary syndrome (PCOS): Causes high, sustained levels of hormones
  • Thyroid malfunction: An overactive thyroid gland or underactive thyroid gland can cause amenorrhea and other menstrual irregularities
  • Pituitary tumor: A noncancerous tumor in the pituitary gland can interfere with the hormonal regulation of menstruation
  • Premature menopause: Menopause usually begins around age 50 but for some, it can happen before 40, stopping menstruation
  • Issues with reproductive organs: Problems such as uterine scarring or lack of reproductive organs also can cause amenorrhea. 

How to treat amenorrhea?

Consult your doctor if 

  • You've missed at least three consecutive periods 
  • You're older than 15 and have never had a menstrual period

It will vary for every person but in some cases, your doctor may suggest waiting to see if your periods return on their own. In other cases, they may recommend treatment.

Treatment for amenorrhea largely depends on the cause and can include:

  • Lifestyle changes if your amenorrhea is brought on by changes to weight, eating habits, or exercise
  • Birth control pills or hormone therapy
  • Medication to treat thyroid or pituitary disorders
  • In severe cases, surgery may be needed if a tumor or structural blockage is the issue