Diet & Fitness

Amenorrhea is the absence of menstrual cycles.

Amenorrhea is called primary when a woman has not started to menstruate by the age of 16 years, while secondary amenorrhea refers to the abnormal cessation of menstruation in a woman who previously has had menstrual cycles.¹ In amenorrheic women, the levels of female reproductive hormones are not sufficient to stimulate menstruation. This condition is sometimes associated with malnutrition, such as that which occurs in anorexia nervosa, or with extreme exercise, which puts excessive nutritional and other demands on the body.^2,3 An association between stress and amenorrhea has also been demonstrated.⁴ Amenorrhea may also result from potentially serious disorders of the ovaries, the hypothalamus, or the pituitary gland; therefore, a physician should always evaluate chronic absence of menstrual cycles. Prolonged amenorrhea can result in early bone loss and increased risk of osteoporosis.⁵ Amenorrhea occurs naturally in women who are breast-feeding,⁶ but in these circumstances it does not put the bones at risk.⁷