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Expert Q&A
Why haven't I had a period?
Asked by Heather, Rohnert Park, California
I haven't had my period since this past May. I've taken home pregnancy tests and had blood tests just to make sure. What's wrong with me?
Living Well Expert
Dr. Jennifer Shu
Pediatrician,
Children's Medical Group
Expert answer
When a woman has normal periods for a while but then stops having them for at least three to six months, this is called "secondary amenorrhea." About 5 percent of women of childbearing age in the United States have these prolonged missed periods. Amenorrhea is a symptom that has an underlying cause. The most common causes are pregnancy (as you have suspected), breastfeeding and menopause.
Other reasons for stopped periods include a recent change in weight (either weight loss or gain), stress (such as emotional stress or physical stress from illness or very strenuous exercise), medication side effects and hormone problems. For example, stopping birth control pills may make you miss your periods for several months. Also, hormonal imbalances such as abnormal thyroid or adrenal gland levels can cause amenorrhea. Finally, cysts or tumors on parts of the body involved with menstruation -- such as the hypothalamus and pituitary gland in the brain, or the ovaries -- may be the cause.
Talk with your doctor about your lifestyle (such as eating and exercise habits), medications and any other symptoms you may have. Along with the urine and blood tests that you've had to check for pregnancy, your doctor may want to check hormone levels related to menstruation (such as LH, or luteinizing hormone, and FSH, or follicle-stimulating hormone) as well as thyroid and adrenal gland hormone levels. She may evaluate your reproductive organs during a pelvic exam or use a special scope to check your uterus. She may also recommend imaging studies such as an ultrasound of the pelvis or a brain scan to look for anything that could be causing the amenorrhea.
Your treatment will depend on what your tests show. If no obvious cause can be found, your doctor may suggest trying certain medicines to see whether your periods will start again.
Good luck, and thank you for your question!
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