Manhattan Women's Health and Wellness

There can be both normal and abnormal causes of not having your period (amenorrhea)

Treatment options available from your Midtown gynecologist normally range from avoiding certain foods, to managing stress, and in rare cases to surgery. To find out more about your specific treatment options, come to Midtown gynecology in New York for an office visit so Dr. Mariz can determine an accurate diagnosis. Once he knows the cause of your amenorrhea, he can discuss your options for treating it. Our OBGYN clinic provides 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, for women of all ages.


AmenorrheaAmenorrhea is the medical term for missed menstrual periods. Pronounced uh-men-o-REE-uh, the condition refers to young women who should have their periods and don’t, or women who have missed a period when they should have had one.

While amenorrhea can be normal, such as in pregnancy or menopause, it can also be a sign that something in the body isn’t functioning properly. The most common cause of missing your period is pregnancy. Other problems can include imbalanced hormones or structural problems with the reproductive tract. Amenorrhea should always be evaluated with a thorough consultation and examination by a gynecologist 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 have never had a menstrual period. Causes of primary amenorrhea can include:

  • Age
  • 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:

  • Birth control pills are affecting your periods
  • You’re breastfeeding
  • You have an Intrauterine device (IUD) in place
  • 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 gain or 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

Drastic weight change can trigger abnormalities in your menstrual cycle

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. Amenorrhea should always be evaluated with a thorough consultation and examination by a gynecologist for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.

If you have missed or are missing menstrual periods, you should see your NYC OBGYN immediately and take note of other things you may be experiencing 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
  • A list of medications you are taking

Diagnosing Amenorrhea

Sometimes, finding the cause of amenorrhea can be challenging for you and your Midtown gynecologist. 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 NYC gynecology specialist about any other recent changes you’ve made in your life.

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 Amenorrhea

Testing for amenorrheaAmenorrhea isn’t always a problem or “condition” that needs to be fixed. Amenorrhea due to pregnancy or menopause is usually normal and can just signify a different stage in your life. With that said, the cause of Amenorrhea should always be known, thus an evaluation by an experienced gynecologist, such as Dr. Mariz in Midtown Manhattan, is vitally important for an accurate diagnosis and appropriate treatment plan.

In addition to relying on your self-reporting lifestyle changes and menstrual calendar and 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
  • Hysteroscopy and/or endometrial biopsy, to see and diagnose problems with the lining of the uterus, the part that you should see as blood when you menstruate

When Treatment Is Required

After diagnosing the cause of the amenorrhea, treatment options will be discussed, some ranging from dietary modifications, managing stress, medications, and in rare cases, surgery. To find out more about your specific treatment options, come to our Midtown gynecology office in New York for an appointment with Dr. Fernando Mariz so he can determine an accurate diagnosis and with you help, can discuss a treatment plan that works for you.

Typical treatments for secondary amenorrhea include lifestyle changes for which you may need additional help from a counselor, nutritionist or physical therapist. Common amenorrhea  treatments may also 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’re underweight
  • Taking hormone supplements such as estrogen replacement therapy
  • Trying different birth control options
  • Surgery to remove things that may be stopping your uterus from menstruating regularly. Surgery may be recommended if you have scarring in your uterus or cervix from a c-section or recent infection.

Important Reminder: This information is only intended to provide Gynecology guidance pertaining to amenorrhea, not a definitive medical advice. Please consult amenorrhea specialist or best OBGYN NYC  doctor about your specific condition. Only a trained, experienced gynecologist can determine an accurate amenorrhea diagnosis and proper treatment.

Have questions about Amenorrhea? Schedule an appointment with Dr. Mariz by contacting our office in Manhattan today.

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DISCLAIMER: PLEASE READ CAREFULLY The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs you may be having. An accurate diagnosis and treatment plan should only be made by your physician in order to exclude a serious condition.