Understanding Amenorrhea

Amenorrhea is the absence of menstrual periods. More specifically, amenorrhea is the absence of menstruation in a woman who is not pregnant or breastfeeding and who has not reached menopause. Failure to have a period usually results from a deficiency of the female reproductive hormones that stimulate menstruation.

The most common cause of the hormone deficiency leading to missed menstrual periods in young women is inadequate nutrition. Anorexia almost always causes amenorrhea. Many women who are not anorexic but who miss their periods have lower dietary intakes of fat, especially saturated fat, as well as protein and total calories, compared with women who menstruate regularly. Women with amenorrhea also tend to obtain a greater proportion of their calories from high-fiber carbohydrates. In preliminary studies of normal-weight women with no obvious eating disorders, those who reported missed periods had diets described as "close to normal" but significantly low in fat. These women also tended to have low percentages of body fat.

Amenorrhea also can result from excessive exercise. Women athletes and performers tend to diet to avoid weight gain. Combined with the increased nutritional demands of intensive exercise, dieting can lead to nutrient deficiencies and lowered body-fat percentages that lead to amenorrhea and bone loss. Ballet and track and field sports are most frequently associated with missed menstrual periods, with as many as two-thirds of women long-distance runners and ballet dancers experiencing the condition.

In one study of women bodybuilders, 81 percent experienced amenorrhea. Amenorrhea also has been linked to smoking and stress, but smoking cessation and relaxation do not necessarily cure it.

The primary reason for treating amenorrhea is that it can cause bone loss that cannot be remedied by taking calcium and vitamin D.x8 Amenorrhea also can result from potentially life-threatening disorders of the hypothalamus, ovaries, or pituitary gland. For this reason, a physician should always be consulted the first time menstrual periods are missed 2 months or more.

Although women who do not have their periods usually cannot become pregnant, many physicians prescribe oral contraceptives to prevent bone loss. The estrogen in the Pill, however, may increase fat mass and water retention.

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