Amenorrhea (Absence of Periods) in Children and Adolescents
Amenorrhea, or absence of periods, in children can be caused by complex underlying hormonal issues, requiring specialist diagnosis, treatment and care.
What is amenorrhea?
Amenorrhea is the medical term for the absence of menstrual periods. Amenorrhea can be a sign of complex underlying hormonal issues, and it may take time to fully understand the cause and the best treatment. There are two types of amenorrhea - primary and secondary.
Primary Amenorrhea
Primary amenorrhea is when a girl has not started having periods by 15 years old, or within 3 years of breast development.
Secondary Amenorrhea
Secondary amenorrhea is when someone who has previously had regular periods stops menstruating for 3 or more consecutive months. At Welbeck, our consultants currently diagnose and treat amenorrhea in children and young people aged 12 to 18.
More information
Amenorrhea can be caused by a range of underlying issues.
Causes of primary amenorrhea include genetic, hormonal, or anatomical abnormalities.
Secondary amenorrhea can be caused by a variety of factors, including:
pregnancy
stress
significant weight loss or gain
excessive exercise
hormonal imbalances (like polycystic ovary syndrome (PCOS) or thyroid disorders)
certain medications
The main symptom of primary amenorrhea is no menstrual period by the age of 15 or 3 years after breast development. The main symptom of secondary amenorrhea is missing 3 or more periods in a row. Other symptoms vary depending on the underlying cause.
Additional symptoms of amenorrhea may include:
hair loss or excessive facial hair growth
acne or oily skin
milky nipple discharge
hot flashes or night sweats
weight gain or difficulty losing weight
thinning hair
pelvic pain
vaginal dryness
headaches
unstable mood and anxiety
Our team will talk to you and your child to understand their specific symptoms and medical history, and may need to perform a physical exam to check development. A range of additional diagnostic tests and scans may be carried out to help with diagnosis and to identify underlying issues.
Additional tests may include:
blood tests
pregnancy test
genetic testing
hormone challenge tests (a patient takes hormones for several days to see if periods can be triggered)
Imaging and scans may include:
abdominal and pelvic ultrasound scan
CT or MRI scans
bone DEXA scan
The treatment for amenorrhea depends on the underlying cause of the condition. Our specialists will recommend the best treatment for your child based on their diagnosis.
Treatments for amenorrhea include:
lifestyle changes such as weight management, reducing stress, and moderating exercise
hormonal therapy
medication
surgery if amenorrhea is due to structural issues such as uterine scarring, ovarian cysts or pituitary tumours
At Welbeck, London’s leading paediatric gynaecologists use the latest innovations in healthcare to accurately diagnose and treat a wide range of conditions in our world-class outpatient centre. Your child will receive the best possible care in a welcoming and supportive environment where you both feel listened to.
With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure your child receives the best possible treatment as quickly as possible, all under one roof.
Appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments. If preferred, initial and follow-up appointments can sometimes be done remotely via video call.
Your child’s health is of utmost importance to us, so we strive to offer same-day and next-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance for your child, their treatment at Welbeck can begin once your provider has confirmed authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
Get in touch today to book an appointment.
We are able to offer appointments to referred paediatric patients aged 12-18. For full information on our paediatrics service, please visit our main Paediatrics page.
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Frequently asked questions
This will depend on the underlying cause of the amenorrhea, but most often, once the underlying cause is diagnosed and treated, menstruation will begin or resume within a few months and should not affect future fertility.
If your child has not had a period by the age of 15 or within 3 years of breast development, or they started having periods but have not had one for 3 or more consecutive months, then it’s important to seek medical advice.
Surgery for amenorrhea is rare and only needed in cases where there is a structural problem, such as anatomical abnormalities of the uterus or vaginaa pituitary tumour.