Published: Sep 10, 2016, edited: Oct 9, 2017 by Dr. Zelmanovich (Gynecologist in NYC), Manhattan Women's Health & Wellness

At Manhattan Women’s Health & Wellness we offer a comprehensive Obstetrics & Gynecology care in NYC for women of all ages. In our OBGYN clinic we provide a full range of gynecologic services, from annual check-ups and routine pap smears to the most complicated gyn procedures and surgeries performed in our office and in the hospital.


AmenorrheaAmenorrhea is the medical term for missed menstrual periods. Pronounced uh-men-o-REE-uh, the condition refers to young girls who haven’t begun menstruating by the time they are 15, as well as to older women who miss three or more menstrual cycles.

The most common way that you’ll miss menstruating regularly is if you’re pregnant. When you have amenorrhea and pregnancy, it isn’t a problem, but it still carries the name. The same is true of women who’ve gone through menopause. So amenorrhea is normal (and desirable) if you’re pregnant or menopausal.  Amenorrhea should always be evaluated with a thorough consultation and examination by a physician  for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

Primary Amenorrhea and Secondary Amenorrhea

Amenorrhea is broken down into two main categories: primary and secondary. You are considered to have primary amenorrhea if you haven’t started menstruating by the time you turn 16 years old. Causes of primary amenorrhea can include:

  • Improperly formed reproductive organs
  • Ovary failure
  • Hormone dysfunction

Secondary amenorrhea covers the rest of the reasons that you may miss periods or completely stop menstruating. In addition to pregnancy and menopause, you might develop secondary amenorrhea because:

  • Certain birth control pills are affecting your periods
  • You’re breastfeeding and haven’t yet started menstruating again, which is called lactational amenorrhea
  • You stop taking birth control pills and your body is adjusting, also referred to as post pill amenorrhea
  • You’ve had your ovaries or uterus removed

Because menstruation is so closely tied to hormone production, a number of lifestyle habits, diet and other physical changes can disrupt your menstrual cycle. Other issues that could cause amenorrhea include:

  • Stress
  • Too much exercising, called exercise induced amenorrhea
  • Poor nutrition
  • Extreme weight loss
  • Depression
  • Ongoing medical issues
  • Prescribed and illegal drugs
  • Obesity
  • Tumors on your uterus
  • Thyroid gland problems, a rare condition also called hypothalamic amenorrhea

Absence of Menstruation

The main symptom that you’ll have to indicate that you may have amenorrhea is the absence of menstruation. In other words, you’re not getting your monthly period. Sometimes, after you begin menstruating in your teens, you may miss a month here and there or even go two months without seeing any significant bleeding. Any of the symptoms listed above could be the cause of a temporary disruption of your menstruation.  Amenorrhea should always be evaluated with a thorough consultation and examination by a physician  for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

You should see your NYC OBGYN immediately, however, if you experience other symptoms in addition to the absence of menstruation such as:

  • Possible pregnancy
  • Pelvic pain
  • Excessive hair growth on your face
  • Hair loss
  • Headaches
  • Nipple discharge that looks milky
  • Acne
  • Changes in your vision
  • Trouble with your balance

Diagnosing Amenorrhea

Sometimes, finding the cause of amenorrhea can be challenging for you and your doctor. You may be asked to assist in making a diagnosis by keeping a careful journal of your periods, how long they last and how heavy the blood flow is. Additionally, always tell your doctor about any other changes you’ve made in your life.

You’ll also need to find out if there’s a history of amenorrhea among women in your family. You’re at a higher risk of developing the menstrual cycle condition if there is. Other factors that put you at a higher risk include:

  • Eating disorders, such as bulimia or anorexia
  • Alcoholism or substance abuse
  • Extreme physical training programs

Complications Can Occur

Some women may enjoy the prospect of not having to deal with the monthly cycles, such as those with amenorrhea and pregnancy. It’s also considered one of the perks of getting old enough to go through menopause. But losing your menstrual cycle abnormally can signal other, more severe complications that you may otherwise never have known about, including:

  • Infertility
  • Osteoporosis
  • Low estrogen levels
  • Tumors
  • Malnutrition
  • Delayed sexual development

Testing for Ameorrhea

Obviously, amenorrhea isn’t always a problem or “condition” that needs to be fixed. On the contrary, amenorrhea due to pregnancy and menopause are reasons for celebration. They reflect turning points in your life. These changes will affect so many more areas of your life in addition to the monthly duties that come with menstruation.  Amenorrhea should be evaluated with a thorough consultation and examination by a physician  for an accurate diagnosis and treatment plan.

Amenorrhea, in itself, is not a disease, but a symptom of an underlying problem that caused the lack of menstruation. In addition to relying on your self-reporting lifestyle changes and menstrual activity, you may have to undergo tests to find the root of your disorder. These can include:

  • Pregnancy test — certainly the first test when trying to figure it out
  • Male hormone test to see if your body is producing abnormal amount of testosterone
  • Thyroid function test to ensure proper functioning of the gland
  • Pituitary gland check with a prolactin test that looks for tumors
  • Ovary function tests to see if they are working properly
  • Hormone challenge test, where you take various hormones for several days to see if they cause you to start menstruating, thereby discovering the missing link
  • Imaging tests such as an MRI, ultrasound or CT scan to help determine whether you have abnormal growths or deformities in your reproductive organs

When Treatment Is Required

Once the origin of your amenorrhea is discovered, you can move on to treatments. Typical treatments for secondary amenorrhea include lifestyle changes for which you may need additional help from a counselor, nutritionist or physical therapist.Common treatments may include:

  • Learning new ways to manage stress, such as meditation or yoga
  • Changing the ways and levels that you exercise
  • Losing weight if you’re obese
  • Gaining weight if you’ve suffered from an eating disorder that’s being treated appropriately
  • Taking hormone supplements such as estrogen replacement therapy
  • Trying different birth control pills or ovulation-triggering medication, such as clomiphene citrate
  • Shrinking pituitary tumors with medication
  • Surgery, which is rare

Though surgical interventions are rare, they might be recommended if a pituitary tumor doesn’t respond to medications. The pressure that it puts on your gland not only causes amenorrhea, but also increases the pressure on nearby blood vessels and on your optic nerves, which can lead to blindness.  Surgery also may be recommended if you have scarring on your uterus following a C-section or a D&C.

Important Reminder: This information is only intended to provide Gynecology guidance, not a definitive medical advice. Please consult best obgyn nyc doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.

Do you have questions about Amenorrhea? Would like to schedule an appointment with the leading OB Gynecologist in Midtown NYC, Dr. Anat Zelmanovich, please contact our obgyn nyc office.

Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
51 East 25th Street, Ste 403
New York, NY 10010
(Between Madison Ave & Park Ave)
(212) 533-4575
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
983 Park Ave, Ste 1D
New York, NY 10028
(Between 83th & 84th Street)
(212) 533-4575
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class gynecologist regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or our Gynecology NYC office today and schedule a consultation with a top Midtown OBGYN gynecologist.