Thyroid

Missing periods lately? Learn more about common causes

Medically reviewed by Neka Miller, PhD on November 25, 2019. Written by Karen Eisenbraun. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Common causes
Related health conditions
Common questions
Related content

Amenorrhea is a condition in which a woman of childbearing age doesn’t get her menstrual period, even though she’s not pregnant. Amenorrhea is not the same as having irregular periods. If you have amenorrhea, you don’t get your period at all. Amenorrhea is not considered a disease in itself, but it may be a symptom associated with a medical condition that can be treated.

There are two types of amenorrhea: primary amenorrhea and secondary amenorrhea [1]. Primary amenorrhea occurs when a woman has not had her first menstrual period by the age of 15 [2]. Secondary amenorrhea, the most common kind of amenorrhea, occurs when a woman who was having normal menstrual periods doesn’t get her period for at least 3 months (this includes hypothalamic amenorrhea).

Amenorrhea causes can be linked to a serious medical condition, so if you aren’t having regular menstrual periods, it’s important to speak to a healthcare provider and determine appropriate amenorrhea treatment.

Here are 4 Everlywell at-home tests related to amenorrhea that may be a helpful place to start.

Perimenopause Test: Wondering if those symptoms and menstrual changes indicate that menopause may be near? Our perimenopause test will let you know if you are transitioning towards menopause.

Thyroid Test: Easily measure your levels for the 3 main thyroid hormones (TSH, T3, and T4) plus thyroid antibodies with this comprehensive test—all from the comfort of your own home.

Women's Fertility Test: Several hormones play a role in a woman’s ability to have normal menstrual cycles and ovulation. Learn if your hormones are balanced to support normal ovarian function needed for pregnancy.

Women's Health Test: This is our most comprehensive hormone panel for women at all stages of life. Our Women's Health test will let you see if different hormones are balanced in your body or if imbalances may be causing symptoms that are keeping you from feeling your best.

Common causes

Primary amenorrhea may be caused by ovarian failure, problems with glands that produce reproductive hormones, or problems with reproductive organs.

There are many potential causes of secondary amenorrhea, including perimenopause, thyroid disorders, polycystic ovary syndrome, chronic stress, and other health conditions.

Perimenopause

Perimenopause is the time period leading up to menopause. It’s marked by a gradual decline in estrogen production. Most women reach perimenopause in their 40s, but some may begin to experience symptoms in their 30s.

Perimenopause lasts until menopause, which is when the ovaries stop releasing eggs. Perimenopause usually lasts for around 4 years, but some women may have symptoms for as long as 10 years.

Symptoms of perimenopause may include:

Hot flashes and night sweats
More severe PMS symptoms
Reduced sex drive
Fatigue
Irregular periods
Mood swings
Difficulty sleeping
Weight gain
Headaches or migraines

Our Perimenopause Test will let you know if you may be transitioning towards menopause. It measures levels of hormones such as estradiol, luteinizing hormone, and follicle-stimulating hormone to determine whether your levels fall within established normal ranges. This test is recommended for women who are starting to notice changes in how they feel as they age.

Understanding your hormone levels and how they affect your overall well-being can help you take control of your health. Equipped with this knowledge, you can work with your healthcare provider to develop a plan for addressing symptoms related to perimenopause.

Thyroid conditions

Amenorrhea may also be related to issues with the thyroid gland. The thyroid is a gland that sits on the front of the neck. It produces several hormones, including hormones that play a role in menstruation.

An overactive or underactive thyroid can lead to menstrual irregularities, including secondary amenorrhea. Both hyperthyroidism (too much thyroid activity) and hypothyroidism (too little thyroid activity) are causes for concern.

Anybody can experience thyroid issues, but some people are more susceptible than others. Women are up to 10 times more likely than men to have a thyroid disorder. One in 8 women will experience thyroid problems in her lifetime [3]. People with a family history of thyroid disease, adults over the age of 50, individuals with type 1 diabetes, people who smoke, and women who have been pregnant within the past 6 months are also at a higher risk of developing thyroid issues.

Other symptoms of thyroid issues include:

Fatigue or sluggishness
Weight gain
Depression
Cold sensitivity
Mental fogginess
Rapid heartbeat
Nervousness
Difficulty sleeping

Our Thyroid Test measures levels for the 3 main thyroid hormones and can help you determine if your symptoms are related to a thyroid imbalance.

Polycystic ovary syndrome

Polycystic ovary syndrome, or PCOS, is a hormonal condition that can cause irregular periods or amenorrhea.

Women with PCOS may have low levels of follicle stimulating hormone, which can lead to premature ovarian failure. Follicle stimulating hormone (FSH) helps control the development and release of eggs in the ovary. Low levels can lead to poor egg development and inability to ovulate. An inability to ovulate may also lead to low levels of progesterone, which can lead to the absence of menstrual periods.

Other symptoms of PCOS include:

Acne
Excessive hair growth
Mood changes
Weight gain
Darkened skin on the neck or in armpits

Our Women’s Health Test measures 10 key hormones that influence a woman’s overall well-being, including several hormones that help regulate menstruation, such as follicle stimulating hormone and progesterone. This test can help you determine if different hormones in your body are imbalanced and contributing to symptoms that are keeping you from feeling your best.

Birth control pills

Some women who take birth control pills may not have menstrual periods. Contraceptives that are injected or implanted can also cause amenorrhea. Even after stopping the use of contraceptives, it may take some time for a woman’s menstrual cycle to return to normal.

Functional hypothalamic amenorrhea

Functional hypothalamic amenorrhea, or FHA, is one of the most common types of secondary amenorrhea [4]. FHA can be related to extreme weight loss, stress, or extreme exercise.

FHA occurs when the hypothalamus, a gland in the brain, stops or slows the release of gonadotropin-releasing hormone (GnRH), which helps regulate the menstrual cycle.

FHA often occurs in women who engage in sports associated with a lower body weight, such as gymnastics, ballet, and long-distance running. This is often sometimes referred to as athletic amenorrhea.

Chronic stress

Stress, both emotional and physical, can also influence the menstrual cycle. Stress can alter the function of the hypothalamus. Regular menstrual periods usually resume after the stress is removed.

In addition to PCOS, amenorrhea may also be associated with health conditions such as:

Disorders related to the pituitary gland, such as Cushing's syndrome
Eating disorders, such as anorexia and bulimia
Ovarian issues, such as premature ovarian failure
Turner syndrome, a genetic disorder characterized by underdeveloped ovaries
Fragile X premutation, a genetic condition causing mild to severe intellectual disability
Galactosemia, a rare genetic condition that affects how the body processes a simple sugar called galactose

Common questions

Can you still get pregnant with amenorrhea?

Even if you don’t have menstrual periods, you could still get pregnant. Because there are so many causes of secondary amenorrhea, there are situations in which amenorrhea can occur and you can still get pregnant. For instance, some women who are breastfeeding may not get their period, but are still ovulating. If you don’t wish to become pregnant, use a reliable form of birth control.

Is amenorrhea a sign of infertility?

Amenorrhea does not necessarily mean you are infertile. The menstrual cycle can be influenced by many lifestyle factors as well as hormone levels. Addressing these lifestyle factors can sometimes cause regular menstrual periods to return. Even when the amenorrhea is caused by hormonal issues, these can often be treated with medication. However, some cases of amenorrhea may be an indication of a disease that can contribute to infertility, so it’s important to work with your healthcare provider to determine the exact cause.