Menstruation Stopping (or Never Starting at Puberty)

Women who have had normal periods that stop for 6 months or more are said to have amenorrhea, or the absence of menstruation. This is called secondary amenorrhea. Girls who have not begun to menstruate by the age of 16 have primary amenorrhea.

The definition of secondary amenorrhea clearly excludes minor lateness of a period and it's important to remember that 5- or 6-week cycles are normal for some women. Stress -- including worrying about whether you will get your period or whether you are pregnant -- can cause your period to be 1 or 2 weeks late. Severe physical or emotional stress or mental health problems can cause periods to stop for a longer time.

Full-blown amenorrhea is most commonly due to problems with the hormones that regulate menstruation. The glands that produce the hormones that affect menstruation include the pituitary gland at the base of the brain, the adrenal glands on top of the kidneys, the thyroid gland in the neck, and the ovaries.

It can take 6 months to a year for normal periods to resume after a woman stops taking birth control pills. This is because the pill blocks certain hormones involved in menstruation and it can take that long for those hormones to return to normal. Menstruation also stops during pregnancy.

In some women, menstruation stops or never starts because their ovaries do not respond properly to the hormones that normally trigger release of an egg. These women cannot ovulate on their own and menstruation is not possible without ovulation. Some women do not produce enough estrogen to ovulate. Other causes of amenorrhea are ovarian cysts and obstructions or other problems in the reproductive tract.

A variety of other factors can cause menstruation to stop, including:

• Vigorous exercise (sometimes not the only cause -- periods should return as the training schedule is reduced)

·                     Obesity

• Poor nutrition (including anorexia and bulimia)
• Diabetes
• Chronic, nonalcoholic liver disease
• Any chronic illness
• Tuberculosis
• Medications such as birth control pills, narcotics, major tranquilizers, and cancer chemotherapy drugs

In rare cases of primary amenorrhea, there is no opening in the hymen through which blood can flow. About one-third of girls with primary amenorrhea have a genetic disorder or a congenital problem with their reproductive tract.