Amenorrhea is defined as the absence of menstrual bleeding. It is not a pathology in itself, but a symptom of an underlying problem and medical checks will be required to determine the cause. Occasional absence of bleeding is not considered as a problem, although further medical checks are necessary if frequently repeated.

Depending upon the onset, amenorrhea falls into a primary or secondary category:

  • Primary amenorrhea: The absence of menstruation between the ages of 14 and 16. While rare, this could be the result of genetic abnormalities which affect genital development or an endocrinological disorder.
  • Secondary amenorrhea: Defined in the context of a woman who has not had regular periods for six months or three consecutive menstrual cycles having previously had regular periods.


Causes of amenorrhea

The most common cause for missed periods is pregnancy, so the first test performed should always be a pregnancy test.

Other possible causes are:

  • Stress
  • Breastfeeding
  • Excessive weight loss
  • Obesity
  • Physical exercise
  • Polycystic ovary syndrome
  • Ovarian failure or early menopause
  • Using single progesterone contraceptives
  • An increase in prolactin (pituitary tumors, taking medication as antipsychotics or antidepressants).
  • Long-standing chronic diseases (diabetes mellitus, heart disease, inflammatory bowel disease)
  • Endocrine disorders (thyroid pathology or cushing syndrome)
  • Treatments involving chemotherapy or radiation therapy


Can I still get pregnant if I have amenorrhea?

Determining the cause of missing periods is first required in order to better understand the issue at hand and therefore requires physical and gynaecological examinations, an ultrasound test and an inspection of hormones in the blood stream (B-HCG, FSH, LH, estradiol, TSH, prolactin, etc.). A comprehensive medical history will also be necessary in order to better diagnose any existing issues.

Subject to results, studies such as magnetic resonance, karyotype, x-fragile, etc. can be requested.


Can I get pregnant if I have secondary amenorrhea?

Secondary amenorrhea is common when ovulation has not occurred. Pregnancy is not possible at such time, while a missed period should not be considered as infertility.

It is important to consult your family doctor or gynaecologist to clinically diagnose and then treat any disorder.

Particular cases of polycystic ovary or ovarian failure can cause secondary amenorrhea and require a reproductive specialist.

Some causes of secondary amenorrhea such as particular cases of polycystic ovary or ovarian failure will require a reproductive specialist in order to fall pregnant using treatments like artificial insemination, in vitro fertilisation or oocyte donation.


We hope this blog post has helped resolve questions regarding amenorrhea, while should you have any questions for our team of fertility specialists, please don’t hesitate to request a free medical visit.

A hug from the whole team

Instituto de Fertilidad Mallorca

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