Aminorrhea: Absence of Menstrual Flow

Aminorrhea (from a- + men + rrhea) denotes the abnormal cessation or absence of menstrual bleeding in a woman of reproductive age who previously menstruated.

Distinction

• Primary amenorrhea: No menarche by age 15.
• Secondary amenorrhea (aminorrhea): Cessation for ≥3 months after established menses.

Causes

Hormonal imbalance (PCOS, thyroid), stress, weight change, exercise, medications, pituitary/tumor, premature ovarian insufficiency.

Management

Evaluate with history, exam, labs (FSH, LH, TSH, prolactin, estradiol), imaging; treat underlying cause.